Abuse and Suicide

From The New York Times

After Abuse, Changes in the Brain

This Is Your Brain in Politics

In today’s NY Times: Psychiatrists Revise the Book of Human Troubles

The American Psychiatric Association is working on the DSM-V.

Is compulsive shopping a mental problem? Do children who continually recoil from sights and sounds suffer from sensory problems — or just need extra attention? Should a fetish be considered a mental disorder, as many now are?

Panels of psychiatrists are hashing out just such questions, and their answers — to be published in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — will have consequences for insurance reimbursement, research and individuals’ psychological identity for years to come.

The American Psychiatric Association, who publishes the book, made contributors sign a non-disclosure agreement and put a $10,000 per year limit on the income they can receive from pharmaceutical companies.

Some groups want to have their cake and eat it too:

Transgender people are themselves divided about their place in the manual. Some transgender men and women want nothing to do with psychiatry and demand that the diagnosis be dropped. Others prefer that it remain, in some form, because a doctor’s written diagnosis is needed to obtain insurance coverage for treatment or surgery.

Some want to be special:

The same team is likely to make a recommendation on so-called sensory processing disorder, a vague label for a poorly understood but disabling childhood behavior. Parent groups and some researchers want recognition in the manual in order to help raise money for research and obtain insurance coverage of expensive treatments.

Others just want to make money:

Industry influence was questioned after a surge in diagnoses of bipolar disorder in young children. Once thought to affect only adults and adolescents, the disorder in children was recently promoted by psychiatrists on drug makers’ payrolls.

It is absolutely astonishing to see just how much influence politics, special-interest groups, and pharmaceutical companies have these days in medicine. I wonder how many more new diagnoses the fifth edition will have than the last.

You Think Your Meds Are Bad?

Now that my brain seems to be partly functioning, I want to share some of things I’ve come across over the past year or so.

One of the more interesting encounters was Neurophilosophy, a blog about ”molecules, minds and everything in between,” as the author puts it, in other words neuroscience, his specialty. Neurophilosopy is part of an online community of blogs focusing on issues in the sciences.

Something that really caught my attenion last year was The Rise and Fall of the Prefrontal Lobotomy. (Some of the pictures are quite disturbing.) In this article, Neurophilosophy gives a brief history of the lobotomy, from the first experiments in the 1890s to its decline in the 1960s (although according to Wikipedia, lobotomies were still being performed into the 1980s). There is also an overview of the mechanics of the procedure.

The article ultimately leads up to the 2005 National Public Radio interview of a man, Howard Dully, who had been lobotomized for his “defiant behavior” at the age of 12 by the infamous Walter Freeman, the inventor of the “ice-pick” lobotomy and the man who “supervised” James Watts’ lobotomy of Rosemary Kennedy.  When I heard the interview, I was absolutely enthralled. You can listen to this interview on NPR’s website.