DOCSLIB.ORG

The Transient Truths of Medical ‘Progress’

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Transient Truths of Medical ‘Progress’ From the Editor The transient truths of medical ‘progress’ There is a widespread notion that • malaria therapy (1917) for gen- today’s medical practices and ad- eral paresis of the insane (the condi- vances—including in psychiatry— tion was later recognized as tertiary syphilis) are superior to the tools and ther- • deep sleep therapy (1920) for apies of the past, yet a second schizophrenia Henry A. Nasrallah, MD • insulin shock therapy (1933), also look at the facts will temper that Editor-in-Chief perception. for schizophrenia. Those discredited therapies were I might have a jaundiced view of prog- lauded as significant advances, only ress but, across most medical special- to be shunned later as harmful, even ties, diseases are still managed, not cured. barbaric. Chronicity is almost ubiquitous among Treating addiction is another saga It isn’t uncommon for medical ailments, and no specialty can of false steps. Fifty-nine different treat- the medical community boast that it restores function com- ments for addiction have been intro- pletely and fully restores patients’ qual- duced over the past few decades, many to reverse or to ity of life. later discredited as “psychoquackery.”2 discredit, after many In the breathless rush to cure desperate Psychiatry has had its share conditions, there often is the risk that years, what turn out to of missteps pseudoscience will masquerade as sci- be useless or harmful Prefrontal lobotomy is perhaps the ence. Many patients suffer needlessly treatments most infamous of many discredited before the medical community exam- treatments that were introduced as a ines the accumulated evidence and dis- great solution to severe brain disor- credits useless or harmful treatments. ders such as schizophrenia.1 Prefrontal lobotomy (leucotomy) was initially Psychiatry isn’t alone in heralded as a major medical advance lacking cures in 1935; its originator, neurosurgeon A fitting slogan of many non-psychiatric António Egas Moniz, shared the Nobel medical specialties is “to treat, perchance Prize in Medicine or Physiology in to cure.” Consider some examples: 1949 for what is now regarded as may- • In cardiology, congestive heart fail- hem. Prefrontal lobotomy was widely ure, a chronic illness, is managed but used for many conditions—not just for rarely cured, and leads to early mortality. To comment on this editorial psychosis—but it fell from favor • Nephrologists struggle to maintain or other topics of interest, rapidly after the discovery of anti- a semblance of kidney function in renal visit www.facebook.com/ psychotic drugs. failure patients, before placing them CurrentPsychiatry, or go to CurrentPsychiatry.com and click on A similar fate befell other treatments on the long waiting list for a kidney the “Send Letters” link. that were introduced to psychiatry: transplant. continued Current Psychiatry Vol. 13, No. 6 23 From the Editor Editorial Staff • Gastroenterologists can only hope Desperation often drives EDITOR John Baranowski to maintain liver function in severe hep- dubious innovation MANAGING EDITOR Erica Vonderheid atitis, or to alleviate the misery of ulcer- Theree ar numerous “desperate” dis- Patrice Kubik ASSOCIATE EDITOR ative colitis. eases across all medical specialties, Art & Production Staff • Rheumatologists do what they can including psychiatry. Radical and harm- CREATIVE DIRECTOR Mary Ellen Niatas to relieve the debilitating symptoms of ful measures are sometimes proposed Pat Fopma ART DIRECTOR rheumatoid arthritis, systemic lupus and marketed to treat many of those DIRECTOR, JOURNAL MANUFACTURING Michael Wendt erythematosus, and Sjögren’s syndrome. conditions; more often, useless, ineffec- PRODUCTION MANAGER Donna Pituras • Pulmonologists know they can tive, futile “treatments” are introduced, Publishing Staff never restore normal lung function for and it might take years before they are 6,7 PUBLISHER Sharon J. Spector their patients with chronic obstructive discredited and withdrawn. Useless MARKETPLACE ACCOUNT MANAGER pulmonary disease; they can only help treatments can be