Talk:Major depressive disorder

There have been no double-blind trials of CES for clinical depression

I asked Lode Runner repeatedly to provide at least "one double-blind trial for clinical depression specific quotation." His answers were:

Moore JA, Mellor CS, Standage KF, Strong H. A double-blind study of electrosleep for anxiety and insomnia . Biol Psychiatry 1975; 10(1):59-63. [Despite the lack of "Depression" in the title, it did record depression. It showed a 59% "clin rating" improvement, 17% self-rated improvement, 5% Beck DI improvement--whatever that is.]

Passini FG, Watson, CG, Herder, J. The effects of cerebral electric therapy (electrosleep) on anxiety, depression, and hostility in psychiatric patients. Journal of Nervous and Mental Disease 1976; 163(4):263-266. [Double-blind. 24% improvement]

The first article was on patients with anxiety and insomnia not clinical depression. The 5% Beck DI (Beck Depression Inventory) improvement was very small and statistically insignificant according to the paper. The abstract [PMID 1091305] states: "Despite largely negative findings, several subjects reported a remarkable improvement in their symptoms some two to three weeks after electrosleep (ES) treatment was concluded, so that it remains unclear whether or not ES may be an effective treatment."

The second paper deals with a mixed group of psychiatric patients and so is again methodology impure. So it is really hard to make any positive or negative conclusions from it, but the abstract [PMID 972328] states: "No difference in the amount of improvement shown by the two groups appeared on any of the five measures employed, although a major placebo effect was evident on all of the criteria. The results argue against the use of electrosleep as a treatment for these symptoms except when it may be employed for its placebo value." Paul gene 15:59, 2 December 2007 (UTC)

I'm sorry, but that's NOT how it works. If there haven't been any controlled studies, then you must find a source that says that. Your (or my) inability to find a source that says there has been a controlled study does not mean you can claim, without sources, that there have never been any. --Lode Runner 17:11, 2 December 2007 (UTC)

Also, we need to take care not to devolve into (as Ben previously, but prematurely, warned) a very lengthy discussion of pros and cons in the middle of this article. The full analysis should be reserved for the cranial electrotherapy stimulation article. In particular, I think that discussion of specific trials is inappropriate; rather, the results over all the trials should be summarized.

I also have a major problem with your specifying, in detail and with quotes, each and every negative study and not mentioning any of the positive studies.

Re: the results from the studies, I am looking into this further. If what you claim is true, then some of the papers I've listed are severely misrepresenting those studies. In the meantime, I'm adding a disputed tag to the section. There are way too many people here out for blood for me to accept any of this at face value. --Lode Runner 17:19, 2 December 2007 (UTC)

Lode Runner is right in that the CES section is getting too long. We should just mention it, say what it is, and quickly summarize the known reliable trials. The weighing of evidence should happen in Cranial electrotherapy stimulation which at the moment blindly endorses CES.

Lode Runner is wrong when he says that the onus on proof is on the doubters. WP:V says:

The threshold for inclusion in Wikipedia is verifiability, not truth. "Verifiable" in this context means that any reader should be able to check that material added to Wikipedia has already been published by a reliable source. Editors should provide a reliable source for quotations and for any material that is challenged or is likely to be challenged, or it may be removed.

So we don't need to prove that it doesn't work, only that known published studies to date say that it doesn't work any better than placebos. That doesn't say that there isn't about to be a study that shows that CES works, it doesn't even say that there hasn't already been one that we didn't find, it just says that we've looked, and if there is such a study, we didn't find it.

And lastly, Lode Runner is right when he says that there several other voodoo treatments in the article that should also be cleaned up. This is supposed to be an article about depression, not an article about treatment of depression. Regards, Ben Aveling 19:51, 2 December 2007 (UTC)

We are all aware the article is in need of massive clean up. Efforts began, but I know I've personally been side tracked a bit, and other editors get to deal with things like this CES instead of the article clean up needed. If you look back on the article history, however, you will see where clean up started. I personally was working from the top down and got through the intro and diagnosis. You are wrong, however, about not including treatments. A section on treatment is appropriate and important per the medical article MOS. Once the clean up is done, if the treatment section is still extremely large, it will probably be split off into a subarticle, but first it all needs cleaning. I don't think anyone is arguing that the treatment section as is now is perfect (see previous convos as well), but it doesn't make the cleaning up any easier if inappropriate material continues to be added to the article unchecked. Collectonian 20:42, 2 December 2007 (UTC)

