Posts Tagged ‘Psychosis Risk Syndrome’

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Seriously great article: “New Psychiatry Manual Defines Almost Anyone as Insane”

Monday, June 28th, 2010

Loewak
By Martijn Benders
June 27, 2010

What is wrong with a psychiatric industry that is financed by drug companies? Well isn’t that very obvious: they will try and try to classify more and more mental conditions as ‘diseases’ simply because their financers want them to do so. Nowadays children can’t behave like children anymore or they are ‘hyperactive’ or diagnosed as ‘ADHD’ and pumped full of drugs of which no one knows what the long term consequences of their use are.

At the same time, digg this, there was a recent research into which jobs have the highest suicide rates. Guess what? Yes, doctors and Psychiatrists rank amongst the highest, the most number of suicides take place in that job catagory.

Ask yourself this: why do these rather suicidally depressed people want to drug everyone? Because that’s basically what the new ‘Psychiatric Manual’ named ‘the Diagnostic and Statistical Manual of Mental Disorders (DSM).

“With DSM-V, American psychiatry is headed in exactly the opposite direction: defining ever-widening circles of the population as mentally ill with vague and undifferentiated diagnoses and treating them with powerful drugs,” Professor Shorter of the University of Toronto writes in the Wall Street Journal.

New diseases in the thick manual include the ‘Psychosis Risk Syndrome’ which is a particular type of ‘disease’ that can be streched to encompass half the world population. Twitch your eye? Behave a little weird? Have a stutter? Well, those might be signs of you having PSR which basically means you have the potential to become psychotic and, according to the manual, must be treated with drugs.

Symptoms of “psychosis risk syndrome” include vague descriptors as “disorganized speech.”

“Minor neurocognitive disorder” describes a reduction in cognitive function over time, such as that normally experienced by people over the age of 50, while “temper dysregulation disorder with dysphoria” refers to children who suffer from outbursts of temper.

The psychiatric industry has become a drugdealer culture. All these drugs do not just effect the people that take them but dissapear and mix with the environment. So ALL OF US are effected by these billions of tuns of chemical drugs that are pumped into the various water systems.

Read entire article:  http://www.loewak.nl/2010/06/27/new-psychiatry-manual-defines-almost-anyone-as-insane/

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The Total Failure of Modern Psychiatry

Sunday, June 27th, 2010

Natural News
By David Gutierrez
June 27, 2010

Modern psychiatry went wrong when it embraced the idea that the mind should be treated with drugs, says Edward Shorter of the University of Toronto, writing in the Wall Street Journal.

Shorter studies the history of psychiatry and medicine.

Modern U.S. psychiatry has adopted a philosophy that psychological diseases arise from chemical imbalances and therefore have a very specific cluster of symptoms, he says, in spite of evidence that the difference between many so-called disorders is minimal or nonexistent. These “disorders” are then treated with expensive drugs that are no more effective than a placebo.

“Psychiatry seems to have lost its way in a forest of poorly verified diagnoses and ineffectual medications,” he writes.

Shorter calls for U.S. psychiatry to abandon its emphasis on “psychopathology” and instead adopt the European approach, which focuses on the symptoms and needs of people as individuals. Yet the draft of the latest edition of psychiatric diagnostic “Bible,” the Diagnostic and Statistical Manual of Mental Disorders (DSM), shows that U.S. psychiatry has no intention of changing course.

“With DSM-V, American psychiatry is headed in exactly the opposite direction: defining ever-widening circles of the population as mentally ill with vague and undifferentiated diagnoses and treating them with powerful drugs,” Shorter writes.

U.S. psychiatry was not always obsessed with psychopharmacology, he notes. Its early years were marked by a psychoanalytic approach that categorized mental disorders in broad, fluid categories such as “nerves,” “melancholia” or “manic-depressive illness.” These categories sufficed because similar treatments would work for people suffering from any version thereof: lithium treated both mania and severe depression, for example, while the specific symptoms experienced by an anxious person had little influence on the therapies needed.

“Our psychopathological lingo today offers little improvement on these sturdy terms,” Shorter said. “A patient with the same symptoms today might be told he has ‘social anxiety disorder’ or ‘seasonal affective disorder.’ … The new disorders all respond to the same drugs, so in terms of treatment, the differentiation is meaningless and of benefit mainly to pharmaceutical companies that market drugs for these niches.”