harmful, too, because Linda Wilson them hang on with partial function. they delay the use of potentially effective Amy Park DIRECTOR OF NEW MEDIA • Oncologists valiantly fight aggres- procedures. CONFERENCE MARKETING MANAGER Kathy Wenzler sive cancers with the hope of prolonging life for a few months or years. Move forward with caution! Editor-in-Chief Emeritus James Randolph Hillard, MD • Neurologists valiantly try to manage What does this brief look at the missteps multiple sclerosis, Parkinson’s disease, of medicine tell us? First, medical prog- Frontline Medical Communications Alzheimer’s disease, epilepsy, stroke, ress is like the mambo: We take steps CHAIRMAN Stephen Stoneburn EVP DIGITAL BUSINESS DEVELOPMENT/CFO myasthenia gravis, and amyotrophic lat- forward but then step backward again; Douglas E. Grose eral sclerosis—often with limited, if any, and, as Karl Popper noted, science learns PRESIDENT/CEO, CLINICAL CONTENT DIVISION success at achieving remission. more from its failures than from its suc- Marcy Holeton Internal medicine has had its share cesses.8 Second, all physicians must be PRESIDENT/CEO, MEDICAL NEWS DIVISION Alan J. Imhoff of discredited therapies, too—ones that judicious and guided by evidence when PRESIDENT, CUSTOM SOLUTIONS were withdrawn because they caused they select treatments. JoAnn Wahl harm or were of dubious or inconclu- For your patients’ sake, choose wisely!9 EXECUTIVE DIRECTOR, OPERATIONS 3 Jim Chicca sive efficacy. Thanks to careful analy- VP, MARKETING & CUSTOMER ADVOCACY sis of the efficacy and safety of medical Jim McDonough procedures introduced during the past VICE PRESIDENT, CUSTOM PROGRAMS Henry A. Nasrallah, MD Carol J. Nathan decade, we know that 40% of 146 pro- VICE PRESIDENT, MULTICHANNEL CUSTOM cedures examined were eventually dis- Editor-In-Chief SOLUTIONS Margo Ullmann credited and withdrawn. (That kind CORPORATE DIRECTOR, RESEARCH of analysis should be undertaken in References & COMMUNICATIONS Lori Raskin 1. Valenstein ES. Great and desperate cures: The rise and psychotherapy, where evidence-based decline of psychosurgery and other radical treatments CORPORATE CIRCULATION DIRECTOR for mental illness. New York, NY: Basic Books; 1986. Donna Sickles therapies can be counted on one hand 2. Norcross JC, Koocher GP, Fala NC, et al. What does not Subscription Services: (800) 480-4851 but dozens more are promoted as legiti- work? Expert consensus on discredited treatments in the addictions. J Addic Med. 2010;4(3):174-180. In affiliation with Global Academy mate.4 Psychotherapy can be harmful.5) for Medical Education, LLC. 3. Prasad V, Vandross A, Toomey C, et al. A decade As with patients in psychiatry, of reversal: an analysis of 146 contradicted medical VICE PRESIDENT, MEDICAL EDUCATION practices. Mayo Clin Proc. 2013;88(8):790-798. & CONFERENCES Sylvia H. Reitman, MBA patients of all these specialties are at 4. Corsini RJ. Handbook of innovative therapy. VICE PRESIDENT, EVENTS David J. Small, MBA risk of suffering disruptive iatrogenic Philadelphia, PA: John Wiley & Sons, Inc; 2001. 5. Berk M, Parker G. The elephant on the couch: side- side effects that, at times, approach effects of psychotherapy. Austr N Z J Psychiatry. torture—just to have progression of 2009;43(9):787-794. 6. Iaonnidis JP. Contradicted and initially stronger effects 7 Century Drive, Suite 302 disease halted but not necessarily to in highly cited clinical research. JAMA. 2005;294(2): Parsippany, NJ 07054 deliver full remission. The quality of life 218-228. Tel: (973) 206-3434 7. Elshang AG, Watt AM, Mundy L, et al. Over 150 Fax: (973) 206-9378 for patients who have a chronic disease potentially low-value health care practices: an www.qhc.com ranges from barely tolerable to poor, but Australian study. Med J Aust. 2012;197(10):556-560. 8. Popper K. The logic of scientific discovery. London, is rarely good or optimal—and that is United Kingdom: Hutchinson & Co.; 1959. Published through an the case across all of medicine, includ- 9. Cassel CK, Guest JA. Choosing wisely: helping educational partnership physicians and patients make smart decision about with Saint Louis University ing psychiatry. their care. JAMA. 2012;307(17):1801-1802. Current Psychiatry 24 June 2014.
