![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by White Stone on February 25, 2003, at 15:06:30
I have definite symptoms from several different disorders; among them are post-traumatic stress syndrome, obsessive-compulsive, bipolar, and GAD. The GP doctor first tried attacking the depression (Effexor and Zoloft) and now has prescribed an antipsychotic (Zyprexa) for the possible bipolar. He hasn't really given me a diagnosis past depression and anxiety. He seems to be trying to arrive at a more conclusive diagnosis based on how the medications effect my symptoms. Is this normal? Is a diagnosis important? Wouldn't it be more helpful to me to have a diagnosis so I could learn everything I could about what he suspects is wrong with me?
Any comments would be appreciated.
Posted by crazychickuk on February 25, 2003, at 15:19:37
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
go to a phsyiciatrist demand to be refered to one, i am still trying to be diagnosed proply myself, but i am sure the phsyiciatrist will diagnose you proply, taking all these meds can be making you have things.. doctors dont know much about mental health and phsyiciatrists are trained in only mental health.. you shouldnt be taking all those meds.. go see one asap :)
Posted by stjames on February 25, 2003, at 15:26:26
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
A GP cannot diagnose mental illnesses.
Posted by fachad on February 25, 2003, at 15:44:24
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
> I have definite symptoms from several different disorders... He seems to be trying to arrive at a more conclusive diagnosis based on how the medications effect my symptoms.
>Is this normal? Is a diagnosis important?
Don't get me started...here's my take on your situation, lifted from another post a few months back:
>Anyway, if you want to know my opinion, AD's are indicated when depression is primary and anxiolytics when anxiety is primary.
I'm somewhat skeptical about the validity of DSM-IV diagnosis. I think they are a convenient way to group symptoms and present something “scientific” sounding to third party payers, but I don't think they are as valid as medical diagnosis like streptococcus caused strep throat.
The one thing I absolutely don't buy into at all is medication treatment specificity in psych disorders. By that I mean I don't think one class of meds is always indicated in one class of disorders.
Benzo's probably help some depression patients. Mood stabilizers help some anxiety patients. ADs help some OCD sufferers. Stimulants help some depression patients, and that does not necessarily mean those patients "really had" undiagnosed ADD all along.
The diagnosis are somewhat questionable, but the specificity of treatment concept is a carryover from the germ / antibiotic medical model and it just does not hold water in psych disorders.
It's a real shame in that it limits the possible treatments that are tried and also results in a diagnosis in the event of response. "Oh, I guess you really had (whatever) disorder, because you responded to (whatever class) of meds. Now expect these symptoms too, because they go along with your disorder."
>Anxiety patients go through life thinking that that's just the best meds have to offer without having been given the freedom of choice to try bzd's on equal footing with ssri's and similar drugs.
Yes, and they have to PAY more for those less effective SSRIs, too. And depression patients go on from one ineffective, side effect laden AD to another, without trying stimulants, unless there is some indication of ADHD, or without trying benzos, unless there is evidence of GAD, or whatever...
The whole post that was taken from is here:http://www.dr-bob.org/babble/20020408/msgs/103154.html
And if you're in the mood for another diatribe along similar lines, take a look here:
http://www.dr-bob.org/babble/20020307/msgs/97442.html
Posted by Geezer on February 25, 2003, at 17:56:08
In reply to Re: Is diagnosis important ?, posted by fachad on February 25, 2003, at 15:44:24
fachad,
Very well said - I believe you have "nailed it". Perhaps the most recent example which lends support to your proposal are the drugs Reboxitin and Straterra. Reboxitin went down in flames (due to a less than scientific study - buy the way - the FDA does not do scientific studies) while Straterra seems to be coming on strong. I can't find a whole lot of difference in the drugs, aside from the geo-political/economic differences you point out.
I have always been perplexed by DSM DXs. Why are people suffering from bio-chemical/neurological brain disorders labled under psychlogical criteria then referred to "Social Scientists" for treatment of a medical condition. A bit like going to a chiropractor for open-heart surgery...oh I know "we just aren't there yet!
Like you I am going back to Methadate Caps. or Concerta, probably add low dose Prozac, already take Trileptal 300mg and Klonopin 2mg., may even add a little Dex. from time-to-time. I have already had ECT and all the rest so it becomes a matter of treating symptoms not pondering some unknown DX that is probably some years in the future. Thanks for saying it like it is.
