Mental Health Blogs

Archive for December, 2009

Another $45 from two people came in yesterday bringing the total raised to date to $3,815.26 from 87 people. Thanks to all of you who’ve contributed so far. There’s still another $184.74 to go from 13 people to reach the overall goal of $4,000 from 100 people. Today is the last day of the fundraiser, so it’d be truly awesome if that goal were hit today.

There hasn’t been a single quarterly fundraiser in the history of doing them on this site that has failed to meet goal. It’d be nice to keep that streak going.

If you’d like to help, the PayPal button is on the right. Or if you prefer snail mail, send me an email and I’ll send you my mailing address.

Thanks in advance for your support. Happy New Year.

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I’d really rather not be writing about the forthcoming DSM-5 (come on everyone, let’s drop the Roman numeral already. Cicero and Seneca ain’t writing the dang thing), but Shirah Vollmer, a psychiatry and family medicine professor at UCLA, has written critically of the DSM on her Psychology Today blog. In other words, yet another academic within psychiatry is criticizing her colleagues who are putting together DSM-5. Who knows? Maybe they’ll listen.

Vollmer’s primary point:

“The biases of psychiatric diagnoses are powerful. The more people who are included in a mental disorder, the more research money there will be to fund the science, and the more drug companies have incentive to produce treatments. On the other hand, the more people who are included in a diagnosis, the more suspicious the public becomes about the quality of the diagnostic criteria. No matter how DSM V will be written, it will be flawed. There is no psychiatric diagnosis which has an objective measure. At the moment, all diagnoses are clinical diagnoses, meaning they are subjective. This is a field of humility. There is a lot that we do not know.

“I think there should be an introduction to DSM V which clearly states that this book is a product of work groups, and as such, the diagnostic criteria are subject to further revision. Perhaps this is obvious, but I think that this point needs to be stated clearly. The public needs to know that psychiatry is a field in its infancy, and as such, skepticism is warranted.”

Skepticism, yes. But ignoring the whole DSM altogether might not be such a bad idea.

It’s been a tough last year or so for DSM-5. The New Scientist called for an end to the DSM or at least its current clunky revision process. The APA delayed the release of DSM-5 by one year to 2013. In late 2008, DSM-3 creator Robert Spitzer slammed the DSM-5 process for its secrecy. And Christopher Lane busted the DSM-5 creators for a lack of transparency.

I’d say DSM-5 is in a lot of trouble. And it deserves to be. The DSMs have become so expansive that researchers could actually assert with straight faces, as they did last year, that almost 50 percent of college-age Americans have a psychiatric disorder. With assertions like that, the so-called Bible of psychiatry looks crazier than the Farmer’s Almanac.

Good for Vollmer for pulling up a chair at what’s becoming a hog killing, if I can put it that way.

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I’m reading “Victims No Longer: The Classic Guide for Men Recovering from Sexual Child Abuse ” by Mike Lew and he discusses his interactions with victims of sexual child abuse and their tendency to ask the question above.

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I moved my office yesterday. As fate would have it, the final piece of mail I received at my old address was a notice from Medicare informing me that I needed to update them if there were any changes in my practice, for example, a change of address. It told me where to go (on the internet, that is).

Okay, so in case you’re wondering, Medicare has 221 downloadable forms on their website.

If I understand the directions right (and do feel free to help me out here) CMS-8551 is the form for me:

Additional Information Physicians can apply for enrollment in the Medicare Program or make a change in their enrollment information using either: 1. Have a National Plan and Provider Enumeration System (NPPES) User ID and password to use Internet-based PECOS. • For security reasons, passwords should be changed periodically, at least once a year. • For information on how to change a password, go to the NPPES Application Help page and select the “Reset Password Page” on the NPPES Application Help page. 2. Go to PECOS to complete, review, and submit the electronic enrollment application via PECOS. 3. Print, sign, and date the two-page Certification Statement and mail it with all supporting paper documentation to the Medicare contractor within seven days of the electronic submission. NOTE: A Medicare contractor will not process an Internet enrollment application without the signed and dated two-page Certification Statement and the required supporting documentation. In addition, the effective date of filing an enrollment application is the date the Medicare contractor receives the signed two-page Certification Statement that is associated with the Internet submission. Physicians who are enrolled in the Medicare Program, but have not submitted the CMS-855I since 2003, are required to submit a Medicare enrollment application (i.e., Internet-based PECOS or the CMS-855I) as an initial application when reporting a change for the first time. If a physician has any questions about reporting a change, the physician should contact his or her designated Medicare contractor in advance of submitting the CMS-855I.
(Note, I deleted the Medicare web addresses from the body of the text I copied)

Okay, so 221 downloadable forms, and the form for change of address is the CMS-8551. No prob, I’m on it. PECOS. What are PECOS? I know what pesos are, but PECOS? So form CMS-8551, downloaded for my change of address is 27 pages long. What would it take to get Medicare to have 222 downloadable forms, with the 222nd form being a one-page change of address form.