You misunderstand. Paul isn't saying "these studies didn't have controls"--he's basically saying "NO ONE HAS EVER DONE A CONTROLLED STUDY, EVER, IN THE HISTORY OF MANKIND." I agree, the former claim doesn't need a source--we merely need to observe the studies and report whether or not they have controls (incidentally, I haven't yet confirmed Paul's assertion that none of them do.) The latter claim most definitely requires a source. At first he didn't have a source at all--but now, he's relying one of the papers he previously dismissed as unreliable. Basically, he's saying that this formerly-unreliable paper now represents a definitive compendium of every single CES/electrosleep study done in the past 50 years, and we can therefore infer that, since no controlled study is mentioned, no controlled study has ever been done.

This strikes me as being just a WEE bit hypocritical. I'm pretty sure it's a clear violation of good faith (WP:FAITH) to use a source you previously dismissed as unreliable (when being used to support the addition of information you don't want to see inserted) as a very sketchy proof-by-omission source for the exclusion of similarly unwanted (by Paul) material.

Re: treatments--they should be mentioned... either in this article or in a spin-off article (e.g. Treatment of Depression). And the "voodoo" methods can be mentioned, so long as there is evidence of use and all disclaimers and negative scientific findings (and/or lack of conclusive study) are mentioned. --Lode Runner 20:07, 2 December 2007 (UTC)

A citation that is poor for one purpose (demonstrating that CES works) may be perfectly good for another purpose (demonstrating that there is little to no evidence that CES works). Even if there are a few studies showing that it works, medical science doesn't really work like that. Individual studies, even when done properly, can return strange results sometimes. New theories, to be accepted, generally require repeated independent studies returning broadly consistent results. If we can't find any evidence of that, then that is fairly clear evidence that there isn't much to find. One confusing factor is that a large number of patients will recover under any treatment, or no treatment, and even more will recover if given a placebo treatment. So it's easy to be fooled into thinking that a treatment is working, because it is getting good results. The question is, are these results demonstrably better than than a placebo would be?

I agree that there should be a treatments section, and that it should mention CES. I just think that the CES part is about 3 times as long as it should be.

And Lode Runner, there's no need to accuse anyone of hypocrisy and no reason for shouting; you have your own reasons for believing in CES and we have reasons for believing that it doesn't. Regards, Ben Aveling 22:36, 2 December 2007 (UTC)

I don't "believe" in CES. I've never used one. I have never known anyone that's used one. I simply want some semblance of objectivity here. It's taken quite a bit of legwork on my part to even get to the point where people acknowledge that we should even have a CES section.

Some of the things that Paul has come up with has been useful (class 3 info, links to individual studies) and I have thanked him for that on at least one occasion. I have re-read the meta-paper, and found that I linked to the wrong study (Passini--possibly the ONLY study that showed no benefit. It is discussed at greater length in the meta-paper.) Instead of Paul saying "these studies aren't sufficient", he has proceeded to declare victory and declare a falsehood in large, section-title letters (see below.)

Finally, I must object in the strongest possible terms to your bizarre reasoning that a source cannot be used--in a literal, direct-quote fashion--to support CES, yet can be used in a weasel-y, proof-by-omission fashion (again, these devices have been around for at least 40 years so that's a LOT of papers that could have potentially been missed in the overview) against CES.

As far as small-scale studies not really working like that--I fully understand. But if the meta-papers I linked to early on are truthful (and yes, they very well could be biased) then the positive indicators do outweigh the negative indicators, and thus the potential is there. Without major trials, I might estimate it to be only a 20% potential...I really wouldn't be surprised at all if it ultimately turned out that CES wasn't a good idea. Again, I am not pro-CES--I am pro-objectivity. --Lode Runner 23:00, 2 December 2007 (UTC)

Another study

Another study: Rosenthal SH. Electrosleep: A double-blind clinical study. Biological Psychiatry 1972; 49(2):179-185. I cannot find details on it without paying subscription fees, but it lists a 21% improvement on the Zung SRDS depression scale. And again, Paul--just because I haven't (yet) told you that study X exists doesn't give you the right to add an unsourced claim that study X does NOT exist. Also, I am not your damned research monkey--every line I've added has been sourced; many of yours have not. Also, given that there have been multiple double-blind trials that measured depression (including the studies you linked), your section title is a lie. This is the third or fourth time you've repeated this lie after I initially corrected you. --Lode Runner 22:14, 2 December 2007 (UTC)