Geezer
Posted by ace on February 25, 2003, at 22:06:54
In reply to Re: Is diagnosis important ?, posted by stjames on February 25, 2003, at 15:26:26
> A GP cannot diagnose mental illnesses.
That is NOT correct.
Posted by Jack Smith on February 26, 2003, at 0:19:38
In reply to Re: Is diagnosis important ? » stjames, posted by ace on February 25, 2003, at 22:06:54
> > A GP cannot diagnose mental illnesses.
>
> That is NOT correct.I agree with Ace. Some GPs may be better at such diagnoses. However, on the average, it is probably better to see a psychiatrist, especially if you are dealing with cocktails and more so if you are dealing with antipsychotics.
Posted by shar on February 26, 2003, at 2:08:31
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
An assessment is important. This is probably best accomplished by a psychiatrist. Your mental, physical, spiritual, whatever else, needs to be looked at as an entity unto itself, as a whole. After a thorough assessment, some guidance should be provided as to a good initial course of treatment. At least that's what we all hope. :)
I don't know that the actual dx is so important, but does seem to follow an assessment. Try to find a good psych doc (psychopharmacologist might be nice if possible) for a complete evaluation.
Shar
> I have definite symptoms from several different disorders; among them are post-traumatic stress syndrome, obsessive-compulsive, bipolar, and GAD. The GP doctor first tried attacking the depression (Effexor and Zoloft) and now has prescribed an antipsychotic (Zyprexa) for the possible bipolar. He hasn't really given me a diagnosis past depression and anxiety. He seems to be trying to arrive at a more conclusive diagnosis based on how the medications effect my symptoms. Is this normal? Is a diagnosis important? Wouldn't it be more helpful to me to have a diagnosis so I could learn everything I could about what he suspects is wrong with me?
>
> Any comments would be appreciated.
Posted by JohnL on February 26, 2003, at 7:40:30
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
This is just my opinion, but I do not believe a diagnosis is all that helpful when it comes to actually choosing medication.
A patient with lifelong anxiety failed every med on the planet. But a small dose of Lithium, as a last resort, completely cured the patient within 24 hours. That was an electrical instability problem that got fixed. Lithium has no place for treating anxiety, but it worked.
Certain populations of depressed patients actually get worse on antidepressants. They get better instead on antipsychotics. In the meantime, they suffered for years because the doctor was only treating them with antidepressants because the diagnosis was depression. The diagnosis and the fix did not jive.
There are hundreds and thousands of such examples. I think a diagnosis is a good place to start, but that's about it.
A better way, in my opinion, is to gather clues from medication trials. For example, someone with anhedonic depression might just remain anhedonic but numb on SSRIs. If that happens to them, then it could be a clue that targeting dopamine and/or norepinephrine might work better than serotonin. And so on.
Obviously brain chemistry is very complicated. But I believe each medication we try gives us important clues that can help decide what the next medication should be, and that this approach will get the patient well faster than trying to stay in a rigid plan where the med has to fit the diagnosis.
> I have definite symptoms from several different disorders; among them are post-traumatic stress syndrome, obsessive-compulsive, bipolar, and GAD. The GP doctor first tried attacking the depression (Effexor and Zoloft) and now has prescribed an antipsychotic (Zyprexa) for the possible bipolar. He hasn't really given me a diagnosis past depression and anxiety. He seems to be trying to arrive at a more conclusive diagnosis based on how the medications effect my symptoms. Is this normal? Is a diagnosis important? Wouldn't it be more helpful to me to have a diagnosis so I could learn everything I could about what he suspects is wrong with me?
>
> Any comments would be appreciated.
Posted by stjames on February 26, 2003, at 10:48:54
In reply to Re: Is diagnosis important ? » stjames, posted by ace on February 25, 2003, at 22:06:54
> > A GP cannot diagnose mental illnesses.
>
> That is NOT correct.Well, if you want to receive treatment from someone who has no training in treating mental illness, go right a head !