Load more

Recommended publications
  • Electro-Convulsive Therapy, History, and the Politics of Museum Display
    A Tale of Two Objects: Electro-Convulsive Therapy, History, and the Politics of Museum Display James Bradley This essay offers a biography of two Electro-Convulsive Therapy (ECT) machines: the Bini-Cerletti machine used for the very first shock treatments and now housed in the History of Medicine Museum, Rome; and a machine from Adelaide based upon H.M. Birch’s original design and used to give the first shock treatments in Australia. In discussing these objects, I take a number of steps. Firstly, a short history of ECT introduces the major debates around the therapy and its history. Secondly, the machines are positioned within this history. Thirdly, the machines’ function within the galleries is discussed. Finally, I ask how these objects might be presented in a way that better reflects their history and the history of psychiatry more generally. Keywords: electro-convulsive therapy, material culture, museums and display, history of psychiatry, technology and innovation Objects and their Lives The subjects of this essay are two early Electro-Convulsive Therapy (ECT) machines that are now museum exhibits. In particular, it presents the machines as objects of material culture, revealing significant contours of the cultural domains of psychiatry and museums. It is, therefore, about the people to which these machines were connected, figuratively and literally, and the work that they did as therapeutic devices and now do as exhibits in museums. In effect, it presents a biography of the two objects. The first of the machines is the original. Designed and built by Ugo Cerletti’s team (notably Lucio Bini), it is now exhibited in the Museo di Storia della Medicina (History of Medicine Museum) at Sapienza, Rome.
    [Show full text]
  • Workbook Psychiatry and Narcology
    Kharkiv National Medical University Department of Psychiatry, Narcology and Medical Psychology WORKBOOK MANUAL FOR INDIVIDUAL WORK FOR MEDICAL STUDENTS PSYCHIATRY AND NARCOLOGY (Part 2) Student ___________________________________________________________ Faculty _________________________________________________________ Course _________________ Group _____________________________________ Kharkiv 2019 Затверджено вченою радою ХНМУ Протокол №5 від 23.05.2019 р. Psychiatry (Part 2) : workbook manual for individual work of students / I. Strelnikova, G. Samardacova, К. Zelenska – Kharkiv, 2019. – 103 p. Копіювання для розповсюдження в будь-якому вигляді частин або повністю можливо тільки з дозволу авторів навчального посібника. CLASS 7. NEUROTIC DISORDERS. CLINICAL FORMS. TREATMENT AND REHABILITATION. POSTTRAUMATIC STRESS DISORDER. TREATMENT AND REHABILITATION. Psychogenic diseases are a large and clinically varied group of diseases resulting from an effect of acute or long-term psychic traumas, which manifest themselves by both mental and somatoneurological disorders and, as a rule, are reversible. Psychogenic diseases are caused by a psychic trauma, i.e. some events which affect significant aspects of existence of the human being and result in deep psychological feelings. These may be subjectively significant events, i.e. those which are pathogenic for the majority of people. Besides, the psyche may be traumatized by conventionally pathogenic events, which cause feelings in an individual because of his peculiar hierarchy of values. Unfavorable psychogenic effects on the human being cause stress in him, i.e. a nonspecific reaction at the physiological, psychological and behavioural levels. Stress may exert some positive, mobilizing influence, but may result in disorganization of the organism activity. The stress, which exerts a negative influence and causes various disturbances and even diseases, is termed distress. Classification of neurotic disorders I.
