World of Psychology

Mental Health Year in Review: 2008

By John M Grohol PsyD
December 17, 2008

Year in Review: 2008
As another year comes to a close, it’s time to review what made the biggest news in 2008 in mental health and psychology. Of course, the biggest news of the year — the historic election of Barack Obama — is not directly related to mental health but worthy of note. His policies and appointments over the next four years are likely to make a substantial impact in funding and policies in American healthcare (and mental health care).

Highlights from Research

This was a bad year for antidepressant research. Antidepressants are a class of psychiatric medications most commonly prescribed to relieve depression, but increasingly being prescribed for practically any ailment. In January, The New England Journal of Medicine published a study that showed there was a publication bias when it comes to antidepressant medications — one where even negative outcomes were repositioned as a positive outcome. This confirmed the long-standing belief that research showing a drug’s ineffectiveness (compared with a sugar pill) rarely see the light of day. And in the rare circumstances when they do, the researchers work to skew the findings to suggest something different than what the data show. CL Psych had the commentary.

In February, another study published in PLoS Medicine further demonstrated antidepressants ineffectiveness when researchers examined the raw data first submitted to the FDA for these drugs’ approval decades ago. The lack of efficacy data, however, didn’t stop the FDA from approving the medications, and since that time, dozens of additional studies have been done that show such drugs are more effective than placebo (but not as effective as drug manufacturers initially claimed). April was no kinder, as further information became available about infamous Paxil study 329 due to legal action, a study that claimed to show Paxil’s effectiveness in the treatment of adolescents in 2001, but was actually shown to be no more effective than placebo. Furious Seasons has a good summary and links to more in-depth analysis.

Also in February, we noted why you often find yourself unable to just say “No” in the heat of the moment. And that, simply through hard work and memorization, you can change the actual structure of your brain (no chemicals needed).

In March, Wyeth’s new antidepressant Pristiq was approved for use in people with depression by the FDA. This entry on our blog quickly turned into one the most-commented upon entries of the year, as people noted the difficulties they had in coming off of Effexor XR, a drug notorious for its difficulty in discontinuing (called, naturally enough, “discontinuation syndrome”).

Genetic testing started making the headlines in 2008, despite the lack of evidence that such testing — especially for mental disorders — provides a person with any actionable information (e.g., information that you can do something with as opposed to esoteric, “Oh, isn’t that nice?” information). For instance, the genetic test for bipolar disorder marketed in March could find a gene shared by only 3% of people who have bipolar disorder. Helpful? Hardly. These kinds of tests are sources of more misinformation than anything else and you should save your money until the science catches up with people looking to make a quick buck off of people’s anxieties about their health.

In July, we wrote about Another Brain Fad for Depression?, which described how research into the science of the brain is already leading some people to draw conclusions about the causes of depression with insufficient evidence.

At the end of July, Nature published research from an international group of researchers that found people suffering from schizophrenia are far more likely to carry rare chromosomal structural changes of all types, particularly those that may alter gene function. They also discovered two new gene areas that, when altered, put people at significantly greater risk for developing schizophrenia.

September saw the complete refutation of the belief that video games cause teenagers to be more violent and antisocial, when the Pew Internet & American Life Project, supported by the John D. and Catherine T. MacArthur Foundation, released a new report showing that video games are a positive social activity for most teens. A book published earlier in the year, Grand Theft Childhood, also refutes the supposed link with findings from prior research.

Conflicts of Interest and Disclosure

2008 will likely go down as the year that many high-profile researchers will rue. In June, Harvard researchers Joseph Biederman, Timothy Wilens, and Thomas J. Spencer were dinged by the ongoing investigations of U.S. Senator Charles E. Grassley for failing to report millions of dollars to their university, as required by Harvard’s rules regarding conflicts of interest. Two researchers — Wilens and Biederman — both failed to report $1.6 million in earnings from pharma over a seven year period, or about $225,000 a year. Biederman was also listed as a co-author of a study that found St. John’s Wort (an inexpensive herbal remedy) was ineffective in the treatment of ADHD. Wouldn’t you know it? One of Biederman’s funders is a maker of ADHD medications.