Posted by Jumpy on February 26, 2003, at 11:14:10
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
> I have definite symptoms from several different disorders; among them are post-traumatic stress syndrome, obsessive-compulsive, bipolar, and GAD. The GP doctor first tried attacking the depression (Effexor and Zoloft) and now has prescribed an antipsychotic (Zyprexa) for the possible bipolar. He hasn't really given me a diagnosis past depression and anxiety. He seems to be trying to arrive at a more conclusive diagnosis based on how the medications effect my symptoms. Is this normal? Is a diagnosis important? Wouldn't it be more helpful to me to have a diagnosis so I could learn everything I could about what he suspects is wrong with me?
>
> Any comments would be appreciated.I read a psychiatrist's impression of diagnostic caterogies in mental illness. He said that most people suffered from a spectrum type illness ... some depression, some anxiety, some OCD, some mood swings, etc. He said pure diseases as classified by the DSM-IV were pretty rare ... that is, it is rare for an individual to just have pure depression and nothing else. So most individuals may need a combination of medications to treat all the various elements of there illness ... so some antidepressant with alittle benzo and alittle mood stablizer is not uncommon.
He had this great analogy. He said when someone has the flu, we don't diagnose them with "runny nose disease" or "cough disease" or "sore throat disease". We say they have an "upper respiratory tract" syndrome (the flu) and treat them with some antibiotics, some cough syrup, some decongesant, etc.
Hope that made sense.
Jumpy
Posted by White Stone on February 26, 2003, at 13:36:25
In reply to Runny Nose Disease » White Stone, posted by Jumpy on February 26, 2003, at 11:14:10
I really appreciated your analogy. It makes perfect sense when viewed that way. Thank you.
Posted by ace on February 26, 2003, at 18:54:43
In reply to Re: Is diagnosis important ?, posted by stjames on February 26, 2003, at 10:48:54
> > > A GP cannot diagnose mental illnesses.
> >
> > That is NOT correct.
>
> Well, if you want to receive treatment from someone who has no training in treating mental illness, go right a head !Not true again. Each doctor has to study for 1 year psychiatry as part of their training. In addition a LOT of psychiatric patients DO get treated from family docs. For instance, my family doc has over 30 psych patients. In addition family docs have to keep up on current literature on ALL specialties. They have a much broader knowledge of medicine than pdocs and, in my opinion, are much more well balanced ( In my time I have seen over 10 pdocs - 2 of them were caring and honest, the rest were patronizing, lazy, rude, and standoffish. I will never see a psychiatrist again. The last one I saw, and this was the FINAL straw, stated 'all your friends must think your a weirdo")
Ace
Posted by ace on February 26, 2003, at 19:00:50
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
Posted by KrissyP on February 27, 2003, at 1:43:29
In reply to Runny Nose Disease » White Stone, posted by Jumpy on February 26, 2003, at 11:14:10
> > I have definite symptoms from several different disorders; among them are post-traumatic stress syndrome, obsessive-compulsive, bipolar, and GAD. The GP doctor first tried attacking the depression (Effexor and Zoloft) and now has prescribed an antipsychotic (Zyprexa) for the possible bipolar. He hasn't really given me a diagnosis past depression and anxiety. He seems to be trying to arrive at a more conclusive diagnosis based on how the medications effect my symptoms. Is this normal? Is a diagnosis important? Wouldn't it be more helpful to me to have a diagnosis so I could learn everything I could about what he suspects is wrong with me?
> >
> > Any comments would be appreciated.
>
> I read a psychiatrist's impression of diagnostic caterogies in mental illness. He said that most people suffered from a spectrum type illness ... some depression, some anxiety, some OCD, some mood swings, etc. He said pure diseases as classified by the DSM-IV were pretty rare ... that is, it is rare for an individual to just have pure depression and nothing else. So most individuals may need a combination of medications to treat all the various elements of there illness ... so some antidepressant with alittle benzo and alittle mood stablizer is not uncommon.
>
> He had this great analogy. He said when someone has the flu, we don't diagnose them with "runny nose disease" or "cough disease" or "sore throat disease". We say they have an "upper respiratory tract" syndrome (the flu) and treat them with some antibiotics, some cough syrup, some decongesant, etc.Hope that made sense.
Jumpy
----------------------------------------------------------------------------------------------------------------------
great point! I hear ya. thanks, kristen
Posted by stjames on February 27, 2003, at 10:49:23
In reply to Re: Is diagnosis important ? » stjames, posted by ace on February 26, 2003, at 18:54:43
> > > > A GP cannot diagnose mental illnesses.
> > >
> > > That is NOT correct.