    [Show full text]
  • The Electroshock Quotationary®
    The Electroshock Quotationary® Leonard Roy Frank, Editor Publication date: June 2006 Copyright © 2006 by Leonard Roy Frank. All Rights Reserved. Dedicated to everyone committed to ending the use of electroshock everywhere and forever The Campaign for the Abolition of Electroshock in Texas (CAEST) was founded in Austin during the summer of 2005. The Electroshock Quotationary (ECTQ) was created to support the organization’s opposition to electroshock by informing the public, through CAEST’s website, about the nature of electroshock, its history, why and how it’s used, its effects on people, and the efforts to promote and stop its use. The editor plans to regularly update ECTQ with suitable materials when he finds them or when they are brought to his attention. In this regard he invites readers to submit original and/or published materials for consideration (e-mail address: [email protected]). CONTENTS Acknowledgements Introduction: The Essentials (7 pages) Text: Chronologically Arranged Quotations (146 pages) About the Editor ACKNOWLEDGEMENTS For their many kindnesses, contributions and suggestions to The Electroshock Quotationary, I am most grateful to Linda Andre, Ronald Bassman, Margo Bouer, John Breeding, Doug Cameron, Ted Chabasinski, Lee Coleman, Alan Davisson, Dorothy Washburn Dundas, Sherry Everett, John Friedberg, Janet Gotkin, Ben Hansen, Wade Hudson, Juli Lawrence, Peter Lehmann, Diann’a Loper, Rosalie Maggio, Jeffrey Moussaieff Masson, Carla McKague, Jim Moore, Bob Morgan, David Oaks, Una Parker, Marc Rufer, Sherri Schultz, Eileen Walkenstein, Ann Weinstock, Don Weitz, and Rich Winkel. INTRODUCTION: THE ESSENTIALS I. THE CONTROVERSY Electroshock (also known as shock therapy, electroconvulsive treatment, convulsive therapy, ECT, EST, and ECS) is a psychiatric procedure involving the induction of a grand mal seizure, or convulsion, by passing electricity through the brain.
    [Show full text]
  • History of Psychopharmacology: from Functional Restitution to Functional Enhancement Jean-Gaël Barbara
    History of Psychopharmacology: From Functional Restitution to Functional Enhancement Jean-Gaël Barbara To cite this version: Jean-Gaël Barbara. History of Psychopharmacology: From Functional Restitution to Functional Enhancement. Handbook of Neuroethics, 2014. halshs-03090884 HAL Id: halshs-03090884 https://halshs.archives-ouvertes.fr/halshs-03090884 Submitted on 11 Jan 2021 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. HISTORY OF PSYCHOPHARMACOLOGY – FROM FUNCTIONAL RESTITUTION TO FUNCTIONAL ENHANCEMENT Version auteur : J.G. Barbara, 2014. « History of Psychopharmacology: From Functional Restitution to Functional Enhancemen», in Handbook of Neuroethics, Jens Clausen and Neil Levy éds., Dordrecht, Springer, 2014, ISBN 978-94-007-4706-7, p. 489-504. Jean-Gaël Barbara Université Pierre et Marie Curie, CNRS UMR 7102 Université Paris Diderot, CNRS UMR 7219 [email protected] TABLE OF CONTENTS CHAPTER TITLE ABSTRACT 1.0 INTRODUCTION 2.0 FROM ANTIQUITY TO THE 18TH C. 3.0 THE CONCEPT OF PSYCHOPHARMACOLOGY (19TH C.) 3.1 THE RATIONAL REFUSAL OF DRUGS 3.2 NOVEL AND OFTEN NAIVE RATIONALISMS 3.3 NEW DRUGS AND NEW CLINICAL TRIALS 4.0 EXPERIMENTS AND NEWLY SYNTHETIZED DRUGS AT THE TURN OF THE 20TH C.
