Posted by Eric on March 28, 2001, at 10:06:30
In reply to Re: New theories of mental disorders needed (long) » Eric, posted by SLS on March 27, 2001, at 19:40:28
> Hi Eric.
>
> > Mental illness research is a joke.
>
> How so?How so? Look at how little research is being done in mental illness compared to other fields of medicine. Its not very much research. And what research is being done is notoriously slow. There doesnt seem to be much of a sense of speeding things up in mental illness research. Its a joke. What we need is research comparable to AIDS research, what we actually get is lipservice research. And we need SPEED!
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> > Sure, big headway has been made in the past fifteen years or so...
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> These two statements seem quite contradictory to me.
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> > ...but much is left to be desired.
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> I would say, "but much is left to do".Why? Whats wrong with saying much is left to be desired? Its true. Much IS left to be desired.
>
> What precisely do you feel the medical research community is doing wrong?I feel the medical research community has other priorities besides mental illness research. That is my personal opinion. We the mentally ill are not one of medicine's priorities. In particular the treatment resistant community is not a priority.
There are still a lot of extremely sick mentally ill persons out there despite all the current available treatments. This Psycho-Babble message board is hard proof of that.Id also like to see some new high tech diagnosis tools developed for psychiatry. So that Pdocs would have some actual tools at their disposal to aid in proper diagnosis besides just interviewing patients. Its ridiculous. If these illnesses are really medical problems(which they are) then some diagnostic tools are needed. SPECT scans, fMRI...SOMETHING!
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> What do you feel they are doing right?The only thing I feel psychiatry is doing right is they are getting modern class psychiatry medications to use on patients, which are being developed by the pharmaceutical companies.
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> What specific changes would you recommend?I would recommend more priority for the mentally ill. LOTS more money to be spent on biological mental illness research. Dropped from the top of the chain of the command...the President of the United States. Gore wanted to do it(or at least said he did). I feel the only way it will ever get done is if its dropped from the top. Trying to push this thing up from the bottom will be impossible. It needs to be recognized as a problem area by our country's leadership and subsequently dealt with in a structured, methodical manner. Kind of like fighting a war. Or kind of like how the AIDS research thing was handled. Both things...major wars and AIDS get priority by our country's leadership.
Mental illness needs to get priority in Washington DC.
I would also recommend that psychiatry be formally merged back into neurology and that all severe forms of mental illnesses be treated as neurological problems and/or neuro-endocrine problems. And not as "psychological" problems of the mind. Again, the only way a change this dramatic and fundamental would go thru would be if it was being strongly encouraged by our country's leadership.
Im tired of my psychiatrist telling me that "my brain has physically changed from longstanding severe depression" but Im not being referred to a neurologist. Doesnt make any sense to me...know what I mean? If Im having problems with my brain not functioning properly, that sounds like a neurological problem to me.
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> > Look at how many treatment resistant folks are out there!
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> Now that you mention it, I have noticed a few.>
> > Very little research is going on to target the treatment resistant community.
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> Are you sure?
>Oh yes, I am sure. I am one of those treatment resistant persons and trust me there is not very much research going on. To list, you have the rTMS trials...which failed. The current VNS program...which there is no telling how that will turn out. And a few clinical trials here and there for treatment resistant people, most of which do nothing but experiment with augmentation strategies for antidepressants. There is very little research going on that seriously tries to find out WHY people become treatment resistant. Or WHY antidepressants poop out.
I find it interesting to know that the only truly novel research in the area of TRD is VNS and VNS was originally an innovative tool developed by the neurology community to combat refractory epilepsy. Hmmmm lets see, some other drugs commonly used in psychiatry were initially developed for neurology usage...anti-convulsants like depakote, Tegretol, lamictal, Neurontin, Topomax. Seems to me, major mental illnesses have some similarity to neurological illnesses?
> I used the following keyword statement to perform a search on Medline:
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> ("treatment resistant" OR trd) AND (depression or bipolar)
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> Results: 327 hits
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> I guess everything is relative. How would you characterize the number 327?Id characterize that number as rather unimpressive. I did the same search on Yahoo and pulled up even more than you did. I looked at many of the results. MOst of the sites pulled up in the search were discussions of rTMS(which doesnt work) or the current hot area of research, VNS. Most of the other sites concerning TRD were just discussions of augmentation strategies for antidepressants such as adding anti-psychotics or lithium to the ADs. In other words, nothing very new or novel nor anything that really works.
I should tell you I was in the rTMS clinical trials myself. rTMS doesnt work. Neither do a lot of these much touted drug augmentation strategies for TRD. This message board is proof of that. Just look at how many individuals on this board bounce on and off meds constantly and repeatedly which they try to augment with...it rarely works.
I dont consider having maintenance ECT for the rest of my life as a viable option. I dont know about you. Im just saying that a lot is left to be desired within psychiatry. What little research is being done in mental health is not enough, nor is it being done in an expeditious manner. Mental illness just does not get priority in the overall scheme of things.
To end this post, if methods of diagnosing were dramatically improved that would go a long long way towards improving the plight of the mentally ill. Again, research needs to go not just into new drugs and treatments but also to dramatically improve diagnosis. Diagnosis is very crude and subjective in psychiatry. Whereas in other areas of medicine they ALWAYS try to get the diagnosis right the first time. It wouldnt be possible without X-Rays, MRIs, EEGs, blood tests and a whole host of other diagnostic tools in other branches of medicine. Psychiatry badly needs some diagnostic tools of its own. The face to face interview just isnt good enough, nor specific enough.
If you want severe mental illness to ever get figured out and fixed psychiatry needs to be overhauled and given back to neurology.
Eric
poster:Eric
thread:57508
URL: http://www.dr-bob.org/babble/20010327/msgs/57773.html