DSM5 in Distress

The DSM's impact on mental health practice and research

Antidepressant Use Skyrockets

A new CDC study based on a large survey of the general population reveals the following alarming results: Read More

Two points about SSRIs

First point: Since the price point for generic SSRIs like Prozac is so low now, it's not a bad price to pay for a placebo.

Second point: It's definitely a placebo for all but severe depression. That's the only arena for which a statistically significant positive effect has been proven. That is only 2.5 million people in the country.

Problem wider than drug companies

Drug companies exist to sell drugs. Obviouly, they are going to look the data and take the view most consistent with widest possible use. It is up to the medical community to train its doctors better. Unfortunately, health insurers want the cheapest possible care, and this is "dumbing down" the mental health fields. Add in the need to cut government budgets, and the fact that mental health helps only a minority of people and thus has less political support and is cut disproportionatyely, and we have a real reveral of fortune for the mentally ill in this country.

I spend my time as a retired professor idioting proofing assessments and training, and given the need, business is very good. If you have any ideas, let us know. At a minimum NIMH budget needs to go to support and train mental health, ie, clinical fields. I fear we waste our time complaining about drug companies; we have more control over medical schools.

Plausible 38.2% of the European population have mental disorder?

THANKS Allen Frances, it is always a joy to read you! What about these estimates from the Sept and Oct issues of Eur Neuropsychopharmacol:

Wittchen et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010.
Eur Neuropsychopharmacol. 2011 Sep;21(9):655-79.
RESULTS: It is estimated that each year 38.2% of the EU population suffers from a mental disorder. METHODS USED: Stepwise multi-method approach, consisting of systematic literature reviews, reanalyses of existing data sets, national surveys and expert consultations. http://www.ncbi.nlm.nih.gov/pubmed/21896369

Gustavsson et al. Cost of disorders of the brain in Europe 2010.
Eur Neuropsychopharmacol. 2011 Oct;21(10):718-779.
RECOMMENDATIONS:--- The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. http://www.ncbi.nlm.nih.gov/pubmed/21924589


Comment from the ground floor

I can't afford a mental health practitioner. Mental health is abysmally covered by my health insurance. The only ones that are affordable are those with sliding scales or part of state programs but the waiting time/red tape to see one is ridiculous. In addition, in some instances, I make enough money to not be eligible. I think there is a segment of population (not quite 'poor' to lower middle class) that is being left out in the cold. My GP (adequately covered by my insurance) on the other hand is just fine with doling out antidepressants. And I'm thankful for that.

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Allen Frances, M.D., was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.


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