    [Show full text]
  • Witness Statement of Professor David Leon Copolov Ao
    WIT.0001.0184.0001 Royal Commission into Victoria's Mental Health System WITNESS STATEMENT OF PROFESSOR DAVID LEON COPOLOV AO I, David Leon Copolov, Professor of Psychiatry, Monash University and Pro-Vice-Chancellor, Major Campuses and Student Engagement, of Monash University, Wellington Road, Clayton, Victoria 3800, say as follows: I make this statement in my private professional capacity as a psychiatrist, academic and former researcher, the long-standing Executive Director of the Mental Health Research Institute of Victoria (from 1985-2004) and my previous governance experience as a Director of the Board of the Royal Women’s Hospital (my term having ended on 30 June 2020) and on the Board of the Peter MacCallum Cancer Centre, with six years (2007- 2013) as Deputy Chairman of that Board and five years (2005-2010) as Chair of the Research Committee of that Board. My experience, since 2009, in Senior Management at Monash University, Australia’s largest university, has also guided my views and recommendations about ‘big system’ reform in the area of mental health. My opinions are not to be interpreted as being provided on behalf of Monash University, the University of Melbourne or any other institution or organisation that I am or have been associated with. 2 As detailed below, I do not have experience on the frontline of the public mental health system. However, I have had extensive peer contact with colleagues in the public mental health system, and am an ardent (but unappointed) advocate for those who are served by and who work in that system. I am also an aggregator of information from people associated with and documentary sources relating to the Victorian public mental health sector.
    [Show full text]
  • Ect-Reviewgroup.Pdf
    A review of the literature, the Acts of Parliament and relevant current practices on regulation of the use of ECT in New Zealand and in other like nations Prepared for the ECT Review Group by Jeanne Snelling LLB(Hons) RCompN 2004 1 TABLE OF CONTENTS EXECUTIVE SUMMARY........................................................................................................................ 3 1 REVIEW METHODOLOGY ....................................................................................................... 13 Part I 2 MEANS BY WHICH ECT MAY BE PROVIDED IN NEW ZEALAND................................ 14 3 ELECTIVE / VOLUNTARY ECT – REQUIREMENTS OF A LEGALLY VALID CONSENT....................................................................................................................................... 15 4 ECT WITHOUT CONSENT – THE DOCTRINE OF NECESSITY ...................................... 27 5 ECT WITHOUT CONSENT – THE PARENS PATRIAE POWER ..................................... 31 6 ECT WITHOUT CONSENT - THE PROTECTION OF PERSONAL AND PROPERTY RIGHTS ACT 1988................................................................................................... 32 7 ECT WITH OR WITHOUT CONSENT – THE MENTAL HEALTH (COMPULSORY ASSESSMENT AND TREATMENT) ACT 1992....................................................................... 36 Part II Legislative Frameworks 8 ENGLAND....................................................................................................................................... 48 9 SCOTLAND ...................................................................................................................................
    [Show full text]
  • The Twentieth Century Revolutions in Psychiatry, Law and Public Mental Health
    Cleveland State University EngagedScholarship@CSU Law Faculty Articles and Essays Faculty Scholarship 2003 Looking Backward: The Twentieth Century Revolutions in Psychiatry, Law and Public Mental Health Sheldon Gelman Cleveland State University, [email protected] Follow this and additional works at: https://engagedscholarship.csuohio.edu/fac_articles Part of the Health Law and Policy Commons, and the Law and Psychology Commons How does access to this work benefit ou?y Let us know! Original Citation Sheldon Gelman, Looking Backward: The Twentieth Century Revolutions in Psychiatry, Law and Public Mental Health, 29 Ohio Northern University Law Review 531 (2003) This Article is brought to you for free and open access by the Faculty Scholarship at EngagedScholarship@CSU. It has been accepted for inclusion in Law Faculty Articles and Essays by an authorized administrator of EngagedScholarship@CSU. For more information, please contact [email protected]. +(,121/,1( Citation: 29 Ohio N.U. L. Rev. 531 2002-2003 Content downloaded/printed from HeinOnline (http://heinonline.org) Fri Sep 28 09:59:20 2012 -- Your use of this HeinOnline PDF indicates your acceptance of HeinOnline's Terms and Conditions of the license agreement available at http://heinonline.org/HOL/License -- The search text of this PDF is generated from uncorrected OCR text. -- To obtain permission to use this article beyond the scope of your HeinOnline license, please use: https://www.copyright.com/ccc/basicSearch.do? &operation=go&searchType=0 &lastSearch=simple&all=on&titleOrStdNo=0094-534X
    [Show full text]
  • The Soviet Doctor and the Treatment of Drug Addiction: “A Difficult and Most Ungracious Task” Alisher B Latypov1,2
