Daily Archives: 19 Jan 14

Psychiatrists From Another Dimension

American Psychiatric Association

‘…[O]ne of the main claimed innovations in the DSM-5 is that it promotes the use of ‘dimensional‘ or quantitative measures of symptoms. Traditionally the DSM has been about  all-or-nothing, categorical diagnoses (“He is depressed”, “She has schizophrenia”). The 5th edition, for the first time, also recommends the use of severity scales.

It’s a move away from digital and in the direction of analogue – such is progress in psychiatry.

In fact, what we might call the ‘dimensional turn’ is more of a statement of intent than anything else. The core of DSM-5 remains the categorical diagnoses – 245 of them, by my count. The dimensional stuff is effectively an appendix. Nonetheless, it’s something.

But why is the DSM promoting symptom scales? Or more to the point, why is it suddenly promoting them now, given that dimensional measures have been used in psychiatry for 60 years? This is where it gets interesting.

The head of the APA’s DSM-5 task force, David Kupfer, stands accused of failing to disclose a conflict of interest which – arguably – means that he has a financial stake in the concept of dimensional assessment.’ (Neuroskeptic)

When intensive care is just too intense

‘As a treatment, it is remarkably successful. Perhaps the greatest tribute to the people who work in critical care is this simple fact: most people leave intensive care alive – despite being dangerously close to death when they arrive. Through a combination of dedication, decision-making and technology, critical care staff ensure that most people pull through. This is the result of years of careful research that has focused clinical practice on restoring the body\’s functioning as quickly and efficiently as possible.

But recently there has been a dawning realisation that the impact of intensive care extends beyond the survival of the body. Dorothy Wade is based at University College Hospital in London and is one of the country’s few intensive care psychologists. She led a recent study which found that more than half of patients assessed at follow-up had marked psychological difficulties. “We learned that patients were suffering from serious depression or having frightening flashbacks and nightmares to their time in intensive care,” says Wade. “This badly affected their quality of life and also held back their physical recovery from their illness.”

In another study, recently submitted for publication, Wade interviewed patients about the hallucinations and delusions they experienced while in intensive care. One patient reported seeing puffins jumping out of the curtains firing blood from guns, another began to believe that the nurses were being paid to kill patients and zombify them. The descriptions seem faintly amusing at a distance, but both were terrifying at the time and led to distressing intrusive memories long after the patients had realised their experiences were illusory.

Many patients don’t mention these experiences while in hospital, either through fear of sounding mad, or through an inability to speak – often because of medical breathing aids, or because of fears generated by the delusions themselves. After all, who would you talk to in a zombie factory?

These experiences can be caused by the effect of serious illness on the brain, but painkilling and sedating drugs play a part and are now used only where there is no alternative. Stress also adds to the mix but is often caused inadvertently by the way intensive care wards are organised. “If you think about the sort of things used for torture,” says Hugh Montgomery, a professor of intensive care medicine at UCL, “you will experience most of them in intensive care. As a patient, you are often naked and exposed, you hear alarming noises at random times, your sleep-wake cycle is disrupted by being woken up for medical procedures through the night, you will be given drugs that could disorient you, and you will be regularly exposed to discomfort and feelings of threat.” — Vaughan Bell (The Observer).

The Military Paradox of Scottish Independence

‘An independent Scotland would seek membership in NATO. It would also require that all nuclear weapons be removed from Scottish territory as soon as possible.

If you detect contradiction in those last two tenets, it means you’re paying attention. An independent Scotland would join a military alliance whose security is explicitly underpinned by a tri-nation nuclear umbrella provided by the United States, the U.K. and France while at the same time enforcing its own nuclear-free zone.’ (Medium).

What scientific idea is ready for retirement?

‘Each year a forum for the world’s most brilliant minds asks one question. This year’s drew responses from such names as Richard Dawkins, Ian McEwan and Alan Alda. Here, edge.org founder John Brockman explains how the question came into being and we pick some of the best responses…’ (The Observer) I don’t know why this kicker focused on the likes of Alan Alda and McEwan. The responses of the cutting-edge scientists are the most compelling.

Aspartame: A Dangerous Excitotoxin That Can Damage Your Brain

English: aspartame; Asp-Phe methyl ester Deuts...

‘Aspartame dominated the artificial sweetener market for 30 years until the introduction of sucralose in 1998. Since then, sucralose has taken over as the most popular, and stevia blends aren’t far behind. That said, over 6,000 drinks, food products, pharmaceuticals and vitamin supplements are still made with aspartame. It’s especially prevalent in diet sodas, low-fat foods, yogurts, cereals, shakes, gums, and some sugar-free foods.

The recipe for aspartame is to combine two amino acids, L-phenylalanine and L-aspartic acid, with a third component called a methyl ester group. All three ingredients have the potential to create serious, chronic neurological problems and are the subject of relentless anecdotal reporting by individuals and warnings by independent health experts. Problems range from headaches to seizures, strokes, tumors and progressive neurological diseases. None of this is officially recognized.

Let’s take a look at each ingredient in aspartame…’ (Blogcritics).