Please don't accuse people of lying. He, or I, or you or all of us may be wrong. I don't believe anyone here is lying. Regards, Ben Aveling 22:38, 2 December 2007 (UTC)

He linked to a double-blind study that measured depression. He then proceeded to call his section "There have been no double-blind trials of CES for clinical depression". I'm sorry, that is a lie. (The non-lie version, if his assertions are correct, might be something like "the two double-blind studies I've bothered to read show no statistically significant link") I might be willing to be charitable and call it an oversight, except that he repeated the same lie multiple times earlier, and has engaged in other bad-faith activities as detailed above. He has repeatedly removed sourced material and inserted his own POV unsourced material. He treats sources as worthless when they're used for positions he disagrees with, then turns around and treats them as golden (worthy of proof-by-omission) when he can use them for his own positions. Now he's taken one of his older fabrications and repeated it again as a large, visible section title.

I see no reason to give him the benefit of the doubt.--Lode Runner 22:45, 2 December 2007 (UTC)

To all: going to be busy for at least the next few days; after that, I'll be focusing my efforts on fleshing out cranial electrotherapy stimulation. Will worry about this article after we've reached some sort of consensus there. Though I don't expect it, I'd be nice if I came back to some objective, reasonably written articles. The links I've given (especially the 'untrustworthy' AlphaStim-promo papers) are great starting places. 99% of the edit wars and arguments here could have been avoided if people here had read them and followed up on the studies they referred to as necessary, instead of insisting--without sources--that the papers were wrong or biased. --Lode Runner 23:23, 2 December 2007 (UTC)

Article problems

I've just read the first part of the "Clinical Depression" item and find it extremely outdated, misleading and innaccurate.

I could just jump in and chnage it to what I think but it's rather a big job and I don't want to waste time writing when it may be edited out. Is there a way to discuss the changes before such are done?

The reason I have come to this article is because someone is quoting the article as an authority on depression and it is not.

I see below so many different types of "treatment" that no one could possibly follow all of them. Many are fad theories and bear little relationship to reality.

There are only 2 basic methods of treatment being talk therapy anmd meds, or a combination of both. Every other "theory" is essentially perupheral, rarely used and rarely succesful.

I have a personal philosophy of "whatever works is good" but to list every fad really does just offer false hope.

I'd much rather see the item state there are more "alternate" theories than you can poke a stick at and maintain focus on those that are know to work consistently.

Being new here I don't know how tro contact anyone etc so I'll give my email here notmeagain@eml.cc

It's a spare email so it doesn't matter as I can just drop it if spammers move in etc.

I've had depression for over 40 years and seen more doctors, had more treatments and tried more drugs than the average bear. I have no medical background but I do know what is a fad and waht isn't.

Hope I haven't offended anyone as much work has been done here but to me it's actually causing problems having ridiculous statements which mislead.

To give you an idea of what I mean here's my first point relating to the diagnosis section :

"Before a diagnosis of depression is made, a physician will perform a complete medical exam to rule out any possible medical or physical cause for the suspected depression."

Doesn't happen. No GP's do this as they don't have time. If you walk in and say you feel depressed they reach for the prescription pad and away you go.

Psychiatrists do take this approach but again the diagnosis is made well before any physical issues are considered.

To have this listed will only confuse people when they sit down with a doctor. In fact it may deter many from trying to get the help they need.

Best, Peter Porter. —Preceding unsigned comment added by Clocodile (talk • contribs) 15:33, 10 December 2007 (UTC)

Um, the entire first part of the article is properly sourced from current materials from experts in the field, and was, in fact, fairly recently redone. A physical exam is what is supposed to be done before the presumption of depression. Unfortunately, not all doctors bother, and if you've had it for 40 years, its doubtful you would have the same experiences as someone who has never been to a doctor. And yeah, some doctors just plain suck. But one of Wikipedias core policies is neutrality and another is verifiability. This article, as all others, strives towards that. Now, if you can find reliable sources that totally dispute the opening sections, by all means, post them here and they will be evaluated and the article updated accordingly. Collectonian (talk) 17:30, 10 December 2007 (UTC)