In the 1950s and ’60s, a new wave of psychiatrists sought to turn away from psychoanalysis — perceiving it as focusing excessively on “unconscious psychic conflicts” — and toward a more “scientific” model instead. As a result, the DSM-III introduced the vague new categories of “major depression” and “bipolar disorder,” even though evidence suggests that there is no substantial difference between the two conditions. At the same time, “major depression” absorbed what Shorter calls two very different conditions, “neurotic depression” and “melancholia.”

“This would be like incorporating tuberculosis and mumps into the same diagnosis, simply because they are both infectious diseases,” he writes.

DSM-V only continues the trend of extending the disordered label to more and more normal people, Shorter warns: “To flip through the latest draft of the American Psychiatric Association’s Diagnostic and Statistical Manual, in the works for seven years now, is to see the discipline’s floundering writ large.”

For example, the new disorder of “psychosis risk syndrome” associates a whole new class of people with full-blown schizophrenia, under the logic, Shorter says, that “even if you aren’t floridly psychotic with hallucinations and delusions, eccentric behavior can nonetheless awaken the suspicion that you might someday become psychotic.” The implication, of course, is that such people should be treated with antipsychotics.

Symptoms of “psychosis risk syndrome” include such vague descriptors as “disorganized speech.”

Other new “disorders” include hoarding, mixed anxiety-depression and binge eating. “Minor neurocognitive disorder” describes a reduction in cognitive function over time, such as that normally experienced by people over the age of 50, while “temper dysregulation disorder with dysphoria” refers to children who suffer from outbursts of temper.

“DSM-V accelerates the trend of making variants on the spectrum of everyday behavior into diseases,” Shorter says, “turning grief into depression, apprehension into anxiety, and boyishness into hyperactivity.”

Read entire article:  http://www.naturalnews.com/029088_psychiatry_failure.htmll

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Australian Psychiatrist Patrick McGorry Wants His Pre-Drugging Agenda to Go Global

Wednesday, June 16th, 2010


“Australia is a place that can actually change the world in mental health, provided we get the right government support to do so.” — Patrick McGorry

By CCHR International
June 16, 2010

A Public Service Announcement on Australian TV features Australian of the Year, psychiatrist  Patrick McGorry,  claiming that nearly half the population will experience mental ill-health during their lifetime. Considering that after World War II, psychiatrists claimed that one in 20 people had a mental disorder, and now it’s every second one of us, that’s a damning 1000 percent failure rate for psychiatrists in reducing “mental illness.” Let’s get real; the reason psychiatrists claim more people are mentally ill is because they can keep  inventing new ways to label them mentally ill—but the press and governments are  starting to catch on, evidenced by all the controversy surrounding psychiatry’s upcoming edition of their Diagnostic and Statistical Manual of Mental Disorders (DSM)—better known as psychiatry’s billing bible. Yet of all the proposed “mental disorders” ranging from overeating to kids throwing tantrums, no proposed model of mental disorder is more  insidious and dangerous than that of Patrick McGorry, who promotes diagnosing people before they develop a so-called mental disorder—drugging them before they become “mentally ill.” Yet the Australian government has bought into it hook, line and sinker—despite the fact McGorry’s plan is so outrageous, even his peers, such as psychiatrist Allen Frances, former Chair of the DSM task force, have called it ”the most ill-conceived and potentially harmful.”

Make no mistake, the pre-drugging agenda is Patrick McGorry’s baby—his dream for a new paradigm in mental health, one that has the power to diagnose and drug people before they become mentally ill—welcome to the Brave New World of Patrick McGorry. And he isn’t stopping with Australia; his plan is to go global. As he recently stated, “Australia is a place that can actually change the world in mental health, provided we get the right government support to do so.”[1]

The fact that McGorry’s agenda is so controversial—it even has other psychiatrists protesting it—has not deterred the Australian government from funding this “ill-conceived” plan. A recent letter to Citizens Commission on Human Rights states, “The Australian Government is providing $25.5 million over four years from 2010-2011 to expand Early Psychosis Prevention and Intervention Centre (EPPIC) model,” developed by McGorry who founded EPPIC and the Orygen Youth Health in Victoria, Australia.

The Australian Government has already been criticized for massive expenditure on psychotropic drugs increasing more than 660 percent during the last decade—with a whopping 3,100 percent increase on antipsychotic drugs (with at least 15 Australian deaths in the under 19 year olds as a tragic consequence of this).  This can only get worse when under McGorry’s plan, with an enormous client base that can be prescribed drugs despite the fact they are not yet  “mentally ill.” It’s called prodrome (prodromos meaning the forerunner of an event)—referring to “a period of prepsychotic disturbance” that may or may not develop into psychosis or “schizophrenia”[2]—in other words, the crystal ball theory.

