Speed Up & Sit Still by Martin Whitely – a review

I’d like to say “God bless Martin Whitely for writing this book”, but unfortunately I’m an atheist. The Western Australian politician and former school teacher clearly is most concerned about the thousands of Australian children who are being put onto psychiatric drugs because of their behaviour. I thought it was only sentimental oddballs like myself who cared about such issues. Consistent with Whitely's apparent committment to protecting children, in June 2011 he was one of the WA ALP MPs who opposed plans by the federal government to send unaccompanied children to Malaysia under an asylum seeker deal.

This book is an authoritative account of the politics, the history, the science and the players in the story of ADHD and ADHD drugs in the US and Australia, most specifically in Perth, Western Australia. The author is an ALP member of the Western Australian Legislative Assembly. Western Australia is the Australian state which had the nation’s highest rate of amphetamine prescription during the 1990s to the early 2000s, with a corresponding highest rate of amphetamine abuse. In 2004 there was a Western Australian parliamentary inquiry into ADHD. Rates of prescribing of ADHD drugs to children in WA have fallen, but have apparently risen in NSW in recent years. Whitely reports two very concerning findings of the Western Australian Ministerial Implementation Committee on ADHD Raine Study Review (MICADHD). The Raine Study from Perth provided the world’s first independent data on the long term effects of psycho-stimulant medication.

A number of Australian politicians from both major parties are mentioned in this book, and not for good reasons. Those names include Nicola Roxon, Tony Abbott, Nicola Roxon, Christopher Pyne, Kevin Rudd and Nicola Roxon. Whitely has been ignored or fobbed-off by an impressive list of big names in Australian politics. To be fair to Rudd, Whitely’s April 2010 letter to Kevin Rudd was badly timed, just a couple of months in advance of the coup that removed Rudd from the position of Prime Minister. The commercial ties to pharmaceutical companies of Professor Ian Hickie from the Brain and Mind Research Institute are noted in this book and detailed in the notes section.

While the ADHD controversies are covered in a fair amount of detail in this book, the importance of this book certainly isn’t limited to questions about the ADHD label, the drugs prescribed as treatments for ADHD, or the broader controversies surrounding the psychiatric labelling of children. Anyone considering using any of the newer psychiatric drugs should be interested in this book , because it exposes the crooked tricks of major drug companies and the lack of effective government control of their activities, and the failings of the TGA (Therapeutic Drugs Administration, Australia's regulatory authority for medicines). Flaws and failings of medical research are exposed, and the issue of influential or powerful medical professionals having conflicts of interest involving drug companies is also explored. Taxpayers should be interested to know that their taxes are used for drug research that is very likely to be biased and influenced by drug companies, and some apparently dodgy drugs are subsidized by the PBS. The lack of openness of the process behind the PBAC researching taxpayer subsidies for drugs is also worth reading about. Western Australian readers might be interested to read about the ethical concerns associated with the 2004 Curtin University study of the ADHD drug Strattera with child subjects, which had Associate Professor Heather Jenkins as the principal investigator. The Children’s Hospital Education Research Institute in Sydney withdrew from this study due to objections from their ethics committee. A question about this sorry episode that interests me is why was this story covered by The Australian but apparently not WA’s local daily The West Australian?

I was a little disappointed that some topics were not covered or barely covered in this book: the controversial diagnosis of juvenile bipolar that has become very popular in the United States with accompanying prescription of psychiatric drugs for children, and the huge international upswing in diagnosis rates of autistic spectrum conditions including Asperger syndrome. The very scientifically suspect concept of childhood schizophrenia even appears to be gaining a higher profile in the US, a trend that I hope never spreads to Australia. While he probably doesn’t have the first-hand knowledge of these matters that he evidently has about ADHD, I would still be interested in Martin Whitely’s views on these events, and this would place the ADHD history into context. My only objection to this book is that there isn’t more of it.

Some quotes from the book:

“It is extremely worrying that old, specious, discredited research can be recycled by the highest levels of government and the medical profession.”

