study: over-​diagnosing depression and over prescribing

drugs and earth blue

A Glut of Anti­de­pres­sants by Roni Caryn Rabin

Over the past two decades, the use of anti­de­pres­sants has sky­rock­eted. One in 10 Amer­i­cans now takes an anti­de­pres­sant med­ica­tion; among women in their 40s and 50s, the fig­ure is one in four.

Experts have offered numer­ous rea­sons. Depres­sion is com­mon, and eco­nomic strug­gles have added to our stress and anx­i­ety. Tele­vi­sion ads pro­mote anti­de­pres­sants, and insur­ance plans usu­ally cover them, even while lim­it­ing talk ther­apy. But a recent study sug­gests another expla­na­tion: that the con­di­tion is being over­diag­nosed on a remark­able scale.

The study, pub­lished in April in the jour­nal Psy­chother­apy and Psy­cho­so­mat­ics, found that nearly two-​thirds of a sam­ple of more than 5,000 patients who had been given a diag­no­sis of depres­sion within the pre­vi­ous 12 months did not meet the cri­te­ria for major depres­sive episode as described by the psy­chi­a­trists’ bible, the Diag­nos­tic and Sta­tis­ti­cal Man­ual of Men­tal Dis­or­ders (or D.S.M.).

The study is not the first to find that patients fre­quently get “false pos­i­tive” diag­noses for depres­sion. Sev­eral ear­lier review stud­ies have reported that diag­nos­tic accu­racy is low in gen­eral prac­tice offices, in large part because seri­ous depres­sion is so rare in that setting…

…The new study drew 5,639 indi­vid­u­als who had been diag­nosed with depres­sion from among a nation­ally rep­re­sen­ta­tive sam­ple of over 75,000 adults who took part in the National Sur­vey of Drug Use and Health in 2009 and 2010. The sub­jects were then inter­viewed in per­son with ques­tions based on the D.S.M.-4 criteria.

history. ancient roman. hairstyles. women.

Antinous Mandragone profil

from an arti­cle in the wall street jour­nal on pins and nee­dles: styl­ist turns ancient hairdo debate on its head

Ms. Stephens is a hairdo archaeologist.

Her ama­teur schol­ar­ship is stick­ing a pin in the long-​held assump­tions among his­to­ri­ans about the com­pli­cated, gravity-​defying styles of ancient times. Basi­cally, she has set out to prove that the ancients prob­a­bly weren’t wear­ing wigs after all.

This is my hair­dresserly grudge match with his­tor­i­cal rep­re­sen­ta­tions of hair­styles,” says Ms. Stephens, who works at Stu­dio 921 Salon & Day Spa, which offers circa 21st-​century haircuts.

Her coif­fure queries began, she says, when she was killing time in the Wal­ters Art Museum in Bal­ti­more back in 2001. A bust of the Roman empress Julia Domna caught her eye. “I thought, holy cow, that is so cool,” she says, refer­ring to the empress’s braided bun, chis­eled in stone. She won­dered how it had been built. “It was amaz­ing, like a loaf of bread sit­ting on her head,” says Ms. Stephens.

A hair­styl­ist by day, Janet Stephens has become a “hair archae­ol­o­gist” study­ing the intri­ca­cies of ancient Greek and Roman hair­styles. As WSJ’s Abi­gail Pesta reports, she’s been pub­lished in the aca­d­e­mic com­mu­nity on her research, which she says proves the intri­cate hair­styles were not wigs.

She tried to re-​create the ‘do on a man­nequin. “I couldn’t get it to hold together,” she says. Turn­ing to the his­tory books for clues, she learned that schol­ars widely believed the elab­o­rately teased, tow­er­ing and braided styles of the day were wigs.

She didn’t buy that.

history. mental health. lead. poisoning.

Shogun2Carousel

the eter­nal hour of lead by deb­o­rah blum from speakeasy sci­ence blog from plos blogs

Accord­ing to Tamiji Nakashima, an anatomist at the Uni­ver­sity of Occu­pa­tional and Envi­ron­men­tal Health in Kitakyushu, the inves­ti­ga­tors stud­ied the remains of samu­rai men, their wives and chil­dren, about 70 in total. Ear­lier tests had found unusu­ally high lev­els in the women com­pared to men; the last study looked at the chil­dren. The researchers tested for lead in rib bones, x-​rayed the chil­drens’ arm and leg bones look­ing for signs of lead poisoning.

The Japan­ese sci­en­tists had already con­cluded that the lead lev­els in women were directly related to the white face paint pop­u­lar in aris­to­cratic cir­cles, which turned out to be loaded with lead. They won­dered if expo­sure to the same mate­r­ial might have harmed the chil­dren and the new results showed them pre­cisely right; they found evi­dence of lead lev­els more than 120 times back­ground level as well as bands of lead deposits in the bones.

