The Corpus Callosum

This Is Depressing

Thu, 05 Nov 2009 08:35:17 -0500

The standard wisdom in management of Major Depression, is that medication plus psychotherapy is better that either treatment alone. Many studies have shown this. But this one does not.

Cognitive Behavioral Analysis System of Psychotherapy and Brief Supportive Psychotherapy for Augmentation of Antidepressant Nonresponse in Chronic Depression
The REVAMP Trial

James H. Kocsis, MD; Alan J. Gelenberg, MD; Barbara O. Rothbaum, PhD; Daniel N. Klein, PhD; Madhukar H. Trivedi, MD; Rachel Manber, PhD; Martin B. Keller, MD; Andrew C. Leon, PhD; Steven R. Wisniewski, PhD; Bruce A. Arnow, PhD; John C. Markowitz, MD; Michael E. Thase, MD; for the REVAMP Investigators

Arch Gen Psychiatry. 2009;66(11):1178-1188.

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Scam Targets Physician Offices

Mon, 02 Nov 2009 09:10:41 -0500

A reader sent me a link about a scam that targets MD offices. It is a retread of a scam that I wrote about in 2004, wherein I mention that I was targeted for this scam. The new version of the scam was noted first in Slate: The GOP's Fake Doctor Council. Then Political Animal picked it up: Old DeLay Scam Makes A Comeback. Later, Free Range Talk wrote about it, summarizing the two earlier posts as well. So if you only want to read one, read this one:

Tom Delay undergoes makeover, so does his scam
by SurferKit
Posted on 21 September 2009 | 12:40 pm

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The Ghost Mall

Sat, 31 Oct 2009 07:45:07 -0500

The world's largest shopping mall boasts some impressive statistics: 7.1 million square feet (659,612 square meters) of leasable space and 890,000 square meters of total floor space; attractions, including a roller coaster and a Venice-like canal; and over 1,500 shops, with an occupancy rate of 0.8%. That's right. Although it opened in 2005, 99.2% of the shops are empty.

Attraction: A bored attendant makes a phone call next to the ghost train ride at the mall
(Photo: Daily Mail, UK)

From Wikipedia:

Since its opening in 2005, it has suffered from a severe lack of occupants. Much of the retail space remained empty in 2008, with 99.2 percent of the stores vacant...The only occupied areas are near the entrance where several Western fast food chains are located and a parking structure repurposed as a kart racing track. The planned Shangri-La Hotel has not been constructed...

The New South China Mall was featured on the PBS show, POV: Utopia, Part 3: The World's Largest Shopping Mall...

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Windows Launch Party Photo

Fri, 30 Oct 2009 09:32:50 -0500

It's not photoshopped, and it really was for the Windows 7 launch.

The picture was taken in Sietes, Spain, which had been decorated for an advertisement for the event. In point of fact, the people of Sietes are not a particularly good customer base:

The tiny village of Sietes Spain will be the new location for an advertisement from Microsoft about Windows 7, which is slightly ironic given the software giant has chosen a place that only has one internet connection, which is about as fast as a slug.

The town of Sietes has only 40 citizens and out of those 40, most of the people who live there do not know how to use a computer, which makes it perfect for the company, which in the past advertised Vista as so easy to use that people with little computer knowledge could figure it out.

The staff of Microsoft arrived in the city with 50 computers and taught them how to use the Windows 7 software while filming the advertisement, which will hit airwaves on Oct. 22nd.

Perhaps most of you have seen the advertisement already. I have not, so I was amused.

The photo, by the way, was a Reuters Editor's Choice, for 20 October 2009.

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Making Fun of Scientology

Thu, 29 Oct 2009 08:49:15 -0500

In general, I try to be respectful of cultural groups, even ones that are rather aberrant. Somehow, though, I find it exceedingly difficult to muster any sympathy or respect for Scientology.

By now, you probably have heard that Scientologists were fined $600,00 Euros in France:

Scientologists convicted of fraud in France

...The Paris case followed a complaint by two women, one of whom says she was manipulated into handing over 20,000 euros in 1998 for Scientology products including an "electrometer" to measure mental energy...

(link HT: Fundamentally Wrong)

The LA Times has an extensive writeup of the Paris conviction. For some reason, coverage of Scientology is a big deal in LA.

Meanwhile, back at Scienceblogs, scientists are all going to wonder, what is an "electrometer?" It is difficult for nonbelievers to learn of such things. But it turns out that there is not only an explanation, but an actual photograph, somewhere on the Internet. Not only that, but the photograph shows none other than L. Ron Hubbard himself. With a sort-of smile. Looking not unlike John Travolta, without the makeup.