Charles Nemeroff resigned in October from his position as chair of the psychiatry department at Emory University, after Sen. Grassley’s continuing investigation into pharmaceutical funding payments, improper reporting, and ethics questioned why the researcher failed to report $1.2 million in pharmaceutical payments since 2000.

Biederman again made unwanted headlines in November for his role in pushing pediatric bipolar disorder with Johnson & Johnson’s help (via its subsidiary, Janssen Pharmaceutical).

Dr. Fred Goodwin, host of a popular public radio show called The Infinite Mind, apparently failed to fully disclose all of his pharmaceutical activities to his listeners and his producer. The investigation into his undisclosed $1.3 million in payments over the past seven years began earlier in the year, when the objectivity of a program about antidepressants and suicidality was called into question by Furious Seasons and later, Slate. Our last update on Dr. Goodwin’s debacle appeared earlier this month.

Other Stories of Note

In January, we reported on how through a single phone call, a child was given forced electrical shock treatment by an ex-patient at the Judge Rotenberg Educational Center. We followed up in March with a post describing how shock treatment for children is advocated by the guy who also holds a patent for the device. The last mention of the Center in local papers was in May, when records from the center were reportedly seized as a part of an ongoing investigation.

January also saw an in-depth piece about the worth (or lack thereof) of brain training programs by NewScientist. Their conclusion? Evidence remains decidedly mixed about the usefulness of these programs, and most software programs that purport to “brain train” have little or no scientific research to back up their use. However, they concluded that conducting such brain training probably can’t hurt you, as the only thing you lose out on is your time and a few bucks if the brain exercises don’t generalize to other areas in your life. For specific mental disorders — such as schizophrenia, OCD, and depression — such programs do seem to help people improve people’s memory. And a small, 34 person study published in March suggests that a specific type of training exercise may help in improving one’s “fluid” intelligence (the ability to reason and to solve new problems independently of previously acquired knowledge).

In February, tragedy struck the Northern Illinois University campus in Dekalb, Illinois when Stephen Phillip Kazmierczak killed five students and himself and injured 20 more at the school. Campus police responded to the shooting within minutes, but could only call for ambulances; Kazmierczak was already dead upon their arrival. The media was quick to jump on the fact that Kazmierczak had previously been treated for a mental disorder, despite there being no connection between violence and mental illness.

In May, a brewing controversy about the legitimacy of the pediatric bipolar disorder diagnosis bubbled over as Newsweek published an interview about the “biology of bipolar disorder,” focused on discussing the brain and bipolar disorder. CL Psych has this commentary about the article. Pediatric bipolar disorder is not an officially recognized diagnosis at this time. But that didn’t stop the The New York Times Magazine from following up with a lengthy piece on childhood bipolar disorder in September (which barely mentions the controversy surrounding the diagnosis given to children as young as 2 years old). Furious Seasons has the commentary.

In July, we noted how Kings County (NY) Hospital let a women with mental illness die in their waiting room, while staffers looked on and did nothing to help. A few weeks later, another person with mental illness also died while in a North Carolina hospital (Cherry Hospital in Goldsboro, NC), due to staff neglect.

October saw the historic and significant passage of mental health parity act (specifically the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008) when the U.S. House passed a $700 billion bailout bill for the U.S. financial sector. The bill, for the first time in the nation’s history, ensures that health insurance will now be required to offer benefits and coverage of mental health concerns at a level equal to that of physical concerns. Insurance companies are no longer legally allowed to limit outpatient visits for psychotherapy (unless they do so already for other doctor’s visits).

October was also the month when the folks who oversee the Golden Gate Bridge finally approved a suicide barrier for the infamous bridge (in the form of a non-intrusive wire net). The bridge is the most popular landmark in the country from which to take one’s own life and advocates have been calling for some type of barrier for decades. Funding is still needed for the new net, and while we wait, another 2 people each month will end their lives on the bridge.