Australia Meets the US in Pre-Drug Scam

McGorry’s plan for Australia to “lead the change” in world mental health is happening—to the detriment of those who may be forced to undergo drug treatment based on a psychiatrist’s hunch that they might, one day, become ill. In the U.S., on May 13, 2009, the Department of Health and Human Services convened a Technical Expert Panel (TEP) discussed “emerging evidence around psychopharmacological interventions for first episode schizophrenia” citing the research efforts of McGorry and others.[3]

The push for pre-diagnosing and pre-drugging has even those within the psychiatric profession calling foul; Dr. Richard Warner, professor of psychiatry at the University of Colorado, counters the idea that science drives McGorry’s pre-disorder assessment, stating, “Given the expected number of false positives, the potential for harm is significant.”[4]

However, as Anthony Pelosi, honorary professor, Department of Psychiatry, Hairmyres Hospital, wrote in a counter to McGorry in the British Medical Journal last year, “this has not stopped their skillful lobbying of politicians, journalists, patients, and carers with upbeat messages about the prevention.”

“Skillful lobbying” is right.

In 2006 McGorry and other researchers, including psychiatrist Michael Berk, Karen Hallam, Craig McNeil, Linda Kaler and psychologist Melissa Hasty reported in the Medical Journal of Australia, “Evidence increasingly indicates that earlier identification may allow for appropriate pharmacological and psychosocial treatments….”[5]

Could they have a Pharma incentive behind this agenda? Berk is financially linked to AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Organon, Novartis, Mayne Pharma, Servier, Sanofi-Synthelabo, Solvay, and Wyeth and Pfizer.[6] Hallam disclosed received speaker fees from Janssen-Cilag; McNeil received consultancy fees, speaker fees and travel assistance from Eli Lilly, Janssen-Cilag and Sanofi-Aventis; and Hasty and Linda received financial assistance to attend conferences from or Janssen-Cilag, maker of the antipsychotic Risperdal (resperidone).[7]

McGorry has received grant support from Eli Lilly, Janssen-Cilag, Bristol Myers Squibb, Astra-Zeneca, Pfizer, and Novartis.[8] He is a paid consultant for, and has received speaker’s fees from all or most of these companies.[9] Studies published in the British Medical Journal in 2005 and 2008 declared McGorry’s “early intervention studies have received partial support in the form of investigator-initiated unrestricted research grants from Janssen-Cilag.”[10]

The U.S. has already begun adopting the “early intervention” fad, which looks more like a trade in children’s lives and a business opportunity for increased pharmaceutical sales. In March 2010, the Department of Health & Human Services Substance Abuse & Mental Health Service Administration Center for Mental Health Services announced $16.5 million in funding for “Mental Health Transformation Grants,” including the “Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP).”[11]

EDIPP is the American sister of McGorry’s EPPIC.  It was originally bankrolled by a $14.4 million grant from the Robert Wood Johnson Foundation. According to investigative journalist Evelyn Pringle, “The founder of RWJF, Robert Wood Johnson, was chairman of Johnson & Johnson for over 30 years, from 1932 to 1963, as a member of the drug maker’s founding family. Throughout the years, the majority of the Foundation’s money has come from investments in J&J stock.”

In an article in Behavioral Healthcare, in 2008, the Mid-Valley Behavioral Care Network (MVBCN), an intergovernmental Medicaid government insurance-managed healthcare organization situated in Oregon, was recommended to study EPPIC used at Orygen and EDIPPP.

Based on EDIPP and EPPIC, the MVBCN developed the Early Assessment and Support Team (EAST) in 2001.  In 2003, the Oregon state legislature allocated $4.3 million to disseminate early psychosis intervention statewide.  By March the following year, new programs had begun in 12 counties.[12]

EDIPPP also replicates the “Portland Identification and Early Referral,” or “PIER,” a treatment research program at the Main Medical Center, in Portland, Maine.[13] People typically are referred to PIER by high school guidance counselors, pediatricians, or other clinicians who attended presentations about PIER’s work, says Pringle. “Virtually every person entering the PIER program is prescribed antipsychotics, such as Risperdal or Invega, marketed by Johnson & Johnson,” she added.