> >
> > Well, if you want to receive treatment from someone who has no training in treating mental illness, go right a head !
>
> Not true again. Each doctor has to study for 1 year psychiatry as part of their training. In addition a LOT of psychiatric patients DO get treated from family docs. For instance, my family doc has over 30 psych patients. In addition family docs have to keep up on current literature on ALL specialties. They have a much broader knowledge of medicine than pdocs and, in my opinion, are much more well balanced ( In my time I have seen over 10 pdocs - 2 of them were caring and honest, the rest were patronizing, lazy, rude, and standoffish. I will never see a psychiatrist again. The last one I saw, and this was the FINAL straw, stated 'all your friends must think your a weirdo")
>
> Ace1 year of study, yikes ! How about several years of practice in seeing patients with mental illness ? That menas a lot more than 1 year of study.
Posted by IsoM on February 27, 2003, at 11:34:39
In reply to Re: Is diagnosis important ?, posted by stjames on February 27, 2003, at 10:49:23
If all of us who are treated by our family docs were to reject their treatment & insist on seeing only an "expert", how long does any one want to guess the waiting period would be before we get our appointment?
Already, one has to wait 3 months or more to see a psychiatrist where I live (near a heavily populated metropolis). The only quick way is to get admitted to hospital emergency & go to the psych ward. But then one has no choice of pdoc assigned.
Seeing the number of absolutely "nutty" pdocs I've seen, I'd rather take my chances with trying a few GPs until I found one who's familiar with depression. Even though medicare covers both, if one doesn't have medicare where they live, GPs are much cheaper too.
I've also found many pdocs who are older don't bother keeping up to date on new meds or developments. Many couldn't be bothered. They already have a comfortable patient load & make enough not to care. I've seen pdocs who simply transfer a non-reponsive patient on to the university hospital rather than try new meds or spend more time tackling a tougher case.
These aren't just my experiences but have been garnered from friends & acquaintances who've been to many of the pdocs here.
YES, in theory, a pdoc should be the one to go too, not a GP. In practice, there's many GPs who have spent a lot of time familiarizing themselves with mental disorders & meds to understand their patient's concerns & sometimes those of family & friends of their own.
Posted by stjames on February 27, 2003, at 12:04:59
In reply to Re: Is diagnosis important ? » stjames, posted by IsoM on February 27, 2003, at 11:34:39
I have quite a different experience. The GP's I see balk at giving me AD's, like when I am between pdocs. In over 20 years I have had no problems finding good pdocs.
Posted by judy1 on February 27, 2003, at 18:09:12
In reply to Re: Is diagnosis important ?, posted by stjames on February 27, 2003, at 12:04:59
I think I may be somewhere in the middle- between pdocs I have seen a couple of Internists who have both been very responsive with meds and willing to make a couple of calls to make sure they were safely prescribing. But because of the complexity of my disorders they were not comfortable (nor did I want them to) in being my primary psychotropic med prescriber. One still is definitely part of my mental health team, along with my shrink and therapist. I think for less complex cases- like a slight to moderate depression or uncomplicated anxiety case- a general practitioner is fine. take care, judy
Posted by ace on February 27, 2003, at 19:08:12
In reply to Re: Is diagnosis important ?, posted by stjames on February 27, 2003, at 10:49:23
> > > > > A GP cannot diagnose mental illnesses.
> > > >
> > > > That is NOT correct.
> > >
> > > Well, if you want to receive treatment from someone who has no training in treating mental illness, go right a head !
> >
> > Not true again. Each doctor has to study for 1 year psychiatry as part of their training. In addition a LOT of psychiatric patients DO get treated from family docs. For instance, my family doc has over 30 psych patients. In addition family docs have to keep up on current literature on ALL specialties. They have a much broader knowledge of medicine than pdocs and, in my opinion, are much more well balanced ( In my time I have seen over 10 pdocs - 2 of them were caring and honest, the rest were patronizing, lazy, rude, and standoffish. I will never see a psychiatrist again. The last one I saw, and this was the FINAL straw, stated 'all your friends must think your a weirdo")
> >
> > Ace
>
> 1 year of study, yikes ! How about several years of practice in seeing patients with mental illness ? That menas a lot more than 1 year of study.
>
>I know what your saying, but some (older GP's) have been seeing psych patients for years too. Gp's must keep up with the psych literature and obviously have to associate with pdocs.