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Another $65 from three people came in yesterday and that brings the total for the fundraiser to date to $3,770.26 from 85 people. Thanks to all of you who’ve contributed so far. There’s still another $229.74 from 15 people to go to reach the overall goal of $4,000 from 100 people. I’d really like to hit that goal by the end of tomorrow and I will not extend things beyond the 31st. So it’s in your hands.

As usual, the PayPal button is on the right. Thanks in advance for your support.

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I’m far too exhausted from traveling yesterday and from writing the much-ignored post on Sen. Debbie Stabenow–which one reporter friend predicts will be ripped off by a major paper any day now–to write anything original for this morning. I’ll save that for later in the day.

For now, I thought I’d share 2009’s 10 most popular posts based on hits of posts authored in 2009. (There are some older posts that remain quite popular too.)

1. Perhaps not surprisingly, this post from April on an experimental homeless housing program in Seattle addressing chronic street drunks took top spot.

2. My January rant on being used by a Rolling stone author got more attention than it deserved.

3. Not sure why my limited thoughts on a New York Times article on psychosis interested so many, but they did.

4. A May post on boys taking Risperdal growing breasts….Well, of course, that would be popular.

5. Adverse events and Pristiq. Say no more.

6. One of my posts on admissions by Jani’s dad got hits all over the place after Oprah dida show on her.

7. Everyone wanted to know about a Harvard doc falsifying a sleep apnea study.

8. And placebo outperforming Seroquel in a teen bipolar depression study is always good for hits.

9. Placebo scores again with psychiatrists trying to explain away the huge placebo effect in child depression studies.

10. Although it got few comments, this post on a study of anti-depressants causing mania in bipolar disorder had many readers.

And that’s the year that was.

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I moved today! My new office is wonderful. Roy made fun of me because I went to 4 paint stores and ‘test drove’ 8 different shades of tan, finally settling on Shabby Chic (tan). It’s perfect and it goes nicely with the “mushroom” colored carpeting that was being installed at 4 pm yesterday.

So I’m excited. Same furniture. Same Dinah. Mostly the same pics on the wall. Somehow, though, I feel like I got something big out of the way.

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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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Another $10 came in from one person yesterday and that brings the total for the fundraiser to date to $3,705.26 from 82 people. Thanks to all of you who’ve contributed so far. There’s still another $294.74 to go from 18 people to reach the overall goal of $4,000 from 100 people and I would dearly love to hit that target by the close of Thursday, the last day of the year. But I’ll leave that up to you all.

As I hinted yesterday, there’s a major post up on the site today, revealing $1.25 billion in federal funds for depression centers (un-needed in my opinion) that suddenly wound up in amendments to the Senate health care reform bill on December 19, apparently to help snare the support of a single Democratic Senator. Amidst all the squawking in the mainstream media and in the lefty and conservative blogosphere over sweetheart deals for other Dem Senators, everyone missed what I’ve written about, even though the other giveaways pale in comparison on a dollar basis. I’ll leave it to you to speculate as to why. But as I have mentioned before, this site does work that you won’t find elsewhere in the media. And, in all modesty, I think it merits your support. Heck, it’s a 2,000 word post. I won’t even tell you what I used to get paid for such work back in the days before the Great Recession.

If you’d like to support my work here, the PayPal button is on the right. Or if you prefer using snail mail, send me an email and I’ll send you my mailing address.

Thanks in advance for your support.

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There’s been a lot of coverage of amendments to the recently-passed Senate health care reform bill over the last 10 days, especially the Medicare giveaways for the State of Nebraska reportedly employed to capture the support of Sen. Ben Nelson (D-Nebraska) as well as giveaways to other Democratic senators. But one provision of the amendments, which were introduced on December 19, has escaped notice of the mainstream media and the political blogosphere alike. That would be $1.25 billion included in the amendments, apparently to secure the vote of Michigan Senator Debbie Stabenow. Sen. Stabenow, a Democrat, was a passionate advocate for the so-called public option who voted to support a bill without a public option in exchange for inclusion of $1.25 billion in new federal spending to support “centers of excellence” in depression treatment. (A list of so-called cash for cloture is here.)

In October, Stabenow introduced the so-called ENHANCED Act of 2009 on the Senate floor. But the Act was not included in the original Senate health care reform bill. Instead, it showed up virtually unnoticed in the manager’s amendment (as the Senate amendments are known) on December 19. Was this inclusion in exchange for Sen. Stabenow’s vote? What would these depression centers do (the relevant text begins on page 277)? Are they really needed? Depression is, after all, a well-researched and understood phenomenon and has been for decades and billions of dollars federal, state and pharma have been focused upon it. Why does the Senator believe that depression and bipolar disorder exist at twice the rate as does NIH? Is she engaging in scare tactics? How would these centers improve access to health insurance coverage for uninsured Americans, which is what I thought health care reform was supposed to be about?

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I’m flying today from Tucson to Seattle and, with the new TSA security measures in place, God only knows how that might play out. A friend of mine is going to handle comment approval a few times during the day, but after about 9.30 a.m. EST until about 7 p.m. EST comment approval is out of my hands. Don’t let that deter you from leaving comments, but know that their approval may be slowed somewhat today.

Things ought to be back to normal later this evening. Have a nice day.

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