Both PIER and EDIPPP are promoted in McGorry’s 2002 book, Implementing Early Intervention in Psychosis: A Guide to Establishing Early Psychosis Services.”[14] The book’s foreword is written by Dr. Jeffrey Lieberman, Professor of Psychiatry, Chairman Department of Psychiatry, Columbia University College of Physicians and Surgeons.[15] Lieberman has taken consulting fees and research grant support from AstraZeneca, Bristol-Myers Squibb, Upjohn Pharmacia, Novartis, Eli Lilly, Janssen, Pfizer, Hoechst AG, & AstraZeneca. He’s on the Speakers Bureaus for Astra Zeneca, Janssen, Eli Lilly and Pfizer.[16]

Lieberman is also the Vice President (North America) of the McGorry instigated group International Early Psychosis Association (IEPA), which was officially incorporated in Victoria in 1998.[17] McGorry is currently Treasurer of the Association.[18] Lieberman is a member of the psychiatric-pharmaceutical company front groups, National Alliance for the Mentally Ill (NAMI) and National Alliance for Research on Schizophrenia and Depression (NARSAD).

Between 1999 and 2003 IEPA received unrestricted education grants from Janssen-Cilag and AstraZeneca.[19] EIPA’s conferences are supported by Janssen-Cilag, AstraZeneca, Eli Lilly, and Bristol-Myers Squibb.[20]

The IEPA lists the “who’s who” of Pre-Psychosis Risk Syndrome (the official label given pre-psychotic symptoms) and many of its board or members disclose manufacturers of antipsychotics as companies they’ve received financing from.

On July 29-30, the First international Youth Mental Health Conference is being held in Melbourne, with keynote speakers, including McGorry. The conference is described by one advocate as an “important and innovative event, attracting the best in the business/industry to discuss the emerging issues of youth mental health.”[21]

It couldn’t have been more adequately stated: business and industry. Herein you see McGorry’s pitch again that Australia is a global leader in this latest psychiatric fad. His invitation online states, “This is an important event for Australia and the mental health field. We expect this to be the first of many similar conferences, bringing together innovators, practitioners, researchers, young people and families to showcase the best of youth mental health innovation from around the globe.”[22] [Emphasis added]

There’s no doubt that this conference, like his Australian award, will be used to demand more funding to increase the business stakes and drive more income into psychiatry’s pre-drugging efforts.  Despite the government already allocating $103 million to McGorry, including the $25 million to further research EPPIC, he continues to call for another $800 million in funding for programs for youth mental health over the next four years.[23]

McGorry recently stated, “You have to be able to give something of yourself to people, if you are going to help them.”[24] McGorry’s brand of “helping” entails stigmatizing children with psychiatric labels that have no basis in science or medicine and then drugging them. That does not qualify as “help.” It’s betrayal. If this agenda to pre-diagnose, and pre-drug is allowed to take hold, we will truly have entered a Brave New World; Patrick McGorry’s.

[1] http://sydney.edu.au/medicine/museum/mwmuseum/index.php/McGorry,_Patrick

[2] http://www.mentalhealth.com/mag1/scz/sb-prod.html

[3] U.S. Department of Health and Human Services, “ASPE Technical Expert Panel on Earlier Intervention for Serious Mental Illness: Summary of Major Themes,” The Lewin Group, 13 May, 2009.

[4] Richard Warner, MB, DPM, is director of Colorado Recovery in Boulder, Colorado, and professor of psychiatry at the University of Colorado, “Early intervention in psychosis: Future or fad?” Centre for Addiction and Mental Health website, http://www.camh.net/Publications/Cross_Currents/Winter_2007-08/futureorfad_crcuwinter0708.html.

[5] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[6] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[7] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[8] http://www.mhanet.ca/documents/2008/Research-Colloquium/0920%20-%20Keynote%20MCGORRY.pdf

[9] http://www.bmj.com/cgi/content/full/337/aug04_1/a695

[10] http://bjp.rcpsych.org/cgi/content/full/187/48/s108; http://www.bmj.com/cgi/content/full/337/aug04_1/a695

[11] http://www.opednews.com/articles/Tracking-the-American-Epid-by-Evelyn-Pringle-100602-668.html

[12] http://www.behavioral.net/ME2/dirmod.asp?sid=9B6FFC446FF7486981EA3C0C3CCE4943&nm=Archives&type=Publishing&mod=Publications%3A%3AArticle&mid=64D490AC6A7D4FE1AEB453627F1A4A32&id=BFCD36BFD75E447CA63F662A633F41FB&tier=4