If someone wants to see a pdoc, great. But I've just been too mistreated and hurt in the past before to ever see one again.
ST-James - if you have a good caring psych it's a great idea to stay with him/her and I am happy for you. But my treatment with my GP is BETTER THAN ANY pdoc I've ever seen -- and I have seen a lot (being hospitalised before and all).
Peter Breggin has a good point in exposing the inadequacies of a lot of pdocs. Some are pure evil, and I'm sure they do it for a sense of power over another and to try and help themselves.
Of course some are lovely, caring, warm humans -- but i HONESTLY think this is the minority.
My GP has told me so many stories of wierd pdocs. The one he thought was most well balanced took a gun, shot his two daughters, himself and his wife. And this guy was treating people! Also a lot of them are on cocain -- this is unequivocal.
But if you feel good about yours thats great. but don't forget there are options.
Please tell me what you think.
Ace.
Posted by KrissyP on February 27, 2003, at 19:25:16
In reply to seeing GPs, posted by judy1 on February 27, 2003, at 18:09:12
I have a story- after my pdoc said "oh I'll take care of your psych meds" I took her upon her offer. I decided MYSELF that I needed to go back on Lamictal-something that has worked for me int he past. My insurance didn't cover it if it was prescribed by a pdoc. I think my pdoc should have looked into something like that BEFORE she "offered to take over my psych meds" did she just want notoriety? kinda gets me
Kristen
> I think I may be somewhere in the middle- between pdocs I have seen a couple of Internists who have both been very responsive with meds and willing to make a couple of calls to make sure they were safely prescribing. But because of the complexity of my disorders they were not comfortable (nor did I want them to) in being my primary psychotropic med prescriber. One still is definitely part of my mental health team, along with my shrink and therapist. I think for less complex cases- like a slight to moderate depression or uncomplicated anxiety case- a general practitioner is fine. take care, judy
Posted by ace on February 27, 2003, at 19:25:45
In reply to Re: Is diagnosis important ? ?stjames, posted by IsoM on February 27, 2003, at 11:34:39
>
> Seeing the number of absolutely "nutty" pdocs I've seen, I'd rather take my chances with trying a few GPs until I found one who's familiar with depression. Even though medicare covers both, if one doesn't have medicare where they live, GPs are much cheaper too.This is so well put Isom. Out of 10 or so pdocs I've seen 1 or 2 have been well-balanced. Their behaviour towards me over the years has been disgusting -- everything from misdiagnosis (I'm 100% certain I know more on OCD than a lot of them), abuse (calling me 'wierd' 'unusual'), dishonesty (telling a doc one thing, telling me the complete opposite), close-minded refusing MAOI treatment - the drug that finally worked for me, telling me 'I ask stupid questions'.
Some I have seen seem to be really on the verge of insanity themselves, no lie. Really unhinged people.
It's funny, every single drug ever prescribed too me by those rascals has either had minimal effect or made me worse. Now that I am educated and have studied some psychopharmacology I have found a lovely well balanced GP who had no probs with prescribing an MAOI. If he sees I've researched the drug thoroughly and is appropriate or not dangerous he will happily prescribe what I want. Simply, I have never had such a good theraputic relationship.
BTW, my GP concurs with everything I think about pdocs. He is an old GP, so he has seen a lot. He believes well over 50% have major psychiatric issues. The most well balanced one he ever met killed his wife, 2 daughters and himself. And this guy treated others!
Also my GP was upset with what a pdoc said to him about me via referal paper. It stated 'I was unusual' My pdoc thought that comment very unfair. BTW, the reason that ratbag pdoc said that was because he saw I wanted an active part in my treatment and disagreed about SSRIs. I basically challenged his power and that is how he reacted. Real professional.
> I've also found many pdocs who are older don't bother keeping up to date on new meds or developments. Many couldn't be bothered. They already have a comfortable patient load & make enough not to care. I've seen pdocs who simply transfer a non-reponsive patient on to the university hospital rather than try new meds or spend more time tackling a tougher case.
>
> These aren't just my experiences but have been garnered from friends & acquaintances who've been to many of the pdocs here.As an aside, a friends sister of mine was crying in great anxiety and pain. She was told to 'grow up'. She wrote to the pdoc later and he sent a paltry letter saying 'thankyou for letting me know your progress'
> YES, in theory, a pdoc should be the one to go too, not a GP. In practice, there's many GPs who have spent a lot of time familiarizing themselves with mental disorders & meds to understand their patient's concerns & sometimes those of family & friends of their own.