I think a lot of people here fail to understand the purpose of Wikipedia articles. We're here to report on reality, not simply a given treatment's medical worth. By all means, we can give evidence supporting or disputing a given treatment's efficacy or proposed mechanism of action, or mention whether a certain treatment has received FDA approval (ahem) or is approved for use in other countries, and we can mention whether guidelines say that a physical exam should be performed--but, ultimately, Wikipedia is here to report on what's happening REALITY. If significant numbers of people are treating depression by shoving pickles in their ears, then we report that. If a physical exam is rarely being performed prior to anti-depressant prescription (and I would say this is almost assuredly the case, though I don't have any non-anecdotal evidence), then that should be mentioned as well, though if source XYZ says an exam SHOULD be performed, that should also be mentioned. If the article becomes too long and cumbersome, we split off the treatment methods into treatment of depression and give only a short summary here.

In summary--if most physicians don't perform a physical exam, then the article should not state otherwise. If certain "alternative" treatments have received significant use/marketing/press coverage, then they should be mentioned (along with any supporting, contraindicating, or lack of evidence.) --Lode Runner (talk) 20:09, 16 December 2007 (UTC)

Not quite, we are here to report VERIFIABLE reality. Find a reliable source that says that most patients are not being given medical exams, then it should be included. Anecdotal evidence is not enough, however, to just remove verified, cited notes on what the proper procedure should be from a very reliable source. If we used anecdotal evidence to modify the articles, I could write a whole section on self-treatment, but that, like all anecdotal evidence, is just original research, not to mention irresponsible. Collectonian (talk) 20:28, 16 December 2007 (UTC)

I never said we should use my anecdotal-only evidence. If many people have the same anecdotal evidence, though, it's a sign that we should look for an actual source to support it.

Regardless,it's a misrepresentation of the source to say that "physicians WILL" do blah blah blah. This implies it's a common and/or required procedure. The exact quote is "A doctor can rule out these possibilities by conducting a physical examination, interview and lab tests." Can, not will, and for that matter the Mayo Clinic isn't (to my knowledge) an authoritative or policy-setting source. I'm editing the article accordingly. --Lode Runner (talk) 22:28, 16 December 2007 (UTC)

No we do not have to report reality. WP:verifiability:"The threshold for inclusion in Wikipedia is verifiability, not truth. "Verifiable" in this context means that any reader should be able to check that material added to Wikipedia has already been published by a reliable source. Editors should provide a reliable source for quotations and for any material that is challenged or is likely to be challenged, or it may be removed."

The publication in question is a reliable source because it is an academic publication, published by NIH. It is vetted by several experts ("This brochure is a new version of the 1994 edition of Plain Talk About Depression and was written by Margaret Strock, Information Resources and Inquiries Branch, Office of Communications and Public Liaison, National Institute of Mental Health (NIMH). Expert assistance was provided by Raymond DePaulo, MD, Johns Hopkins School of Medicine; Ellen Frank, MD, University of Pittsburgh School of Medicine; Jerrold F. Rosenbaum, MD, Massachusetts General Hospital; Matthew V. Rudorfer, MD, and Clarissa K. Wittenberg, NIMH staff members. Lisa D. Alberts, NIMH staff member, provided editorial assistance."). Therefore it qualifies as a reliable source according to a WP policy--WP:RS: "Reliable sources are authors or publications regarded as trustworthy or authoritative in relation to the subject at hand. Reliable publications are those with an established structure for fact-checking and editorial oversight. In general, the most reliable sources are peer-reviewed journals and books published in university presses; university-level textbooks; magazines, journals, and books published by respected publishing houses; and mainstream newspapers. As a rule of thumb, the greater the degree of scrutiny involved in checking facts, analyzing legal issues, and scrutinizing the evidence and arguments of a particular work, the more reliable it is."

On the other hand, if you can find a publication, which states that most GPs do not perform physical examination before prescribing antidepressants, go ahead, put it in there. However, I disagree with your, Lode Runner, reading of the NIH guide. That's what it states: "The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist. A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective." Paul gene (talk) 03:03, 17 December 2007 (UTC)

Jesus Christ, have I offended the Union of Delusional Rule Lawyers or something? I have said, done or advocated absolutely NOTHING that violates any of the WPs, verifiability included. In fact, I have used "reality" as a synonym for "verifiability", and repeatedly argued AGAINST inserting any unsourced material. Please stop spamming this talk page with explanations of rules that NO ONE here (...except, at times, yourself) is violating.

