Another year is over, and so brings us to the close of another year of great stories, great friends, and great insights into the world of psychology — our annual Year in Review of Mental Health.
Conflicts of Interest, Lawsuits and Transparency
Perhaps 2009 will be noted as the year of reckoning for pharmaceutical companies, who have not enjoyed good press this year. In January, we noted how Eli Lilly settled a Zyprexa lawsuit for $1.4 billion with 30 states due to its off-label marketing of the atypical antipsychotic drug for use in dementia and Alzheimer’s disease. Philip over at Furious Seasons puts the total Zyprexa tab at $2.8 billion with settlements with 39 states, with another 6 states pending. Keeping in mind that Zyprexa has had $37 billion in sales since its introduction, these lawsuits hurt Eli Lilly, but not nearly as much as you may think. But Eli Lilly appears not to be alone. Bloomberg reported earlier this month that lawsuits surrounding the antidepressant Paxil may have totaled over $1 billion during the drug’s long history. The problems with drug marketing were not limited to a single company, or a single drug, and revelations continued throughout the year.
The other thorn in pharmaceutical companies’ side had to have been the ongoing, seemingly-endless investigations by Senator Charles Grassley’s office into the links between pharma and others — notably, researchers, continuing medical education and nonprofit organizations. The problem hasn’t been the relationships themselves (although that can be a problem if not properly firewalled), but the lack of transparency into the relationships. Psychiatric researchers continue to minimize their payments from pharmaceutical companies, continuing education programs were caught basically regurgitating marketing propaganda as “education” to psychiatrists and others, and nonprofits were called-out for their failure to disclose to the public (they are public charities, after all) the sometimes-significant involvement of pharmaceutical companies in their budgets (for instance, nearly 75 percent of NAMI’s donations were said to come from various pharmaceutical companies).
But who’s really “clean” these days? As we found out, even Johns Hopkins Medicine’s name was pimped out by its publishing partner, Medizine, pushing for-profit white papers to an unsuspecting public. Johns Hopkins Medicine says “mea culpa, we didn’t know!” but it still leaves a bad taste in everyone’s mouth seeing how easily respectable names are traded and sold in this industry.
While some argued that psychology was rotten to the core, we were the first to demonstrate how the professionals who made the claim were self-serving individuals who didn’t declare their conflicts of interest ahead of time and argued from carefully selected data that didn’t jive with the reality of clinical psychology practice today. Elitism is a fine philosophy for some, but it’s not one I’d recommend for any profession, certainly not psychology.
The Institute of Medicine issued a historic report about conflicts of interest and their solutions.
Technology, Social Networking and Such
2009 will also be known as the year that Twitter took off, and so we couldn’t resist but do an entry about the psychology of Twitter (and the psychology of twitter, part 2). We could help call out the BBC’s horrid reporting on the topic of social networking supposedly showing that it “harms health.” We demonstrated how the research evidence shows that online connections actually help improve health. Connecting with others and researching your health conditions and questions online helps people with those conditions and answers their questions.
Relevant to Facebook’s recent changes to their privacy settings, we asked Do Users Understand Facebook Privacy Settings?. The research says that, by and large, they do. Although I’m sure Facebook has done their own usability testing of the new settings, prior research suggests the changes were made not for usability reasons, but for marketing ones — to put more of a user’s Facebook profile in the public arena.
Signaling perhaps the end of psychological test security, Wikipedia for years has made the Rorschach inkblot cards available, but only in July did it attract folks’ attention. You can’t protect an image forever.
Conferences and Meetings
Kicking off the conference circuit this year at the annual SXSW conference in Austin, TX, there were a number of talks that covered mental health and technology, including Dr. Keely Kolmes’ talk, Therapy 2.0: Mental Health For Geeks, and mine on social networking in health. April 25th saw the world’s first “un-conference” on mental health — Mentalhealthcamp.
At my keynote presentation at the International Conference on the Use of the Internet in Mental Health in Montreal, I noted how a single, static Internet page that’s been online for over a decade has likely saved hundreds of thousands — maybe even millions — of people’s lives. The conference was the first to bring together international researchers from around the world to present and discuss mental health internet interventions.
In October, I traveled to Amsterdam to talk and learn at the First International e-Mental Health Summit, which brought together hundreds of researchers from around the world. One of the key take-aways from the conference was this — online and mobile phone applications are effective and becoming more and more popular, in helping people with everything from depression, trauma and anxiety, to quitting-smoking and reducing alcohol consumption.
I was also honored to attend the 25th anniversary of the Rosalynn Carter Symposium on Mental Health Policy and learned a lot about the Carter Center’s Mental Health Program. This is a national program setup that helps get policy-makers, lawmakers, consumers, professionals, administrators and invested others talking when it comes to mental health care in America. It does fantastic work and I can’t say enough good things about them. We also connected with the Carter Center earlier this year and noted when they announced their 2010 fellowships for mental health journalism.
Conditions and Treatments
In March, we noted the controversy surrounding the best course of treatment for ADHD, where a researcher suggested medications should not be the first choice of treatment (behavioral interventions have greater research support and are less likely to have long-term effects on a child’s still-developing brain). A few days later, I noted the problem with child ADHD treatment when an op-ed by a pediatrician barely touches upon non-medication treatments. It’s no wonder we’re a society that expects a pill to cure everything — doctors don’t even know the best evidence treatments available, nor always share that information with their patients.
In April, we found ourselves in the midst of a surprising controversy surrounding a government educational program for postpartum depression. Reading far more into the proposed MOTHERS Act than was actually in the text of the bill, some opponents saw nightmarish images of intrusive doctors turning in non-compliant mothers. We saw only an effort to help improve people’s understanding of postpartum depression and bringing that education directly to the people who would most benefit from it — pregnant women. We called out Doug Bremner’s false claims about postpartum depression when he decided, sans ovaries, to enter into the debate.
April also saw the FDA’s call — finally — for a review of how they treat ECT equipment. Previously, no electroconvulsive therapy (ECT) equipment has needed FDA approval because it was grandfathered in. FDA’s request for comments is closing soon.
One of the very few breakthroughs in genetic research was reached this year when researchers found that some of the genetic roots of schizophrenia and bipolar disorder may be very similar. The groundbreaking studies implicated an area of Chromosome 6, which is known to include genes involved in immunity. This area also has genes that seem to control how and when genes turn on and off. This was also one of the first studies to pool data from three different research institutions, which likely made the difference in finding significant results.
A new test promises to predict antidepressant medication response in the future, perhaps helping doctors pick out the best medication for you.
Oprah had the opportunity to help portray mental illness as something commonplace and not to be afraid of. Instead, she profiled a 7 year old girl with schizophrenia because, after all, that makes for far better ratings, right?