Jon Jureidini quoted in the book:

“When you have got a kid with ADHD and oppositional defiance disorder and depression and anxiety disorder...what this says is not that he has got four disorders, but that there is something wrong with the kid and people haven’t properly understood what it is yet.”

“The most startling finding was that past stimulant use increased the probability of an ADHD child falling behind at school by a massive 950 percent.”

“Roxon has allowed the response to concerns about misdiagnosis and over-prescription to remain delegated to the ADHD industry.”

“Sceptics are generally not motivated to specialise or become ‘expert’ in conditions they don’t believe in.”

“All of the participants declared their connections to drug manufacturers, but astonishingly claimed there were no conflicts of interest.”

“If the history of the stimulants is any guide, we can expect to receive the first meaningful data in relation to the long-term safety and efficacy of Strattera in about 2080.”

Speed Up & Sit Still (website by Martin Whitely MLA)
http://speedupsitstill.com/

Whitely, Martin (2010) Speed Up and Sit Still: The Controversies of ADHD Diagnosis and Treatment. UWA Publishing, 2010.
http://uwap.uwa.edu.au/books-and-authors/book/speed-up-and-sit-still/

Labor MPs oppose Malaysian deal.
by Alisha O'Flaherty
June 3rd 2011
ABC News
http://www.abc.net.au/news/stories/2011/06/03/3235319.htm

Curtin University misled about ADHD drug.
Julie-Anne Davies
The Australian
January 10, 2009
http://www.theaustralian.com.au/news/nation/university-misled-about-adhd-drug/story-e6frg6pf-1111118525451

I really shouldn't laugh.....

Julia Gillard vows to plough ahead despite polls.
From: AAP
Herald Sun.
June 28, 2011.
http://www.heraldsun.com.au/news/breaking-news/julia-gillard-vows-to-plough-ahead-despite-polls/story-e6frf7jx-1226083234667

"She is now the most unpopular modern prime minister since Paul Keating at his worst."

Julia Gillard now leads 'most unpopular Australian government in past 40 years'.
Alison Rourke
Guardian.
18 June 2011
http://www.guardian.co.uk/world/2011/jun/18/julia-gillard-most-unpopular-leader-australia

"With her personal approval rating collapsing (nearly 60% of those polled disapprove of her), Kevin Rudd is now the preferred Labor leader by a margin of two to one."

Labor would win election under Rudd: poll
By Jeremy Thompson
Updated Mon Jun 27, 2011.
ABC News.
http://www.abc.net.au/news/stories/2011/06/27/3254766.htm?section=justin

"Fifty-one per cent of those polled believe Australia has become a "worse place" since Ms Gillard became Prime Minister."

Secret behind Blanche d'Alpuget and Sue Pieters-Hawke airport scuffle.
Annette Sharp and Clementine Cuneo
The Daily Telegraph
June 28, 2011.
http://www.dailytelegraph.com.au/news/sydney-nsw/bob-hawkes-wife-blanche-dalpuget-and-daughter-sue-pieters-hawke-in-catfight-involving-afp/story-e6freuzi-1226083064129

"Federal police were called after an altercation between the two women in the Qantas chairman's lounge at Brisbane Airport on Thursday. Witnesses said one of the women slapped the other four times."

Rudd soon to meet Aung San Suu Kyi

Australia's Foreign Minister Kevin Rudd will be making an official visit to Burma this week, and will meet Burma's opposition leader Aung San Suu Kyi. This will be the first visit to Burma by an Australian foreign minister since 2002. I expect we will see lots of photos and media coverage.

Suu Kyi to press Rudd on Burma inquiry.
Ron Corben
Sydney Morning Herald. smh.com.au
June 25, 2011.
http://news.smh.com.au/breaking-news-world/suu-kyi-to-press-rudd-on-burma-inquiry-20110625-1gk50.html

Another quote to ponder

(this post has been edited a number of times for clarification)

"We're trying to say that some who have failed psycho-social therapy but are severely unwell in a pre-psychosis stage, maybe some of them do need anti-psychotics and that needs to be studied before it's ever advocated for of course," he says."