[13] http://www.opednews.com/articles/Tracking-the-American-Epid-by-Evelyn-Pringle-100602-668.html

[14] http://books.google.com.au/books?id=lyLfMPsnvJ0C&pg=PA136&lpg=PA136&dq=Portland+Identification+and+Early+Referral+McGorry&source=bl&ots=lEp9tdT8ZV&sig=_zlnHeFk8oqxTHSjbvLf0XQmlY4&hl=en&ei=lP0RTKThLMWPcMnSzNAH&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBQQ6AEwAA#v=onepage&q&f=false

[15] http://69.5.18.33/ahrp/cms/index2.php?option=com_content&do_pdf=1&id=345

[16] http://69.5.18.33/ahrp/cms/index2.php?option=com_content&do_pdf=1&id=345

[17] http://www.iepa.org.au/ContentPage.aspx?pageID=10

[18] http://www.headspace.org.au/about/headspace-board/

[19] http://www.iepa.org.au/ContentPage.aspx?pageID=59

[20] http://www.iepa.org.au/ContentPage.aspx?pageID=59

[21] http://www.iymhconference.com.au/why-attend/

[22] http://www.iymhconference.com.au/

[23] Mental Health Update, GetUp! Action for Australia, 21 Apr. 2010, http://www.getup.org.au/blogs/view.php?id=1936&dc=1086,21560,1

[24] http://sydney.edu.au/medicine/museum/mwmuseum/index.php/McGorry,_Patrick

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Meet the Psychiatrist Pushing For A Brave New World of Pre-Drugging Kids—Patrick McGorry

Friday, May 21st, 2010

By CCHR International
May 21, 2010

One of the most controversial proposed disorders for the upcoming revision of psychiatry’s billing bible of mental disorders, (the DSM-5) is Psychosis Risk Syndrome (PRS) a “mental disorder” that, if voted into DSM, would confirm the allegations that psychiatry is manufacturing a Brave New World for itself—heavily backed by Big Pharma—of drugging children before they develop a “mental illness.” Already criticized for the millions of children being needlessly drugged and the lack of scientific criteria to substantiate any mental diagnosis as a legitimate medical condition, some psychiatrists now want the power to pull out their crystal ball and predict the onset of a psychosis and drug it before it has even occurred. And perhaps the strongest proponent is Australian psychiatrist Patrick McGorry.

Even psychiatrist Allen Frances, former chairman of the previous DSM task force expressed alarm over the proposed diagnosis and its repercussions should it be legitimized, stating, PRS “stands out as the most ill-conceived and potentially harmful.” The Syndrome fails badly on all 3 counts, he says:

“1. It would misidentify many teenagers who are not really at risk for psychosis;

2. The treatment they would most often receive (atypical antipsychotic medication) has no proven efficacy; but,

3. It does have definite dangerous complications.”

Frances adds: “Drug company marketing would influence parents and clinicians to be especially alert to any strangeness in teenagers.” False positives could be as high as 70-90 percent.[i] This can only lead to greater numbers of children and adolescents being harmfully drugged—already one of the major criticisms against psychiatry and a point of contention among many psychiatrists today.

Australian psychiatrist Patrick McGorry, speaking at the APA convention in New Orleans, as a cheerleader for “early intervention” (i.e. pre-drugging) is undeterred. Despite the unpredictability and risk of the drugs prescribed to treat PRS, McGorry wants to go full steam ahead, increasing the number of children being placed on extremely dangerous and even lethal drugs. It should come as no surprise that McGorry is a paid consultant for, and has received speaker’s fees from AstraZenecca, Janssen-Cilag, Eli Lilly, Novartis, Sanofi, Bristol Myers Squibb and Pfizer.[ii]

The theory of PRS wasn’t McGorry’s. He credits Dr. Ewen Cameron, the Canadian psychiatrist who became infamous in the 1980s after it was revealed he had performed cruel and brain-damaging experiments on his patients in the 1950s and 1960s with funding from the CIA.[iii] However, McGorry tested it in a world-first trial. Another study he conducted in 2002 was funded with an unrestricted grant from Janssen-Cilag and supported by pharmaceutical company-funded groups NARSAD and the Stanley Foundation, as well as several Australian agencies. McGorry and colleagues predictably found that risperidone (Risperdal)—made by Janssen—reduced the risk of “transition to psychosis” in young people.[iv] Risperdal has been linked to Type 2 diabetes.