Nakashima and his col­leagues believe that the chil­dren were poi­soned by touch, as they were fed, hugged, car­ried by their moth­ers, the lead-​rich paint rubbed off on them. They also spec­u­late that the grad­ual lead-​poisoning – with its inevitable taint of death and dis­abil­ity – helped put an end to the shogu­nate reign in the late 19th cen­tury, set­ting up the trans­fer of power to an emperor.

mental health. recovery movement. history.


from recov­ery in reach an intro­duc­tion to the his­tory of the recov­ery movement

In 1881, researchers at Mass­a­chu­setts’ Worces­ter Asy­lum for the Insane learned about recov­ery when they sur­veyed 1,157 peo­ple who had been dis­charged dat­ing back to 1840. Of the patients who were dis­charged as “recov­ered,” 58 per­cent remained well for the remain­der of their lives. The idea of recov­ery in the United States is also closely con­nected to the recov­ery move­ment in the sub­stance abuse field, par­tic­u­larly with Alco­holics Anony­mous, which began in the 1930s as a fel­low­ship of peo­ple focused on sobriety.

The nor­mal process of recov­ery was often stilted in the United States through­out the 1940s and 1950s as state hos­pi­tals sought more to con­fine patients than to help them recover. Even through­out the years of dein­sti­tu­tion­al­iza­tion that began in the 1970s, peo­ple with men­tal health dis­or­ders were fre­quently told that they would likely get worse and even lose their jobs and their friends. Despite these false­hoods, peo­ple with men­tal health dis­or­ders have con­tin­ued to believe in them­selves and in one another and to help one another recover.

history of psychiatry. therapeutic zeal.

mickey nardo at one bor­ing old man: on his­tory

…What I took from that read­ing had to do with a topic well known to any prac­tic­ing physi­cian – Ther­a­peu­tic Zeal. It’s the dan­ger behind the Hip­po­cratic Oath’s injunc­tion to “Do No Harm.” These rad­i­cal treat­ments were intro­duced for the dev­as­tat­ing, often fatal ill­nesses only seen behind the walls of Asy­lums and State Hos­pi­tals. But with some suc­cesses, they were increas­ingly applied in patients with less debil­i­tat­ing ill­ness or diag­noses. That’s what Ther­a­peu­tic Zeal means, becom­ing too invested in treat­ing and over­look­ing the dan­gers. In the case of lobot­omy, Rose­mary Kennedy, the younger sis­ter of JFK, was a prime exam­ple. As best I can tell, her diag­no­sis was mod­er­ate men­tal retar­da­tion. In her early twen­ties, she was treated with lobot­omy for behav­ioral prob­lems. The con­se­quences of the treat­ment became an addi­tional life­long dis­abil­ity, last­ing until her death at age eighty-​six – a tragedy.

history. abortion law. roe vs. wade.

from fem­i­nist law pro­fessers: sex, drugs, and rock and roll

In dis­cussing the his­tory of abor­tion the Roe Court noted that abor­tion laws were a rel­a­tively recent devel­op­ment in the United States. Both church and state had either been silent on or offered lit­tle sanc­tion for abor­tion over much of Anglo-​American reli­gious and legal his­tory. The Court cited what has been called the first United States law to explic­itly bar abor­tion, an 1821 Con­necti­cut statute.

This is a par­tic­u­larly use­ful exam­ple of how efforts to con­tain the cul­tural con­flu­ence sum­ma­rized in the expres­sion sex, drugs and rock and roll became the source of abor­tion law. Accord­ing to some, the Con­necti­cut statute was adopted in almost direct response to an alleged sex­ual scan­dal that took place in Con­necti­cut in 1818 involv­ing a min­is­ter named Ammi Rogers who was accused of impreg­nat­ing a young woman to whom he was not mar­ried and then giv­ing her an abortion-​inducing substance.

high heels. gender.

from the bbc: why did men stop wear­ing high heels?

A wave of inter­est in all things Per­sian passed through West­ern Europe. Per­sian style shoes were enthu­si­as­ti­cally adopted by aris­to­crats, who sought to give their appear­ance a vir­ile, mas­cu­line edge that, it sud­denly seemed, only heeled shoes could supply.

As the wear­ing of heels fil­tered into the lower ranks of soci­ety, the aris­toc­racy responded by dra­mat­i­cally increas­ing the height of their shoes — and the high heel was born.

Although Euro­peans were first attracted to heels because the Per­sian con­nec­tion gave them a macho air, a craze in women’s fash­ion for adopt­ing ele­ments of men’s dress meant their use soon spread to women and children.

In the 1630s you had women cut­ting their hair, adding epaulettes to their out­fits,” says Semmelhack.

apocalypse. not happening. gary lachman.

2013: or, what to do when the apoc­a­lypse doesn’t arrive”

The desire for some once-​and-​for-​all break with the given con­di­tions of life seems, to me at least, to be embed­ded in our psy­che and is a form of his­tor­i­cal or evo­lu­tion­ary impa­tience. Social, polit­i­cal, or cul­tural con­di­tions may trig­ger it, but in essence it’s the same reac­tion as los­ing patience with some annoy­ing, mun­dane busi­ness and, in frus­tra­tion, knock­ing it aside with the intent to make a “clean start.” While in our per­sonal lives this may result in noth­ing more than a string of false begin­nings and a lack of stay­ing power, on the broader social and polit­i­cal scale it can mean some­thing far more serious.