"Should" is still a slightly inappropriate word, given that this is specific to the Mayo Clinic only and not a policy set forth by any recognized national or worldwide authority (in the highly standardized field of medicine), but I have no doubt that such a source probably does exist so I'll give it the benefit of the doubt--it's better than "will." --Lode Runner (talk) 23:04, 17 December 2007 (UTC)

Regarding the "civility" of the above post--I find it much more offensive to spam someone with paragraph after paragraph of irrelevant rules quotes than it is to indirectly call someone "delusional". I'm sorry, but I have been more than patient. It's become clear that Paul isn't interested in any objective balance at all--he prefers, instead, to remove sourced material to fit his own points of view and lecture people on the rules of Wikipedia, even when he's the only one who has violated said rules.

I don't have a major problem with this last edit, Paul, but you should really think about simply making it and explaining why the source supports the change, instead of giving a condescending and erroneous lecture about how you are absolutely and objectively in the right and I am in the wrong. Given your biased and rule-breaking behavior re:CES devices, I'm not inclined to cut you much slack, and we don't need the extra clutter on this talk page. --Lode Runner (talk) 03:01, 18 December 2007 (UTC)

References problem

Hello, in the latest revision (as of this one), there is a problem with the references that I can't figure out. Try looking at "References", #28, and there is a table of contents and numerous lines that look like source citations. I can't find where the source of this problem is. Could someone who is better versed at ref tags please fix this? Thank you. --Kyoko 21:22, 19 December 2007 (UTC)

Fixed. There was an open ref tag at the end of the sentence with no content and no closing ref, so it was basically attempting to throw the whole rest of the article into a footnote :P Collectonian (talk) 21:51, 19 December 2007 (UTC)

Where do we put Styron, Solomon

I believe we should highlight two works:

Darkness Visible: A Memoir of Madness, William Styron, a classic and extraodinary book, by someone who is a master of words, about the descent into the hell of depression.

The Noonday Demon, Andrew Solomon, National Book Award, 2001, Finalist Pulitzer, extraordinary self-account, history, social analysis, etc. http://www.noondaydemon.com/

Neither of these books are by "psychiatrists or psychologists," but deserve (as do others I presume, but none as important as these, in particular Styron) a citation not buried in "references."

Best, Shlishke (talk) 22:36, 22 December 2007 (UTC)

Merge from Depression and natural therapies

Depression and natural therapies is a povfork, and contains little if anything not already in this article (other than unsourced and poorly sourced information with NPOV problems). It should be merged into this article. --Ronz 16:12, 3 October 2007 (UTC)

Agreed. No reason to have that seperate at all. Collectonian 17:38, 4 October 2007 (UTC)

Keep these articles separate but have them interlink better. Currently, Clinical depression doesn't link to this article, for instance. There seems to be enough info here to justify having a separate article. That being said, Depression and natural therapies should be expanded perhaps to discuss in greater detail the history behind using natural therapies to treat depression. I think that would certainly make the article even more encyclopedic. (Based on the thread just above, this article already seems to be pushing the file size threshhold. Merging would certainly cause a size issue.) -- Levine2112 ^discuss 17:31, 10 October 2007 (UTC)

If going with separate articles, then wouldn't it better to have the entire treatment section as a separate interlined article rather than just the natural therapies aspect? Collectonian 21:12, 11 October 2007 (UTC)

Exactly. Then we don't have the povfork issues. --Ronz 21:15, 11 October 2007 (UTC)

We don't have a povfork issue in the first place. The article wasn't created as a fork for pushing a point of view, at the risk of repeating myself. It was created to cover ground that wasn't covered in the first article.