  • In Australia, McGorry’s Early Psychosis Prevention and Intervention Center’s (EPPIC) preventive treatment center for young people, PACE, receives drug company funding from Janssen-Cilag. Much of the policy development embodied in the Australian Clinical Guidelines has come out of EPPIC research programs. As Richard Gosden, Ph.D., a highly respected Australian author and academic stated: “This may have paid off handsomely for the company…. It may not be coincidental that a half page of the Clinical Guidelines is dedicated to dosage recommendations for using risperidone in first-episode psychosis. The Clinical Guidelines do not extend these dosage recommendations to include other schizophrenia drugs and the recommendations for risperidone give the appearance of an official endorsement of the drug.” [v]

McGorry’s theory has psychiatry’s skeptics and even psychiatrists aghast:

  • One respected American research group equated the practice of pre-drugging children to “performing mastectomies on women who are at risk of—but do not have—breast cancer.” [vi]
  • Honorary Professor Anthony Pelosi from the Department of Psychiatry, Hairmyres Hospital, East Kilbride, stated, “So far, evidence from randomized trials does not support the use of psychological therapies or drugs as preventive interventions.”[vii] Further, “After teachers, college counselors, and families were encouraged to refer young people with possibly prodromal [early] symptoms directly to the same clinic for the same care plans…almost 90% were receiving unnecessary ‘preventive’ interventions.” [viii]
  • Fellow Australian psychiatrist Niall McLaren says the diagnostic criteria for PRS “has no scientific validity whatsoever…it can never be reliable and…will have huge unforeseen consequences.” Essentially, it means “putting large numbers of teenagers and young adults under the long-term supervision and control of psychiatrists” and that “supervision” includes the “aggressive, indefinite prescription of antipsychotic drugs.” It is the “clearest example I know of pseudoscience.  Not since [lobotomies] has psychiatry stumbled so far from the principle of Primum, non nocere. First, do no harm.” [ix]
  • Dr. Richard Warner, professor of psychiatry at the University of Colorado, counters the idea that science drives McGorry’s pre-disorder assessment, stating that the screening instrument he uses “is not that accurate in routine use.” Further, “McGorry speculates that a variety of interventions may be effective in preventing schizophrenia in high-risk cases…. Given the expected number of false positives, the potential for harm is significant,” stated Dr. Warner. [x]
  • Dr. Jerald Block, a US psychiatrist writing in Bioethics Forum, reported that “preventive pharmacology” (which McGorry, et al. practice) is “ethically questionable territory” because the treatments given “frequently have side effects and complications” and “you are potentially harming people.” The symptoms used to identify them as at risk of schizophrenia are “also remarkably common…adolescence is a period of life that is normally marked by tumultuous changes in personality.” [xi]
  • Melissa Raven, psychiatric epidemiologist and policy analyst, adjunct lecturer in Public Health at Flinders University, South Australia, and David Webb, board member of the World Network of Users and Survivors of Psychiatry and working with the research/policy office with the Australia Federation of Disability Organizations, were published last month, writing: “McGorry’s campaign is part of a wider push to promote the medicalization of mental health (for which psychosocial wellbeing is a better term).” “Further doubts must be raised about McGorry’s agenda when you see the substantial funding his organization (Orygen Youth Health) receives from the pharmaceutical industry and also from the US Stanley Foundation, which is notorious for its particularly aggressive approach to the detention and mandatory treatment of people labeled with psychiatric disorders.” He has “personally received funding from many manufacturers of antipsychotics, frequently reports no conflicts of interest, particularly in his many recent Medical Journal of Australia articles, including a supplement on early intervention that repeatedly advocates the use of antipsychotics.” [xii]

Psychosis Risk Syndrome is nothing more than psychiatrists with conflicts of interest drumming up more business at the risk of teenage lives, while increasing the profits for the pharmaceutical industry they serve.

[i] Allen Frances, M.D., “DSM5 ‘Psychosis Risk Syndrome’–Far Too Risky,” Psychology Today, http://www.psychologytoday.com/blog/dsm5-in-distress/201003/dsm5-psychosis-risk-syndrome-far-too-risky.

[ii] http://www.mhanet.ca/documents/2008/Research-Colloquium/0920%20-%20Keynote%20MCGORRY.pdf; http://www.bmj.com/cgi/content/full/337/aug04_1/a695.

[iii] Richard Gosden, Ph.D., “Pre-Psychotic Treatment for Schizophrenia: Preventive Medicine, Social Control, or Drug Marketing Strategy?” Ethical Human Sciences and Services, Vol 1, No. 2, Summer 1999, pp. 165-177, http://sites.google.com/site/richardgosden/ehss.

