Live from the APA: 15-minute Speed Blog

John McManamy Health Guide
  • I’m off to a schmooze luncheon in 15 minutes, so this is a 15-minute speed blog.


    Yesterday or the day before, so I heard, the anti-psychiatry crowd had their usual demonstration outside the APA annual meeting. Any time I’ve seen their demos, they are always carrying placards that say, “Psychiatry Kills” and other nonsense. Significantly, they never come inside, where they actually might learn something.


    Here’s what they could have learned:


    Believe it or not, the anti-psychiatry people could have picked up a lot of evidence in support of many of their positions. One look inside the exhibit hall at all the pharm company exhibits provides more than ample evidence of moneychangers in the Temple. Typically, you will find about 2,000 pharm reps at these meetings, about one for every ten psychiatrists. Through the symposia they sponsor at the annual meeting and other venues, they the drug industry profoundly influences how psychiatrists are educated.

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    Buried away in the nooks and crannies between the massive pharm displays was a man handing out “No Free Lunch” brochures. “Just say No to Drug Reps” ran the heading. Ten doctors had signed his petition taking the “Just Say No” pledge.


    “There’s more docs lining up at one of the booths to collect personally-engraved memory sticks,” I sympathetically said to the guy. But he gamely replied that he has ten more people than yesterday.


    Gotta admire someone like that.


    This morning, at a breakfast symposium, Holly Swartz MD of the University of Pittsburgh, in a talk on psychotherapy for bipolar, presented a case study of a patient not responding too well to meds, with clear worries regarding family and ability to continue with her graduate studies.


    She presented four options. Three involved adding or increasing meds doses. One involved initiating psychotherapy with the meds. The audience responded via portable electronic keypads. “This is a slam dunk,” the psychiatrist next to me commented.


    Fifty-two percent of the psychiatrists chose the meds options. Only 48 percent chose the psychotherapy option.


    Knock me over with a feather. Are psychiatrists really that dense? The psychiatrist next to me informed me that five years ago, probably only five to ten percent would have responded with the psychotherapy option. We have a long way to go.


    I just came back from a brain science lecture by Ronald Duman PhD of Yale. Dr Duman has been at the forefront of studies involving cell growth in various areas of the brain. Stress can kill neurons or cause them to atrophy. Antidepressants and exercise can reverse this process. Dr Duman and his colleagues have mapped out some of the biochemical processes.


    This is exciting stuff, and is changing the way we think regarding mental illness.


    On the way back to the press room, I popped into a poster session, and got to talk to a brain scientist on the fine points of the mitochondria. Apparently, there could be a link between how the mitochondria generates cellular energy and how this may impact on a range of mental illnesses.

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    Interestingly enough, I also ran into a psychiatrist acquaintance who was all ears when I gave him my 15 minute elevator pitch about recovery algorithms for patients. I mentioned this idea in previous blogs, and will be returning to it. The point is there is a basis for informed collaboration between patients and doctors. But first, we have to take the trouble to inform ourselves. Demonstrating outside the convention hall just isn’t going to cut it.


    This is John Mcmanamy, "live" from the APA ...

Published On: May 21, 2007