This is what I believe is a revealing quote attributed to Professor Patrick McGorry from an article in The Australian newspaper from only ten days ago. I believe this quote is revealing for a couple of reasons. Firstly, it shows that the professor is indeed prepared to consider prescribing highly problematic anti-psychotic drugs to a patient who does not meet the full diagnostic criteria for a psychotic mental illness, a situation which is just the type of scenario that professor emeritus Allen J.Frances MD from the US has repeatedly expressed much concern about.

The second thing that I find interesting about this quote is the apparently confused thinking that it betrays. If a patient is in "a pre-psychosis stage" then presumably they are not fully psychotic. Commentators have claimed that McGorry's new diagnosis of "pre-psychosis" has a huge false-positive rate, with most of the youth that it identifies as potential cases of psychosis or schizophrenia not being genuine early cases at all. So I've got to wonder how these patients can be "severely unwell". If they are "severely unwell", why don't they qualify for a full diagnosis of a psychotic mental illness?

According to what Prof. McGorry himself has said about the new psychiatric disease category of "Psychosis Risk Syndrome", which Prof. McGorry has strongly advocated for, a huge 70% of the patients who meet the criteria for this proposed new "pre-psychotic" mental illness and are given only non-drug intervention will NOT proceed to becoming genuinely psychotic:

"Six studies around the world now show 30 per cent of patients given supportive care only went on to develop psychosis but 10 per cent of those given drugs and cognitive behavioural therapy went on to psychosis, McGorry says."

If this is true, the intervention does help some people, but it also needlessly labels a large proportion of patients. Given what I've read about the large false-positive rate and the apparent lack of need for drug therapy of the majority of the people who have been given this "pre-psychosis" label, I frankly find it hard to believe that so-called "pre-psychotic" patients can be "severely unwell" due to psychosis, as Prof. McGorry claims they could be in the quote from The Australian. I'm very much tempted to consider whether, if these patients do indeed have severe problems, are their problems due to some issue or illness other than psychosis? This raises the spectre of psychiatric misdiagnosis, an issue that one can find throughout the entire history of psychiatry as a medical specialty, and a problem that has ruined many lives. The more that I read about the expensive federal government funded plans of the former Australian of the year Professor Patrick McGorry, the more concerned I feel.

Just to put into perspective the issue of incorrectly prescribing antipsychotic drugs to young people who don't really need them, I'd like to point out that these drugs, also known as neuroleptic drugs, have many serious problems as acknowledged side effects, including obesity, diabetes and a number of different forms of permanent brain damage that cause disturbing-looking facial tics. Tardive dyskinesia is one of these drug-induced tic syndromes. It is a tragic fact that the drugs themselves can mask the underlying brain damage and tics that can be caused by the use of these drugs, so that the patient and the prescribing doctor may be unaware of the damage being done by these drugs until the patient is taken off the drugs, and then the hideous tics become obvious. The patient can then look forward to a life blighted with bizarre involuntary tics that make then look crazier than they ever were before.

It appears that Professor McGorry is so obsessed about the supposedly 20% of patients who might be saved from developing full psychosis by being given drugs and therapy early that he has overlooked the majority of patients who would be identified with the proposed new diagnosis, the false-positives, who would be falsely diagnosed and permanently stigmatized as having a pre-psychosis mental illness, and who risk being given drugs that can ruin lives. It also appears that McGorry is so over-focused on potential benefits of his new vision of adolescent mental health that he doesn't realise that at least some people are going to notice the definite hazard of causing harm, and might identify this as a bigger thing than the potential pluses. I believe that I see a clinician who has no proper perspective on the issue.

Dunleavy, Sue (2011) Schism opens over ills of the mind. Australian. June 16th 2011.
http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

A political quote to ponder, from a Boganville resident

A recent quote from the Prime Minister in parliament:

".... and I'm finding...ah...his...uh...sense of high dungeon...uh...very very interesting indeed."

Go back to Fountain Lakes, Julia.