[iv] Arch Gen Psychiatry, Vol 59, Oct. 2002, http://www.meb.uni-bonn.de/psychiatrie/zebb/literatur/mcgorry.pdf.

[v] Richard Gosden, Ph.D., “Pre-Psychotic Treatment for Schizophrenia: Preventive Medicine, Social Control, or Drug Marketing Strategy?” Ethical Human Sciences and Services, Vol 1, No. 2, Summer 1999, pp. 165-177, http://sites.google.com/site/richardgosden/ehss.

[vi] http://www.ministryoflies.com/pdf-articles/Yale-Lilly.pdf.

[vii] Anthony Pelosi, “Head to Head, Is early intervention in the major psychiatric disorders justified? No,” BMJ 2008;337:a710, http://www.bmj.com/cgi/content/full/337/aug04_1/a710.

[viii] http://www.bmj.com/cgi/content/full/337/aug04_1/a710.

[ix] Niall McLaren, M.D., “Psychosis Risk Syndrome (PRS),” 14 May 2010 (soon to be published).

[x] Richard Warner, MB, DPM, is director of Colorado Recovery in Boulder, Colorado, and professor of psychiatry at the University of Colorado, “Early intervention in psychosis: Future or fad?” Centre for Addiction and Mental Health website, http://www.camh.net/Publications/Cross_Currents/Winter_2007-08/futureorfad_crcuwinter0708.html.

[xi] http://www.ahrp.org/cms/index2.php?option=com_content&do_pdf=1&id=386; http://ww.bioethicsforum.org/ethics-of-preventive-psychopharmacologic-treatments.asp.

[xii] David Webb, Melissa Raven, “McGorry’s ‘early intervention’ in mental health: a prescription for disaster,” Online Opinion, http://www.onlineopinion.com.au/view.asp?article=10267.

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New York Magazine: Shrink Revolt—The controversy over psychiatric diagnoses and the DSM continues

Monday, April 26th, 2010

New York Magazine
By Jennifer Senior
April 25, 2010

Two Jews may, as the saying goes, have three opinions, but that appears to be a fairly modest ratio when compared with psychiatrists. It was inevitable that revisions to the Diagnostic and Statistical Manual of Mental Disorders would invite controversy—it’s the classic reference work for mental-health professionals, and a convenient field guide to understanding crazy exes for the rest of us—but even the American Psychiatric Association, which first appointed the work groups to update the text two years ago, couldn’t have predicted the squabbles now under way. Dr. Allen Frances, the man who chaired the task force that created the current edition (the DSM-IV), has today emerged as the most trenchant, and relentless, critic of the proposed revisions to the upcoming edition (the DSM-5; among the changes is a transition to Arabic numerals). Last Tuesday was the final day those revisions were open to public comment. “And hopefully,” Frances says, “most of them will drop out.”

Basically, Frances believes that the first draft of the DSM-5 is too promiscuous with its labels, both by loosening diagnostic criteria and by introducing a host of new and, to his mind, problematic maladies—like Binge Eating Disorder (more or less defined as gorging on massive amounts at least once a week for three months). By the estimate of one DSM-5 task-force member, Frances says, this disorder already afflicts 6 percent of the population. “And that,” he notes, “is before drug companies start marketing something for it.”

As Frances pointed out in a recent Los Angeles Times editorial, such taxonomic adjustments only seem to further shrink “the ever-shrinking domain of the normal.” Take another DSM-5 proposed addition: Temper Dysregulation Disorder With Dysphoria. Frances fears this may be deployed for kids who have typical temper problems. Or Major Depressive Episode: As it’s redefined, it could now be used to describe someone who’s spent two weeks grieving over a lost spouse, he contends. But the worst offender, in Frances’s view, is Psychosis Risk Syndrome, which attempts to identify and treat youngsters before they become psychotic. In his view, there isn’t any evidence that early intervention with medication helps, while there’s plenty to suggest that many teens could be misidentified. “And that I saw as a public-health danger,” he says, “because there are real drawbacks to being on antipsychotics.” Like weight gain and diabetes. “Those children are also disproportionately on Medicaid,” he adds.

