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.