    Latypov Harm Reduction Journal 2011, 8:32 http://www.harmreductionjournal.com/content/8/1/32 REVIEW Open Access The Soviet doctor and the treatment of drug addiction: “A difficult and most ungracious task” Alisher B Latypov1,2 Abstract This paper reviews the development of early Soviet drug treatment approaches by focusing on the struggle for disciplinary power between leading social and mental hygienists and clinical psychiatrists as a defining moment for Soviet drug treatment speciality that became known as “narcology.” From this vantage point, I engage in the examination of the rise and fall of various treatment methods and conceptualizations of addiction in Russian metropolitan centres and look at how they were imported (or not) to other Soviet republics. As clinical psychiatrists appeared as undisputed victors from the battle with social and mental hygienists, the entire narcological arsenal was subdued in order to serve the needs of mainstream psychiatry. However, what that ‘mainstream’ would be, was not entirely clear. When, in 1934, Aleksandr Rapoport insisted on the need for re- working narcological knowledge in line with the Marxist approach, he could only raise questions and recognise that there were almost no “dialectically illuminated scientific data” to address these questions. The maintenance treatment of opiate users, which emerged as the most effective one based on the results of a six-year study published in 1936, was definitely not attuned to the political and ideological environment of the late 1930s. Maintenance was rather considered as a temporary solution, in the absence of radical therapeutic measures to free Soviet society from “narkomania.” As the Great Terror swept across the Soviet Union, Stalin’s regime achieved its objective of eliminating drug addiction from the surface of public life by driving opiate users deep underground and incarcerating many of them in prisons and the Gulag camps.
    [Show full text]
  • The Adventures of an Alienist
    POWER OF ONE The adventures of an alienist John H T Ellard have had a long and interesting life. I have been doubly solution was to prove that one was a “real” doctor by acquiring the fortunate in that most of the rewarding activities came into Membership of the Royal Australasian College of Physicians. For I my life not through my own endeavours but by being that reason, many psychiatrists in my generation have the hard- presented to me, often quite unexpectedly. won FRACP after their names. My first choice of a career came from seeking vocational guidance while in secondary school. I was advised to become a The immediate postwar years psychologist. Having no other aspirations, I set off in that direction and, in due course, gained admission to the Faculty of Looking back now, it is interesting to reflect on the medical world Arts at the University of Sydney, hoping to gain an honours degree in New South Wales 60 years ago. There was one university — the in psychology. All went well until my second year — in 1942. By University of Sydney — and its Faculty of Medicine had one then, theThe Second Medical World Journal War ofhad Australia become ISSN: pressing, 0025-729X and I found4/ Professor of Medicine, one Professor of Surgery and one (part- myself being18 December interviewed 2006 by 185 an 11/12army 642-645recruitment officer. He told time) Professor of Psychiatry. Consider their numbers now! me that, ©Thewith my Medical university Journal background, of Australia if I were to2006 join the There were many roles to be filled.
    [Show full text]
  • 10. Early Psychosis: Preventive Medicine, Scientific Assault on Mystical Tendencies, Or an Extension of Social Control?
    Richard Gosden Schismatic Mind – Early Psychosis 265 10. Early Psychosis: Preventive Medicine, Scientific Assault on Mystical Tendencies, or an Extension of Social Control? Introduction In recent years psychiatric researchers have extended the definition of schizophrenia to include a pre-psychotic phase. Detection and intervention programmes have been implemented and neuroleptic medication is used as prophylactic treatment in the belief that it can prevent the development of psychosis in people who are thought to be at-risk.1 The pre-psychotic signs of schizophrenia are usually referred to as ‘early psychosis’2 or as ‘prodromal’ symptoms of schizophrenia.3 Australia has become a particularly active site for this type of research and a National Early Psychosis Project has been launched as “a collaborative endeavour between the Commonwealth, State and Territory governments of Australia to develop and promote a national model of best practice for early intervention in psychosis”.4 Promoters of the concept see pre-psychosis detection and intervention as a form of preventive medicine. Their basic argument is that if the incidence of schizophrenia can be reduced by early identification and treatment, as has been the case with prevention programmes for other diseases, then numerous community benefits will follow in the form of cost savings and in the avoidance of personal trauma and family disruption.5 However, people who are already sceptical about bio-medical approaches to schizophrenia are likely to interpret drug-based preventive medicine campaigns differently. Apart from the risks involved in the prophylactic use of neuroleptic drugs, so-called preventive medicine might be variously seen as an unnecessary expansion of social control, a threat to human diversity through the enforcement of hyper-normality, a violation of human rights, a campaign against mystical tendencies in young people, and a marketing ploy for the new generation of atypical neuroleptic drugs.