Gutless

I’d like to dedicate this lovely tune, by the legendary and not-gutless Courtney Love, to the Australian Labor Party,

the party who have never had the guts to challenge or to educate voters who misguidedly view refugees as a threat to our nation

the party who swiftly respond to popular outrage over animal cruelty while not swerving from policies which cause cruelty to human refugees

the party that has leaders who stuffed up the live cattle trade with Indonesia and endangered the relationship between Australia and Indonesia, leaving the great big mess for their outcast Foreign Minister to sort out

the party who can’t bring themselves to catch up with the twentieth century and end the embarrassment of our backwards nation still not allowing same-sex marriage

the party who has caved in to the expensive and questionable demands of a professor psychiatrist who has a flair for self-promotion, who lacks scientific credibility, has many conflicting interests and has routinely broken the rules of professional conduct by failing to declare conflicting interests in published journal papers

the party that has a long history of political dynasties (the less polite term for this is nepotism)

the party who were happy to sit in opposition for many years under an internally popular but shockingly useless leader

the party who still revere a past leader who was a drunken womanizer who ruled during times of high unemployment and high interest rates, and has been a vocal advocate of the brutal regime of “Myanmar”

the party who still revere a past leader who was a smug smartarse despite the shockingly high rates of unemployment and interest rates during the times when he was a treasurer and a Prime Minister, and who appointed an obese predatory paedophile as a federal government minister

the party who were happy to allow a hardworking individual to pull them out of the wilderness of opposition, and later pull the nation through the international global financial crisis using great judgement and decisiveness, while all the time reserving the right to knock him down and replace him should he become less useful

the party who failed to support their leader when he took on the might of Australia’s mining companies with a new tax

the party who failed to confront that leader when all that power went to his head, preferring instead to simply wipe him out and start with someone else

the party who allowed an unelected union leader to publicly announce the outcome of the most controversial leadership coup in Australian political history

the party who caved in to the demands of mining company billionaires who don’t like to pay tax

the party who kiss-up to and obey the US government, and who have prominent members who inform on other members to the US embassy, and who trot along to the Australian-American Leadership Dialogue every year, and munch hot dogs at baseball matches like the aspiring yankee doodle dandy suckholes that they are

the party who has a leader who will soon be going to Western Australia for a conference, perhaps in the hope that the mining state will be the least hostile place to be a year after the political assassination of their former leader, and months after the party caved in to the threats and demands of mining billionaires who like to avoid paying tax

you’re gutless!

The Prime Minister's Speech

I don't know why it is that some people have an irresistible impulse to imitate funny accents and funny voices the very instant after they've heard a novel way of speaking. It was during one of these childish moments that I stumbled across an explanation for the the strikingly gauche way that Prime Minister Julia Gillard speaks. Her supposedly broad Australian accent has been much celebrated and hated, and is as much a part of her personal mythology as her famous but no longer authentic red hair. I have for a long time wondered about her accent. I have travelled through all of the states of Australia, with the exception of Tasmania, and there are definitely many subtle regional variations of the Australian accent, some from rural Victoria being particularly different, but I don't recall running into anyone with an accent reminiscent of Gillard's. When I watched the story about Julia Gillard's personal background on Australian Story on ABC television which was broadcast only days before Gillard's political assassination of the then-PM Kevin Rudd in 2010, I was fascinated to note that none of her family members shown on that show seemed to have the same strange accent as Julia's. So where did this accent come from? My best guess was that Gillard's accent is not a regional variation, but something peculiar to some union or some political group that Gillard has at one time been a member of.

By some unknown neurological mechanism I find that I have the gift of perfectly imitating any weird accent immediately after hearing it, but not if I delay the imitation for more than a second or two. So there I was speaking like a Julia, and I was surprised at how easy it was. I was really on a roll. I simply pushed my chin in a particular direction as I spoke, as though I had some type of fine motor defect that skewed my perception of the position of my chin. It felt much more like a speech impediment than an accent, so simple was the genesis of this odd mode of speech. The famous Gillard accent isn't an accent, it's a speech disorder. I guess I shouldn't complain that we have a PM who can't speak properly. I do sincerely believe that disabled people have as much of a right to a place in society as anyone, but by cripes, I wish she'd get some speech therapy.