Sardaka 10:09, 12 October 2007 (UTC)

It appears to be a POV fork, whether that was the actual intention or not. For whatever reason, you did not add it to the main article, but instead created a new article that that only discusses "natural" therapies with no clear definition of what "natural" is except that it isn't anti-depressants. The list could quite easily and snuggly fit into the main from the get go, which would have served to improve the original. If you felt the article was already too large (though other articles about medical issues are just as long if not longer), then the better option would be a separate treatment page all together. Instead, you made no attempt to contribute to this article, but created a page that focuses only on the treatments of interest to you. To me, that is very much a POV fork. Collectonian 14:12, 12 October 2007 (UTC)

The existence of an article on depression doesn't mean that there couldn't be other articles about depression. For example, if you look up Sydney, you will find many articles about it, on different aspects: general, history, architecture etc. This is a legit way of covering the subject. With depression, there can be more than one article to cover different aspects of the issue. the existence of the first article doesn't preclude others.

Sardaka 09:52, 17 October 2007 (UTC)

Sydney is a country, not a medical condition and those are not POV forks. The natural therapies article is not a seperate aspect moved, it is a POV fork and will be merged. After the merge, and the during the clean up discussed below, if appropriate, neutral sections will be broken out covering ALL treatment options, not just your fork. Collectonian 13:38, 17 October 2007 (UTC)

I've restored this conversation from the archive to allow more discussion since the merge hasn't happened or been conclusively rejected yet. Collectonian (talk) 05:41, 1 January 2008 (UTC)

Absolutely no need for merge as page is already 63k long! We should be looking to split articles off this one not merging it... Johnfos (talk) 01:37, 3 January 2008 (UTC)

Three months have passed and there is no consensus to merge, so I'm removing the tag... Johnfos (talk) 01:00, 5 January 2008 (UTC)

What should be done

Depression and natural therapies is, as others have said, a POV joke. That's not to say we can't mention therapies that aren't scientifically proven--on the contrary, we should document ANY therapy that has been used on a significant scale or somehow achieved prominence or approval somewhere in the world--but it's a joke to separate out the "natural" options. "Natural" medicine is just medicine, like "natural" food is just food. The word is simply meaningless. A molecule from a plant isn't any different than one from a lab.

What we need is a Treatment of Depression article. Yes, I do believe a separate article is needed, because some contentious therapies (such as CES) inevitably turn into a massively detailed (sourced) analysis. I don't think such analyses are a bad thing, but if they all turn out to be like CES, they would clearly render this article unmanageable. Even if you were to restrict yourself to accepted, mainstream, FDA-approved (or pending-approval) methods,there is still a LOT of ground to cover: SSRIs, SNRIs, dopamine reuptake inhibitors, tricyclic, MAOI, electroshock therapy and each of the other electric therapies approved or pending approval, light therapy, psychotherapy...

I would do this myself, except I don't think I can deal with another Paul Gene-type sabotage effort again. (He believes that all negative studies about CES--all 1 or 2 of them--should be explained in detail, yet doesn't allow anyone to mention the positive studies without a mile of disclaimers and forty paragraphs of debate on the talk page. I'm all for plenty of skepticism when it comes to "alternative" medicine, but damn...) I could just do a cut/paste job and walk away, but I wouldn't feel quite right about that. Perhaps someone with a little more stamina than myself is up for it.--Lode Runner (talk) 10:07, 6 January 2008 (UTC)

While I agree, in theory, that the Treatment section could likely support being a sub-article, I think this article as a whole should be fixed first. Some fixes were done to the first bit, but the majority of it has problems with sourcing, neutrality, etc. With the article as a whole in better shape, then we can better evaluate if one (or even two) sub-articles might be needed. Otherwise, we'll just have the same problems in two places instead of one. As for the potential of massive detailed analysis on some stuff, if there is enough information to support that kind of thing (like CES), then it should be in its own article with the depression article briefly mentioning its releveance specifically here with a main link at the top of that section. I disagree with your categorizing Paul's work as sabotage efforts. As this article deals with a medical topic, it is vital that we are especially vigilant about the sources being used so as not to present misinformation. While Wikipedia is, of course, not a medical text, people will look here and read what's in the article and may very well act on it. So that what is here is verifiable and well sourced are of extra importance. Collectonian (talk) 10:34, 6 January 2008 (UTC)

Please, do me a favor: Stop lecturing me on the rules of Wikipedia. I am not violating them. I am not suggesting we violate them. Paul, in fact, is the only one who has violated them--he has repeatedly misrepresented sources (WP:V), removed sourced material (WP:OR, WP:UNDUE), and used untruthful phrases (WP:VAN).