    [Show full text]
  • A Qualitative Investigation of the Transition Into Long-Standing
    Broomfeld et al. J Eat Disord (2021) 9:103 https://doi.org/10.1186/s40337-021-00458-w RESEARCH ARTICLE Open Access How and why does the disease progress? A qualitative investigation of the transition into long-standing anorexia nervosa Catherine Broomfeld1* , Paul Rhodes1 and Stephen Touyz2 Abstract Objective: Despite an increased interest in understanding characteristics of long-standing anorexia nervosa (AN), there is a lack of knowledge into the processes that occur with the development and maintenance of the disease. This has impeded the development of novel treatment approaches that may prove more efective than traditional medical models of therapy. To improve the prognosis of these long-standing presentations, an understanding as to how and why the AN disease progresses is required. It was therefore the aim of the current study to investigate the transition of AN from earlier to later stages. Method: The study adopted a narrative inquiry approach and a total of 11 women with long-standing AN partici- pated in an interview. The newly developed photovoice method assisted in data collection with typologies of chronic illness facilitating the emergence of salient themes. Results: The qualitative analysis resulted in the identifcation of fve themes: (a) transition, (b) trauma, (c) functionality, (d) identity, and (e) failure of current models of treatment. Conclusions: Together with identifying key themes, the study provides insight into some possible reasons why cur- rent treatment models are failing to promote recovery. Future research examining the efectiveness of treatment that targets underlying causes and maintaining factors of the illness are suggested. Additional education for health profes- sionals is also recommended in order to reduce the trauma that is currently being experienced by some patients with a long-standing illness.
    [Show full text]
  • The “Great LSD Scandal” at Newhaven Private Hospital & the Social Foundations of Mental He
    Beyond the aetiology debate: the “great LSD scandal” at Newhaven Private Hospital & the social foundations of mental health legislation in Victoria, Australia Megan Kristine Lomax ORCID ID: 0000-0002-1457-8247 Doctor of Philosophy October 2017 Department of History & Philosophy of Science School of Historical & Philosophical Studies Faculty of Arts Thesis submitted in total fulfilment of the degree of Doctor of Philosophy 1 ABSTRACT This research presents a case for the extension of existing analyses of Australian psychiatric scandals beyond the conclusion that such events are an inherent feature of the profession by virtue of its failure to resolve the aetiology debate. A mid-century impasse in the aetiology debate – the continuous shifting over time of professional commitment between organic and environmental aetiologies of mental illness – has been identified as the catalyst for the emergence of the therapeutic paradigm of eclecticism that fostered the deep sleep therapy and ‘Therapeutic Community’ programs that were central to Australia’s two infamous psychiatric scandals at Chelmsford and Townsville, respectively. While these two affairs were enduring the scrutiny of commissions of inquiry, the recommendations of which translated to the legislative reform of mental health services in the states of New South Wales and Queensland, a third such scandal was unfolding at Newhaven Private Hospital in Victoria involving the “injudicious use” of therapeutic LSD. By the late 1980s and early 90s, a number of former “patients” of Newhaven emerged claiming that they had never suffered any mental illness and that the LSD they had received had not been administered for therapeutic purposes but rather as a recruitment tool for a fringe religious sect known as The Family that had commandeered the hospital and the loyalty of a number of its staff.
    [Show full text]