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Sexual Orientation Change Efforts Fruitless

Mon, 26 Oct 2009 09:08:39 -0500

In 2007, the American Psychological Association commissioned their Task Force on Appropriate Therapeutic Responses to Sexual Orientation. The background is this: early in the history of mental health treatment efforts, homosexuality was considered to be an illness. Therefore, it was thought to be appropriate for therapists to try to change the sexual orientation of persons who are homosexual.

This attitude never was universal; it is said that even Sigmund Freud was skeptical of it. Even so, it was not until 1962 that efforts began to remove homosexuality from the DSM. It was decided, in 1973, to remove the diagnosis from the subsequent edition. The American Psychiatric Association issued a statement at that time, in support of civil rights protection for homosexual persons. The American Psychological Association followed suit in 1974. In 1991, the American Psychoanalytic Association finally saw the light. In 1992, homosexuality was removed from the World Health Organization's International Classification of Diseases.

Even so, a small number of licensed mental health practitioners continued their efforts to pathologize and "treat" homosexuality.

The American Psychological Association's Task Force on Appropriate Therapeutic Responses to Sexual Orientation set out to research this matter and issue a definitive proclamation. This is described:

Sexual "Conversion"? American Psychological Association Says Not Through Psychotherapy
October 10, 2009
Psychiatric Times. Vol. 26 No. 10
Natalie Timoshin

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Yet Another Annoying Cartoon

Sun, 25 Oct 2009 23:34:15 -0500

We used to see a lot of cartoons that portray a psychiatrist's couch. That is not so common anymore. When we do see them, they tend to be annoying. This is no different, because it is so unrealistic.

No psychiatrist would put the couch under the window like that. It would defeat the purpose of the couch.

(HT: Economic Populist)

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Veolia Environnement Wildlife Photos

Thu, 22 Oct 2009 23:25:34 -0500

The Veolia Environnement Wildlife Photography competition winners have been announced. (The spelling, Environnement, is correct; it's a French company.) The competition is operated by the Natural History Museum (London) and BBC Wildlife Magazine, sponsored by Veolia Environmental Services.

The overall winner is this one (click to enlarge)

My favorite is one of the Highly Commended photos in the 10-years-and-under age category:

The photo of the leaping wolf was written up on the BBC news website:

Jose Luis Rodriguez captured the imaginations of the judges with a picture that he had planned for years, and even sketched out on a piece of paper.

"I wanted to capture a photo in which you would see a wolf in an act of hunting - or predation - but without blood," he told BBC News. "I didn't want a cruel image."

With a great deal of patience and careful observation of the wolves' movements, he succeeded in taking the award-winning photograph.

Mr Rodriguez used a custom-built infrared trap to snap the wolf as it leapt into the air.

The entire collection, comprising 17 categories, is at the Natural History Museum website. What is most remarkable to me, is how many good photographs are taken by young people.

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Gang Mentality

Wed, 21 Oct 2009 07:28:51 -0500

I spend a lot of time working with gang kids.

One of the amusing things, is to see some of these kids strutting around, feeling like a million bucks, because they are so smart. In actuality, they have IQs in the 90-100 range. But the rest of their crew is down in the 70-80 range. Such is the life of a genius.

Tonight I watched the PBS Frontline special, The Warning. It's about the warning that Brooksley Born gave the the US government about the hazards posed by the under-the-counter derivatives market. Born tried to institute regulation, as the chairperson of the Commodity Futures Trading Commission during the Clinton administration. She was totally shut down and pushed out, not only by the Administration, but by Congress as well.

The program featured everyone's favorite homies: Alan Greenspan, Robert Rubin, Larry Summers, Timothy Geithner, and the majestic Phil Gramm. Among others. Many others.

By the way, the word homies is derived from the French hommes, meaning men. No disrespect intended.

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Gorilla in a CAT Scanner

Mon, 19 Oct 2009 07:55:04 -0500

Sometimes I think I have difficult patients. Then I saw this:

Yes, it is a gorilla in a CT scanner. The poor animal had mastoiditis; the scan was used prior to surgery. The surgery was successful. See The Big Picture at the Boston Globe for the original, from a series on World Animal Day 2009.

(HT: Reddit user Micah)

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K Street Remains the Fourth Branch of Government

Fri, 16 Oct 2009 07:47:43 -0500

Just goes to show how lobbying reform hasn't gone anywhere near far enough:

Bank Lobbyists Are Not Only Trying to Kill NEW Legislation, They Are Trying to Weaken EXISTING Regulations

By George Washington of Washington's Blog.
Everyone knows that the lobbyists for the financial giants are trying to kill any tough new regulations.

But they are also trying to weaken existing regulations.