If I seem a little sensative about this, it's because the tactic is getting old. On this page alone I've been subjected to it like a half dozen times already. Don't like what someone is saying? Just link to the WPs, repeatedly, at every opportunity, even if they don't apply to the current situation, and just hope you wear them down.

I have never argued for anything other than good verifiability. On the other hand, Paul has repeatedly removed my SOURCED material and inserted his own erroneous interpretation of a source that he didn't even believe was authoritative to begin with (he argued it shouldn't be used at all), but now claims it's a comprehensive overview of every CES study done prior to 2003, and thus can be used as a proof-by-omission. He's also repeatedly edited the section to claim that there is only "inconclusive and negative" studies, when in fact most studies in the sources show at least a small positive outcome, with several showing major positive effects. There's an entire paragraph devoted to negative-outcome studies right now, even though the sources I've given clearly show that they are the minority.

The statements in the article should represent reality, period. To this end, I have written and supported the inclusion of anti-CES material (e.g. "to date there exists no consensus or even prospective clinical trials to support its use") as well as pro-CES material. Paul has never once written or supported anything remotely pro-CES, and I believe every pro-CES line currently in the article has been COMPLETELY REMOVED by Paul at least once. Even in their CURRENT form, he's loaded them full of inane disclaimers such as "according to the authors"... what the hell? OF COURSE it's "according to the authors". You could put that disclaimer after every single source in Wikipedia.

This is turning into a rant, sorry, but it's imperative that people understand how insidiously and relentlessly POV his edits have been, and how cynical and hypocritical his rationalizing has been. You weren't exactly openminded yourself, but I suppose this can be for the benefit of others. This is what Paul said about the first source I found:

The current supporting source for this chapter is a promotional material and is not acceptable.

(I don't think he is referring to *precisely* the same paper, but he makes the connection between them himself a little later on. Says they're basically the same, and the criticism applies to both.)

He also said:

...is a link to a promotional brochure, and not a peer reviewed publication so it is not very reliable.

He never once wavered--he REPEATEDLY said that this source was untrustworthy. Then, a little later, he apparently decided (without explanation) that it was a 100% comprehensive paper, and used it as proof-by-omission that no other studies have been conducted: According to a 2002 review, there have been no controlled trials of SES for clinical depression as a primary diagnosis. This is a lie. The paper makes no such claim. I called him on it, removed the passage, explained that proof-by-omission isn't strong enough to make such a boldfaced claim (at best, it's WP:SYN--which is forbidden), and he reverted my edits anyway. I believe there was another edit-revert exchange before I gave up. I just now removed the passage once again--let's see if Paul re-inserts his old lie yet again. --Lode Runner (talk) 13:44, 6 January 2008 (UTC)

Please check your temper and reread what I wrote (and if you are noticing that you are ranting while posting, why not just step away from the keyboard and calm down first). Ranting doesn't help and I wasn't lecturing you. I was primarily offering my view on the discussion you started, including my view that before we look at splitting, we clean the article as a whole and pointing out the issues with the article that I see. I wikified stuff because other people will read this discussion and some of those folks may not know much about that, and personally I like quick links whenever anyone refers to a policy or guideline in case I want to check it in light of the discussion. I also gave a one sentence (apparently ill placed since you focused almost entirely on that) saying that I disagreed with your assessment of Paul's actions. I get you vehemently disagree with Paul's actions, but I'd rather this discussion actually stay focused and not get into yet another argument with no resolution. This is an extremely important article and it needs attention, not editors bickering. Collectonian (talk) 14:05, 6 January 2008 (UTC)

I was in the middle of clarifying my annoyed tone when you replied. I do not need you to tell me to calm down, nor spam me with WP links. Suffice it to say, I'M AWARE OF THE RULES OF WIKIPEDIA. I've already been reminded of them in a very long-winded fashion on this very page. I find it *at best* extremely condescending to link to the WPs at every opportunity, even (or especially) when they don't apply. It's a non-sequitur. It basically allows people to sidestep the issue and blow off everything you say.

If you meant it sincerely then I apologize for my tone, but I strongly urge you to ditch the habit. I am innately distrustful of anyone who needlessly spams WPs. And, if you'll care to note, I didn't "focus almost entirely on" that one sentence. In fact, before I added the clarification, it only had one very short (3 sentence) paragraph. --Lode Runner (talk) 14:15, 6 January 2008 (UTC)