She who waits.
Australian Story.
ABC TV
June 21 2010
http://www.abc.net.au/austory/specials/shewhowaits/default.htm

What does an Australian psychiatrist professor need to do?

Is Louise Milligan the only Australian journalist who is interested in investigating issues associated with Australian psychiatrist professors and drug company influence? It appears that an Aussie shrink boffin with conflicts of interest has got to draw attention to himself by playing a part in a controversial matter (such as testifying in a trial about a horrible crime) and also have a following of seriously unhappy ex-patients, before he need fear attracting the scrutiny of Australian journalists.

Two TV news reports about the misdeeds of Melbourne psychiatrist Professor Graham Burrows:

Medical scandal uncovered.
Louise Milligan
Seven News.
http://au.news.yahoo.com/video/vic/watch/25670720/

More complaints against Burrows.
Louise Milligan
Seven News.
http://au.news.yahoo.com/video/vic/watch/25693691/

Review by The Cochrane Collaboration cautions about vested interests as possible source of bias in McGorry studies

"However, as with the Australian studies, many of the trials were undertaken by leading figures in the world of early intervention who could have a vested interest in the findings - just as industry has in the outcomes for the drugs they manufacture."

All but one of the many "Australian studies" referred to here have Professor Patrick McGorry as a co-author. It seems clear that former Australian of the Year Prof. McGorry is one of the "leading figures" referred to here as having a potential conflict of interest. I'd say that is an understatement.

If you are going to click on one of the links and have a look at the review, you might wish to check the summary of the main results in the abstract of the systematic review. You'll see that there is very little to get excited about among the results of trials of various early or preemptive interventions for psychosis. The whole idea of preventively treating people who appear to be at risk of developing schizophrenia/psychosis, people with "prodromal symptoms", is not supported by this systematic review:

"At the moment it is not clear whether treating people presenting with prodromal symptoms of schizophrenia provides benefits. There is inconclusive evidence on the personal and social consequences of providing treatment to people who will not necessarily become unwell. Further evidence is needed before recommendations can be given."

This is one type of mental health service that has been most assertively advocated by Professor McGorry. It appears that there is no reason to believe that it is effective, or more beneficial than harmful, but the Gillard Government has committed to spending hundreds of millions of dollars on McGorry's new EPPIC centres that have been promoted as having psychosis prevention and treatment of "prodromal" youth as a major element of their services.

Perhaps you are not familiar with the Cochrane Collaboration, the organization that is behind these systematic reviews. It is probably the world's most respected source of information in medicine. It is my understanding that it doesn't do medical research, but it judges the worth of medical research trials (published or not) and compiles systematic reviews of studies of various medical interventions and drugs, based on only studies that meet certain standards, and if this evidence is searched for but simply doesn't exist, the Cochrane Collaboration makes it clear that no conclusions can be made. The Cochrane Collaboration are like the great big rubbish filter of medical science, and my oh my, there is so much rubbish research published in medical journals.

Sources:

Marshall, M. and Rathbone, J. Early intervention for psychosis. The Cochrane Library. Cochrane Database of Systematic Reviews. 2011 Issue 6. page 24.
Art. No.: CD004718. DOI: 10.1002/14651858.CD004718.pub3.

http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/pdf_fs.html

http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/frame.html

Schism opens over ills of the mind.
Sue Dunlevy
The Australian.
June 16, 2011.
http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

June 20th World Refugee Day

"Each year the United Nations High Commissioner for Refugees (UNHCR) celebrates World Refugee Day on 20 June. The global theme for World Refugee Day in 2011 is “1 refugee without hope is too many.”"

UNHCR
World Refugee Day 2011
http://www.unhcr.org.au/unhcr/index.php?option=com_content&view=article&id=216&Itemid=95

Protest rallies are planned to mark this occasion in cities around Australia on various dates:

Socialist Alternative
World Refugee Day rallies
http://www.sa.org.au/index.php?option=com_k2&view=item&id=6888:world-refugee-day-rallies&Itemid=396

Today's political quote

"Look, I think everyone needs to pop a Mogadon."