Specifically, Robert Borosage notes:

The [derivatives] bill that the House will consider on Wednesday creates a clearinghouse, not a publicly managed exchange. It also allows banks to decide that a deal is so unique that it needn't be posted on the clearinghouse. The best experts in the field -- like Michael Greenberger of the University of Maryland -- warn that the legislation might end up WEAKENING current law. That is no small achievement, because, as we saw in the collapse of AIG, current law is toothless...

This version appeared on Naked Capitalism. The full post has all the sausage-y details, including a mention of the Democratic congressperson who is leading the charge to weaken financial oversight, who happens to have gotten more than two million dollars from the finance, insurance, and real estate (FIRE) businesses and coalitions.

Barry Ritholtz (The Big Picture) has more, just in case you're feeling the need for another kick in the head: Why Financial Reform Died: "Banks Run Congress. A groovy interactive graphic, showing the same thing in greater detail, is at WSJ.

Open Secrets tallies the FIRE lobbying expenditures and calculates the return on the investment: 258,449 percent.

And to illustrate a perverse oddity: Simon Johnson (Baseline Scenario) shows how the US Chamber of Commerce is lobbying against the interest of its own membership: The Chamber of Commerce Has It Backwards.

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Giant Mucus Blobs Increasing

Tue, 13 Oct 2009 07:26:01 -0500

National Geographic reports on a new consequence of global climate change: giant, mucus-like sea blobs. They've been around for a while, actually, but now there are more of them.

This is from the on-line article, Giant, Mucus-Like Sea Blobs on the Rise, Pose Danger. The danger comes from the fact that these blobs harbor bacteria:

The study team discovered that the blobs are hot spots for viruses and bacteria, including the deadly E. coli. Coastal communities regularly test for E. coli, and its presence is enough to close beaches to swimming.

Study leader Donavaro said, "Now we see that ... the release of pathogens from the mucilage can be potentially problematic" for human health.

They start out as little flecks known as "marine snow." They accumulate bits of dead organic matter, and some tiny living things. Because they are more common in warmer water, the increase is being attributed to global climate change.

Anyone want to place a bet on how long it takes for us to see an American Petroleum Institute public relations campaign: "Giant Mucus Blobs are Good for You." ?

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General Fatigue of the Insane?

Mon, 12 Oct 2009 09:04:11 -0500

This is about chronic fatigue syndrome and the association with XMRV. I apologize in advance for the provocative title, and the subsequent gratuitous references to the Nobel Prize, but there is a point to this.

Take a look at this summary of the "old-fashioned disease":

During the nineteenth century general paresis of the insane emerged as a new psychiatric disorder which was extremely common and completely devastating. While retrospective studies have found earlier instances of what may have been the same disorder, the first clearly identified examples of paresis among the insane were described in Paris after the Napoleonic Wars. Initially regarded as a complication of insanity by such influential psychiatrists as Jean-Etienne Dominique Esquirol, general paresis was first described as a distinct disease in 1822 by Antoine Laurent Jesse Bayle.

It is now known to be a late stage of the disease of syphilis...

General Paresis of the Insane was once the most common diagnosis in psychiatric hospitals. (Or so I recall, but can't quickly locate a reference.)

Julius Wagner-Jauregg was granted a Nobel Prize for developing a treatment for General Paresis of the Insane, now known as neurosyphilis. He was one of only two psychiatrists to have been a Nobel laureate. [The other was Eric R. Kandel. (Egas Moniz, who developed the prefrontal lobotomy, doesn't count; he was a neurologist.)]

In the history of medicine, it was an eye-opening moment: an illness that had been thought to be psychogenic, turned out to be the result of an infection.

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Neurologists Say Enhancement Is Ethically Proper

Mon, 12 Oct 2009 00:41:10 -0500

The topic of neural enhancement has created controversy. This came to wide attention in late 2007, upon the publication of various articles in Nature, as noted by Shelley Batts, Janet Stemwedel, David Dobbs, Daniel MacArthur, Scicurious and others. But so far as I know, no esteemed medical organization has taken a position on the subject. Until now.

New Guidance Document Takes on the Ethics of "Neuroenhancement"
Medscape Medical News
Susan Jeffrey

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Are Randomized Controlled Trials Relevant?

Fri, 09 Oct 2009 08:52:07 -0500

This is from an open-access article in the Canadian Journal of Psychiatry: an article featuring a debate about the relevance of randomized, controlled trials to clinical practice. It is mostly about research on psychotherapy, but with some treatment of psychopharmacology.

Are Randomized Controlled Trials Relevant to Clinical Practice?
Can J Psychiatry. 2009;54(9):637-643.
Steven D Hollon, Bruce E Wampold

There is no abstract. Click on the title to go to the journal page, then click on the title there to download the PDF.

I'm not going to summarize the article. It is short and concise enough that there is little point in that. Rather, I will present a couple of points that I consider to be interesting.

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