Online

In February, we noted the 90 Day Jane blog, a hoax website that purported to be the countdown blog for a woman who was going to kill herself after 90 days. She made it seven days, and then the publicity stunt was up, the blog removed, and everyone went on with their everyday lives. That didn’t stop a man from ending his life in November while transmitting live via a webcam. The first such suicide online apparently was conducted in 2003.

In July 2008, we launched our first new blog here at Psych Central, Bipolar Beat with Bipolar Disorder for Dummies authors Dr. Candida Fink and Joe Kraynak. Bipolar Beat has been a great success and enjoys its own following by people who have been diagnosed with bipolar disorder (or knows someone who has). In December, we followed that up with the launch of Celebrity Psychings, written by Alicia Sparks.

Lori Drew was found guilty in November for her role in the death of Megan Meier. Megan’s mom and her friends helped start a foundation in her name to try and educate and reduce online bullying (which is far more prevalent and harder to stop than real-life bullying).

Our Top 5s for 2008

Top 5 Most Commented Upon Blog Posts for 2008

Top 5 Most Read Blog Posts for 2008

Top 5 Most Read News Stories for 2008

For the top ten brain articles of 2008, please visit our friends over at NewScientist magazine.


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Links to This Article

Mental Health Year in Review: 2008 - World of Psychology | kozmom (12/18/2008)

From Psych Central's World of Psychology:
Year in Review: Your Picks | World of Psychology (11/20/2009)

8 Comments to
“Mental Health Year in Review: 2008”

While money is involved of course figures will be manipulated in favour of anti-depressants!

I agree- whenever there is money involved, you have to be somewhat skeptical. Where are they getting their information from and can we really trust it?

I think it is actually a GOOD year for anti-depressant research when some critical thinking and analysis actually goes into it.

We have known for a while now that SSRI’s simply aren’t all that effective and indeed THAT WAS NEVER THOUGHT TO BE AN ADVANTAGE OF THEM - the main advantage was that you didn’t need to go on an MAOI diet.

You never needed to go on an MAOI diet with tricyclics either, the primary antidepressant used in the U.S. before SSRIs. SSRIs in this country were indeed hailed as being more effective with less side effects than either tricyclics or MAOIs when they were first introduced and for the first 10-15 years they were marketed here.

If you’d like to provide some proof of support that this was a “good year for anti-depressant research,” I’m all ears.

I consider good research to be quality research. So… The thought was that it seems like some quality research was done this year. About time ;-)

Less side-effects. Could be wrong but I was fairly sure that that was thought to be the main virtue of SSRI’s. Anti-cyclics weren’t any more effective than MAOI’s - were they? I thought that less side effects rather than greater efficacy was basically the thing across the board for psych meds..

Quality research is done everyday in psychology and mental health. This, however, was a story about the topics that we believe had the biggest impact in the field.

Indeed, that is the marketing spin on SSRIs, as we have pointed out on this blog for years. However, “good research” shows that not to be the case after all.

Much of the research that is done in medications in particular is sponsored in full or in party by pharma. They employ some very clever research, don’t get me wrong, but clever research isn’t necessarily quality research. We have known for a while now how results are misinterpreted, math is mangled, and so on and so forth when there is something personal at stake. I guess this kind of exposure has been going on for a while. Despite this, people still don’t seem to be listening.

People seem to want depression to be just like diabetes and for it to be managed with a pill. Not sure why but people seem to think that is what is required in order for their distress to be legitimate. So… On for the search for the happy pill ( - sorry, not a pill that makes people ‘happy’ a pill that makes people ‘normal’).

All the research… And we really don’t see to be any closer to finding the genetic basis or the neurological basis for mental disorders. Gee… One might start thinking they are social / cognitive after all ;-)

I also recommend this list of leading research discoveries in 2008 by NARSAD researchers:

http://www.narsad.org/news/press/rg_2008/res2008-12-23b.html

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    Last reviewed: By John M. Grohol, Psy.D. on 17 Dec 2008

 


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