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?
An academic controversy erupted when JAMA editors flailed around because an academic called them on the carpet about their failure to objectively peer-review a JAMA-published research article. Their handling of the situation in a very public and embarrassing manner was a clear demonstration of how journals are not some unbiased bastion of objectivity.
A Swedish study that appeared in JAMA put to rest the false conventional wisdom that people with mental illness are more likely to commit violent crimes (again).
A significant review of fMRI research demonstrated that much of the fMRI research is fundamentally flawed. Those pretty pictures of brains lighting up are compelling, but too often tell us virtually nothing of value.
New research published showed antidepressant use up 75% over the past decade, while psychotherapy use was down 35%. Guess who does more direct-to-consumer marketing, therapists or drug companies? And of course, we couldn’t help but note that not only drugs can change your brain chemistry, but psychotherapy can too!
It’s been another tough year for the military and its mental health. In May, we recounted how soldiers were ordered not to commit suicide, as though duty alone would cause someone to change their mind. This year will mark the military’s highest suicide rate ever. This year also saw the sad loss of 13 lives due to Major Nidal Hasan, the Ft. Hood Army psychiatrist who went on a killing rampage.
February saw one of our most commented-on topics of the year, Suicide: When It Hurts Too Much To Live.
February saw the launch of our first new blog of the new year by Elisha Goldstein, Mindfulness and Psychotherapy. We followed by the launch of another half dozen blogs this year (and we have more on the way!).
In June we launched our first annual mental health journalism awards to recognize outstanding mental health journalism online. Why? Because old-school organizations don’t recognize online media and we’re sick of having great online writers ignored just because they’re writing online.
June also saw the 100th anniversary of the organization formerly known as the National Mental Health Association (NMHA), Mental Health America.
Texas finally fired or suspended 286 abusive employees who cared after the vulnerable patients in their state mental hospitals. Georgia has had similar problems with its state mental health hospitals, and I’m sure those aren’t the only two states who have these sorts of problems. Philadelphia has an approach that tries to keep people with mental illness out of prisons that we’re hoping other cities and states consider.
We lost a true advocate for mental health in the death of Senator Edward M. Kennedy last year. Without his tireless efforts and support for many, many years, last year’s national mental health parity bill may have never passed.
The revision of the diagnostic bible for mental disorders lumbered along in 2009, and we noted its progress, especially when it came to its lack of transparency in its updates. It’s publication date has been pushed back another year, until 2013. A few days ago, we published some suggestions for change for the DSM-V and beyond.
In September, we noted the future publication of Carl Jung’s Red Book. While now available for purchase, your order may be delayed for months still due to the huge, unexpected demand for this book. An interesting insight written by one of psychology’s most interesting characters.
We published the prevalence of common mental disorders graph last year, because while information is knowledge, useful infographs hold even more knowledge.
The sad saga of Balloon Boy made the rounds at the end of October.
And where would our sanity be without learning that another celebrity — this time, golfer Tiger Woods — hasn’t lived up to the unrealistic expectations of his fellow humans?
5 Most Popular Blog Entries for 2009
5 Most Read News Stories for 2009
Do we see a pattern?