February 21, 2017
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Anti-psychiatry is a pseudoscience that downplays or rejects the existence and severity of psychiatric conditions, denies the efficacy of established treatments and demonizes medical doctors. Not all anti-psychiatry activists are committed to all of these three positions, but they are common beliefs within the movement. It is thus very reminiscent of anti-vaccine activists who wrongly think that vaccine-preventable diseases are natural and not very harmful, reject vaccines and demonize pediatricians. In terms of debating tactics, anti-psychiatry activists make use the same standard denialist toolkit: quoting scientists out of context, cherry-picking data, misunderstanding basic science and so on.
A recent paper by Jakobsen and colleagues (2017) claims to have shown that the antidepressant class SSRI has questionably clinical efficacy. It turns out that they base this claim on a piece of highly deceptive statistical trickery: they erect an arbitrary and evidence-free effect size threshold for clinical significance and then reject all treatments that do not fulfill it.
Because the threshold they picked was so large, they would be forced to reject both psychotherapy and a considerable portion of medications used in general medicine as well. The researchers cite National Institute for Health and Care Excellence (NICE) as support for their criteria, but NICE dumped this criteria as flawed around eight years ago. In the end, SSRIs are effective and a useful treatment for depression (but do not work perfectly for everyone) and clinical significance is a spectrum and not a black-and-white issue.
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November 3, 2013
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Out of all the pseudoscience that are criticized on this website — from creationism and the anti-vaccine movement to anti-GM sentiments and alternative medicine — no subject has attracted more malicious attention from denialists trolls than the articles refuting anti-psychiatry. I often respond and end up in never-ending debates where they simply repeat the same arguments over and over again despite having had their errors explain to them in great detail with references to the scientific literature. When they fail their misguided war of attrition, they resort to verbal abuse by calling me fascist, pig, dickhead, Führer etc. and claim that I must consider individuals with mental conditions who receive evidence-based treatment to be “roadkill” (I do not). After a while this comes very tiresome, so those individuals have their comment privileges removed for violating the comment guidelines. However, they do not let this stop them from spouting their nonsense. They simply use proxies, new names and email addresses to continue with their behavior (while keeping the assertions exactly the same). Some even try to impersonate me. I ban the new identities or turn off comments. This makes things calm down for a while, but it starts back up again the next time I publish a post debunking anti-psychiatry.
Recently, a previously banned user now going by the name of Tin attempted to post an anti-psychiatry diatribe on an argument describing some common anti-psychiatry archetypes that scientific skeptics are likely to come across when they take on anti-psychiatry proponents online. Although using a new name and IP, he still used the same email address as he did when he was banned the first time, thereby giving it away and so the comment got caught by the spam filter. Usually I would not bother to write anything about it and just empty the spam queue, but some of the claims he made in that comment was absurdly wrong on so many different levels that it could be useful for other scientific skeptics to have access to a detail refutation of those assertions.
In his comment, Tin confuses a debate about the scientific details with a debate on the validity of the entire field and tosses in appeals to false balance. He also makes a number of other flawed arguments, such as calling Psychology Today an academic journal, when it is really just a magazine and blog website. He also asserts that antidepressants are not better than placebo despite the fact that meta-analyses taking publication bias into account show that they do outperform placebo in a clinically significant way. Tin even fails to understand that ICD-10 also has an ADHD diagnosis and that ADHD is diagnosed outside the U.S. Finally, the five papers that allegedly show that anti-psychiatry is based on evidence either do not support his position, directly contradicts his position or is irrelevant to the discussion. The rest of this article examines those anti-psychiatry claims in additional detail. Read more of this post