It is not the drugs fault?

A frequent commentator, jgarveyrose, asked me if there was an association between psychotropics and homicide. This is a very hard question to answer, because the rates of homicide are low, and mass murder lower. The addition of information to such a low baseline rate, according to Bayes' theorem, means that the increased risk is of … Continue reading It is not the drugs fault?

The faceborg is bad for you

This paper made me go and have a look at my facebook stats. The average person in the cohort study had 300 facebook friends: I have under 70. I cannot access my like statistics: I need to recite number 12 of the 16 points and not care what people think of me. Because facebook is … Continue reading The faceborg is bad for you

Adult ADHD is (probably) something else.

I am not sure if Adult ADHD exits. I have no doubts about childhood ADHD and I am aware of some people who do not "grow out" of ADHD. But most of the people coming to see me with "ADHD" have... something else. It makes me doubt the validity of the concept. A paper by … Continue reading Adult ADHD is (probably) something else.

Personality or Mood?

One of the unwritten truths in psychiatry is that when we talk about personality we mean one. The Borderline. It is not that the others don't exist, it is that they are not the ones that cause us problems. Clinically, it is a challenging diagnosis to make. Do not believe the textbooks that make it … Continue reading Personality or Mood?

Moderate effects are useless

I like negative meta analyses. They say: many have been down this path. It has no fruit. Here be but salt, ash, and stone. Nothing whole liveth here. Do not repeat this: investigate elsewhere. The more difficult meta analyses are those that show a moderate effect. This week's JAMA psychiatry has such an analysis. The … Continue reading Moderate effects are useless

Genetics of depression show sexual dimorphism?

The genetics of depression has been an interestly difficult problem. In this paper, which is long, complex, and well worth reading, post mortem brain samples are used to demonstrate differential genetic expression by region between people with depression and controls, that differ by sex. This is then replicated in mice experimental models, and using a … Continue reading Genetics of depression show sexual dimorphism?

Yes, Virginia, medications may work.

Child Psychiatry is not adult psychiatry: children are not adults: what works for adults may not work for kids, and when kids are involved the problem is often affecting the family, the school or the wider society. So, let us start with the latest press problems: the number of prescriptions in Scotland in going up. … Continue reading Yes, Virginia, medications may work.

Educationalist ruin professional education?

If you make things too onerous, there will be pushback. My boss has the American Board, and every few years he has to go over the States and sit a MOC exam. From their website. Maintenance of Certification program participation includes meeting all four components of the MOC Program. Diplomates are only required to complete … Continue reading Educationalist ruin professional education?

Anxiety is not a risk factor for suicide, PTSD included?

There are many who will look at completed suicide and consider that any mental health disorder caused it. There are others who work from theory and consider that those who are frightened may be at risk, so those with clinical panic symptoms or phobias or overwhelming worry must be at higher risk. There is a … Continue reading Anxiety is not a risk factor for suicide, PTSD included?

Watch this neuroimaging space?

Some of the tools we have coming out of the Magnetic Resonance Suite look attractive, such as high resolution diffusion imaging. On a population basis, you can see the difference between normal, psychotic, depressed and manic networks. The pictures are pretty, and some of them may be useful. Recent work from the international Study to … Continue reading Watch this neuroimaging space?