Talk:Psychiatry

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Facts

On January 28, I made a plea for some citations in the "Other criticisms" section. Today, David Kernow has done the same. Both of us it would seem have done this out of deference to providing multiple points of view. While I do not doubt that the claims being made in this section could be true, we really need someone to provide citations. There are so many instances of vague wording as to call into question the veracity of the claims: "some believe...", "there is evidence this leads...", "according to critics...", etc. The wording of these phrases indicates that some research or review has been done, and therefore a reference must exist somewhere. However if citations cannot be provided, these claims will have to be removed. So, for the anti-psychiatry-minded, could you guys please provide these sources? Semiconscious • talk 19:15, 21 February 2006 (UTC)

Hi I'm not just anti-psychiatry minded but I've added some citations. I'm sorry but I cannot yet get to grips with how to do this properly, and link cites to full references, despite trying to read the help pages on it.Franzio 11:52, 1 March 2006 (UTC)

Hi, I've just done some brief research on the supposed 'effacity' of ECT as a treatment for depression disorders (and the oft-mistreated condition of schizophrenia), and would like to request information on the positive results of ECT treatment. I've found much negative about the treatment, including long-term memory loss (http://www.ahrp.org/infomail/05/07/08.php AND http://www.healthyplace.com/communities/Bipolar/news_2005/book_1.asp), wholesale abuse (http://www.guardian.co.uk/race/story/0,,1388367,00.html) and the real results of the treatment (http://www.wildestcolts.com/mentalhealth/shock.html) but NONE for positive results, other than doctors who are pro-ECT stating that it 'works', but with no physical evidence to back the statements up.

As a result of this, I am proposing that the statement which mentions ECT as an effacious treatment be modified as soon as is reasonable to do-so. Gotheek 00:31, 13 March 2006 (UTC)

Hi, there's actually quite a bit of data on ECT's effectiveness. For instance, here's a meta-analysis from the Lancet which shows the efficacy of ECT over "sham" ECT in 6 trials and over pharmacotherapy in 18 trials:

• "Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis." Lancet 2003 Mar 8;361(9360):799-808.

I noted that all of your sources above are regular webpages -- in case you don't know, nearly all medical references can be found at http://www.pubmed.com. I found the above link by just searching on the terms "efficacy electroconvulsive therapy" Scot ^→Talk 01:56, 15 March 2006 (UTC)

Teaching/training details

I may have missed it but could anyone clarify what specialist training psychiatrists receive? This would seem to to be part of the core of what modern psychiatry is. I know the article mentions the different areas of practical experience. But, for example, how much teaching is there on the various lines of work on mental health (e.g. genetic, neurological/psychological, social). How much teaching and training on medication, how much on psychosocial interventions esp. particular ones like Cognitive Behavioural Therapy? How much on general counselling skills? Who does the training? Franzio 11:52, 1 March 2006 (UTC)

Good point, Franzio -- the article could include more specifics about the training. I'm actually in a psychiatry training program in the US now, so I'll see if I can dig up my copy of the ACGME (Accreditation Counsel of Graduate Medical Training) requirements for US psych residency programs and summarize them briefly. Scot ^→Talk 07:13, 15 March 2006 (UTC)

Nurse & Pharmacist prescribing

I think the introductory statement about only doctors (incl. consultants) being able to prescribe in the UK isn't accurate, not clear if it's referring only to psychiatric drugs. Qualified and registered nurses and pharmacists have had limited prescribing powers for a number of years, which are currently being extended - I'm not sure on the exact situation with regard to psychiatric drugs so will leave any amendments to others who are. Franzio 18:53, 2 March 2006 (UTC)

I've edited to avoid the possible error. See UK Dept of Health but still not entirely clear on current practice. Franzio 18:04, 13 March 2006 (UTC)

POV tags and self-reference

I removed some POV-section tags. There is no attempt being made at resolving whatever POV dispute there was originally.

I also removed a self-referential remark about Wikipedia's anti-psychiatry article. Please review Wikipedia:Avoid self-references if this is problematic.

The section "improvements and criticisms" contains a few named references with no further details in the "references" section. This is not acceptable. Could the person who inserted this material please WP:CITE. JFW | T@lk 04:56, 12 March 2006 (UTC)

I put the POV-section tags in the Psychiatry article because someone put a tag in the main Anti-psychiatry article (which I doubt it is fair). I hope someone will remove that tag too! Cesar Tort (talk · contribs).

The assertion that "cures are not expected in psychiatry" is WP:NOR. What is this highly speculative statement based on?

The reference to the anti-psychiatry article is a self-reference. What part of the above-quoted policy don't you understand? JFW | T@lk 19:55, 12 March 2006 (UTC)

It is said that there is no cure for mental illness, so cures are not expected in psychiatry. --WikiCats 02:35, 13 March 2006 (UTC)

"It is said" does not really satisfy WP:CITE. As an aside, complete response does actually occur in psychiatry, although admittedly not as often as one would like. JFW | T@lk 04:08, 13 March 2006 (UTC)

Just to clarify:

The statement “cures are not expected in psychiatry” is not true except in most cases. And in the case of schizophrenia or bipolar disorder it is completely true.

On the issue of citations who would you accept as a reliable source? --WikiCats 08:36, 13 March 2006 (UTC)

I assume the named references to which you refer are those I inserted at someone elses request, as you can see above. I wasn't sure about the procedures for full refs, seems to vary from page to page. In the end I managed to add them to the antipsychiatry page, and then didn't want to add them here because there were only about two references and it didn't seem right to have more critical references than main psychiatry ones! Please do as you wish with them. Franzio 18:12, 13 March 2006 (UTC)

Deleted page?

What's going on, this page isn't existing at the moment? --Horses In The Sky 23:08, 13 March 2006 (UTC)

Pharmaceutical Industry criticism paragraph

Regarding this paragraph, from the "Improvements and Criticisms" section:

Drug companies spend large amounts of money marketing drugs. There is evidence this leads some physicians to prescribe more drugs and to prefer advertised drugs instead of more appropriate, better, or cheaper drugs (or prescribing them when drugs are not needed at all). A 2005 UK cross-party parliamentary inquiry into the influence of the pharmaceutical industry details some of the evidence. The inquiry concludes, amongst other things, that (Pg 100) 'The influence of the pharmaceutical industry is such that it dominates clinical practice" and there are serious regulatory failings resulting in (Pg 101) "The unsafe use of drugs; and the increasing medicalisation of society." There is also a list of scientific and other references provided by the campaign organization No Free Lunch, detailing the prevalence and consequences of the acceptance by medical professionals of gifts from pharmaceutical companies.

This is an interesting topic, and a discussion of the inappropriate reach of Big Pharma into medical practice may belong somewhere -- but it's not specific to psychiatry and so doesn't really belong here. I'm going to delete it from here if there are no objections. Scot ^→Talk 07:08, 15 March 2006 (UTC)

There are a lot of people on Wikipedia who think it's awfully unethical to make money developing drugs that potentially benefit millions of people. They have a particular peeve for psychopharmaceuticals. JFW | T@lk 07:11, 15 March 2006 (UTC)