Read entire article:  http://nymag.com/news/intelligencer/65632/

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Former DSM Chairman: Psychosis Risk Syndrome (being pushed by Patrick McGorry) is “ill conceived and potentially harmful”

Thursday, March 18th, 2010

DSM 5 ‘Psychosis Risk Syndrome’-far too risky

Psychology Today
By Allen Frances
March 18, 2010

Among all the problematic suggestions for DSM5, the proposal for a ” Psychosis Risk Syndrome” stands out as the most ill conceived and potentially harmful. It aims to solve a pressing problem in psychiatry- the need for early identification and preventive treatment. Psychotic episodes create tremendous short term impairment and may impact negatively on long term prognosis and treatment efficacy. It would save great suffering if we could get there early and do something useful to reduce the lifetime burden of illness before too much damage is done.

But good intentions are not enough. The whole concept of early intervention rests on three fundamental pillars- being able to diagnose the right people and then providing them with a treatment that is effective and safe. “Psychosis Risk Syndrome” fails badly on all three counts: 1) it would misidentify many teenagers who are not really at risk for psychosis; 2) the treatment they would most often receive (atypical antipsychotic medication) has no proven efficacy; but, 3) it does have definite dangerous complications.

First, let’s deal with the misidentification problem. Even in the most expert of hands (ie in very highly selected research clinics), at least two of three people who get the diagnosis do not go on to become psychotic. Of great counterintuitive interest, the longer the research clinic operates the lower becomes its rate of correct identification. With time and spreading reputation, the clinic attracts increasingly heterogeneous referrals- so that it is more difficult to discriminate from among them those who are truly at risk for psychosis.

That would be the misidentification rate once the diagnosis became official and was applied in the real world? No one can say for sure, but two thirds is certainly a lower limit of misidentification. There are several reasons to believe that the ratio of wrong diagnoses would actually be much higher: 1)the raters in general practice would be much less expert than specialists in research clinics; 2) the “patients” would be closer to normal and harder to discriminate; and, 3)drug company marketing would influence parents and clinicians to be especially alert to any strangeness in teenagers. It has been estimated that the false positive rate would jump from about 70 percent in specialty clinics to about 90 percent in general practice.

This means that as many as an astounding nine in ten individuals identified as “risk syndrome” would not really be at risk for developing psychosis.

Those supporting the diagnosis for DSM5 have attempted to fix this overwhelming problem by inserting a definitional criterion that the person must be seeking treatment. They hope this requirement would both reduce the rate of false positives and ensure that those who are misidentified will need some form of treatment. Their preferred treatment for “risk syndrome” is cognitive/behavior therapy which might be helpful (and is unlikely to be harmful) even to those who have been misidentified.

This fix fails badly on both counts- ie in reducing false positives and in guaranteeing safe treatment. Under the best of circumstances, the overwhelming majority of “treatment seekers” will still be false positive. Once the diagnosis is official and marketted, the problem will get much worse as a new army of “treatment seekers” is brought in by their families. Their perceived “strangeness” may come from many causes other than psychotic risk, including:1) drug use; 2) adolescent developmental issues and rebelliousness; 3) culturally dystonic creativity 4) stable schizotypal personality; or, 5)normal eccentricity. A far more efficient signal to noise filter would have been to require that the individual must also have a close family member who has experienced psychotic episodes.

Then we get to the worrying treatment issues. It is the height of unrealistic wishful thinking to assume that most of the misidentified patients will get cognitve therapy. Cognitive theray is in short supply and largely unavailable-especially for this population. On the other hand, antipsychotic medications are fairly ubiquitous and already frequently given for off label indications, particularly to kids on Medicaid.

It has not yet been established that antipsychotic medications are effective in preventing psychotic episodes or in improving life course in those who would meet the criteria for “risk syndrome”. This is an area that to date has received little study and the few existing findings are equivocal.

In contrast, the harmful effects of atypical antipsychotics are extremely well established and frightening. Teenagers starting at an average weight of 110 pounds gained an average of 12 pounds in 12 weeks- and one of the antipsychotics caused an 18 pound weight gain in this period. This raises the risk for diabetes, metabolic syndrome, and a shorter life span.

To sum up: 1) The “risk syndrome” would misidentify many (somewhere between 3-9) kids for every one correctly identified;and, 2) the treatment most likely to be offered has no proven efficacy, but can have extremely dangerous complications. This is a clearly the prescription for an iatrogenic public health disaster.

Read the rest of the article here:  http://www.psychologytoday.com/blog/dsm5-in-distress/201003/dsm-5-psychosis-risk-syndrome-far-too-risky

Read comments by Patrick McGorry pushing Psychosis Risk Syndrome

Also see TIME Magazine Article “Drugs Before Diagnosis?”

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