How heritable is Schizophrenia?

I was reviewing multiple choice questions for an answer bank, and the answer to the rate of schizophrenia among monozygotic twins was given as 50%. I thought this is not that high. So I went had a look a the data. In 2003, Sullivan and Kendler performed a meta analysis. They found. Seven of the … Continue reading How heritable is Schizophrenia?

Why the Victorians drank so much.

The victorias recorded their drinking by the glass and the bottle. But the sizes of these have changed. One glass of wine can now hold ten or more georgian wine glasses. From the BMJ Christmas Issue. We sought to measure the capacity of glasses used for unfortified wine (excluding sparkling wines) with a stem and … Continue reading Why the Victorians drank so much.

The slippery slope of death (Burn Belgium to the ground).

I hate euthanasia. They are now, in Belgium, killing people with depression. Something I have a personal response rate of well over 90% because I do not give up. Where there are guidelines. Where there are new biological treatments coming online to supplement cognitive therapy, medications, and ECT, such as TMS, Ketamine, transcranial electrical stimulation, … Continue reading The slippery slope of death (Burn Belgium to the ground).

Psychosis hunts with diversity?

This is a novel study and it contradicts most clinical knoweledge. There are some problems, which the authors correctly note, but the quickest summary comes from the editorial on the paper which is in prepublication form at JAMA Psychiatry. From my point of view, the main issue is that this paper shows marked variations, which … Continue reading Psychosis hunts with diversity?

Suicide in my email

Correlation A new report projects more than 1.6 million deaths due to drugs, alcohol, and suicide among people living in the United States during next decade (2016 to 2025). That would represent a 60% increase compared to the previous decade (2006 to 2015), which saw 1 million people die from drugs, alcohol, and suicide in … Continue reading Suicide in my email

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