Once again, your comments are spot on. I will have a GP any day over some psycho pdoc. You are wright too- contrary to what st-james said a lot of GPs are extremely familiar with psychiatric diagnosis and practices etc. They also see a lot of psych patients themselves (not everyone can pay for a whore docter...oops..I ment psych doctor!) Older ones I believe are better than some shrinks.Please tell me what you think! We definately are like-minded!
God Bless,
Ace.
Posted by jane d on February 27, 2003, at 23:20:33
In reply to Is diagnosis important ?, posted by White Stone on February 25, 2003, at 15:06:30
> I have definite symptoms from several different disorders; among them are post-traumatic stress syndrome, obsessive-compulsive, bipolar, and GAD. The GP doctor first tried attacking the depression (Effexor and Zoloft) and now has prescribed an antipsychotic (Zyprexa) for the possible bipolar. He hasn't really given me a diagnosis past depression and anxiety. He seems to be trying to arrive at a more conclusive diagnosis based on how the medications effect my symptoms. Is this normal? Is a diagnosis important? Wouldn't it be more helpful to me to have a diagnosis so I could learn everything I could about what he suspects is wrong with me?
>
> Any comments would be appreciated.
White Stone,I'm sorry to respond so late. While trying to compose yet another post about whether diagnoses matter, and GPs vs Psychs I kept coming back to your statement about trying Zyprexa. You don't say what symptoms of bipolar you have or even what form of bipolar your doctor suspects. Since he only suspects you have it that must mean that you are not now manic or psychotic so why are you taking an antipsychotic? It is not the first choice of drugs as a preventative treatment for bipolar and the antipsychotics are generally conceded to be riskier than drugs like Effexor and Zoloft. For this reason I would try to find a psychiatrist if I were in your shoes.
The way he is approaching your treatment is otherwise pretty standard. As other posters have stated the diagnosis doesn't mean as much here as it does in other diseases. Every diagnosis is just a collection of symptoms that have been observed to occur together frequently. From this we assume that they will someday be found to have a common cause. How they are grouped keeps changing. What's most important may not be that you have 6 of 12 (numbers made up) symptoms of depression and therefore can be called depressed but which subset of those symptoms you have.
Jane
Posted by stjames on February 28, 2003, at 10:35:33
In reply to Re: ATTN St-James, on GP's and Pdoc's. » stjames, posted by ace on February 27, 2003, at 19:08:12
> Peter Breggin has a good point in exposing the inadequacies of a lot of pdocs.
Dr Breggin is a qwack.
Posted by stjames on February 28, 2003, at 14:55:39
In reply to Re: ATTN St-James, on GP's and Pdoc's. » stjames, posted by stjames on February 28, 2003, at 10:35:33
http://www.quackwatch.org/11Ind/breggin.html
Breggin is not certified by the American Board of Psychiatry and Neurology, which is the recognized agency for certifying psychiatrists.
Having completed three years of psychiatric training, Breggin is entitled to call himself a psychiatrist or a "specialist in psychiatry." Until 1996, the Maryland Board of Quality Assurance maintained a lists of "identified" specialists. Anyone who completed an approved training program was eligible for listing. No special examination or additional qualifications were required.
To become licensed in the United States, every physician must pass an examination given by the National Board of Medical Examiners or an equivalent examination by a state licensing board. Thus being a "diplomate" of the National Board of Medical Examiners means nothing more than the fact that the doctor has passed a standard licensing exam. Most resumés I have seen do not list this credential.
The American Board of Forensic Examiners is not recognized by the American Board of Medical Specialties (ABMS), which is the recognized standard-setting organization. ABMS offers subspecialty certification in forensic psychiatry and forensic pathology, neither of which Breggin has achieved.
Only one of the six journals with which Breggin has been affiliated is significant enough to be listed in MEDLINE, the National Library of Medicine's principal online database.
On September 5, 2002, I found that Breggin had 33 citations listed in MEDLINE. None of these publications appears to be a research report. Eight were letters to the editor, two were books, and most of the rest were expressions of his opinion on various psychiatric topics.
This is the end of the thread.
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