- Foreign Minister and former ALP Prime Minister of Australia Kevin Rudd, responding to reporters' questions on a day in which there was more speculation that Rudd might have aspirations to re-take the top job, and there was reportedly a shouting match between Rudd and the current ALP PM Julia Gillard during discussions of a foreign affairs matter.

McGorry has his critics ....

Ahmed, Tanveer (2010) Mental health claims overblown. Sydney Morning Herald. smh.com.au August 12, 2010.
http://www.smh.com.au/opinion/politics/mental-health-claims-overblown-20100811-11zoj.html

Attard, Monica (2010) Professor Patrick McGorry, 2010 Australian of the Year. Sunday Profile. ABC Radio National. January 31st 2010.
http://www.abc.net.au/rn/sundayprofile/stories/2010/2806382.htm

Dunleavy, Sue (2011) Schism opens over ills of the mind. Australian. June 16th 2011.
http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

Dunleavy, Sue (2011) US expert slams Patrick McGorry's psychosis model. Australian. June 14, 2011.
http://www.theaustralian.com.au/national-affairs/us-expert-slams-patrick-mcgorrys-psychosis-model/story-fn59niix-1226074544901

Frances, Allen J. (2011) Continuing Controversy On Australia's Mental Health Experiment: Seven questions for Dr McGorry. Psychology Today Blogs. June 13th 2011.
http://www.psychologytoday.com/blog/dsm5-in-distress/201106/continuing-controversy-australias-mental-health-experiment

Frances, Allen J. (2011) Australia's Reckless Experiment In Early Intervention: prevention that will do more harm than good. Psychology Today Blogs. May 31st 2011.
http://www.psychologytoday.com/blog/dsm5-in-distress/201105/australias-reckless-experiment-in-early-intervention

Frances, Allen J. (2010) DSM5 'Psychosis Risk Syndrome'--Far Too Risky. Psychology Today. March 18, 2010.
http://www.psychologytoday.com/blog/dsm5-in-distress/201003/dsm5-psychosis-risk-syndrome-far-too-risky

McGorry's early intervention model slammed. Australian Doctor. June 14th 2011.
http://www.australiandoctor.com.au/thisWeek.asp

Marshall, M. and Rathbone, J. Early intervention for psychosis. The Cochrane Library. Cochrane Database of Systematic Reviews. 2011 Issue 6. page 24.
Art. No.: CD004718. DOI: 10.1002/14651858.CD004718.pub3.
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/pdf_fs.html
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/frame.html
[see "Other potential sources of bias" in the summary of findings]

Raven, Melissa and Jureidini, Jon (2010) Misleading claims in the mental health reform debate. On Line Opinion. August 9th 2010.
http://www.onlineopinion.com.au/view.asp?article=10793
["...we also believe it matters that high-profile mental health advocates are able to mislead by proclaiming authoritative-sounding statistics that almost no one bothers to check, and that misleading claims are incorporated into health policy. This uncritical acceptance is an impediment to evidence-based policy. Worse, when the inaccuracies of claims are pointed out, there is often reluctance to acknowledge the misinformation and attempt to rectify it, as is the case with GetUp." ]

Speed Up & Sit Still (blog of Martin Whitely MLA)
http://speedupsitstill.com/

Webb, David and Raven, Melissa (2010) McGorry's 'early intervention' in mental health: a prescription for disaster. On Line Opinion. April 6th 2010.
http://www.onlineopinion.com.au/view.asp?article=10267

Weber, David (2011) Mental health centres under attack. ABC News. May 12, 2011.
http://www.abc.net.au/news/stories/2011/05/12/3215323.htm

Weber, David (2011) Professor McGorry hits back at critics. The World Today. ABC Radio National. May 20 2011.
Audio:
http://www.abc.net.au/news/audio/2011/05/20/3222359.htm
Transcript:
http://www.abc.net.au/worldtoday/content/2011/s3222359.htm

Williams, Daniel (2006) Drugs before diagnosis? Time. June 18th 2006.
http://www.time.com/time/magazine/article/0,9171,1205408,00.html

McGorry hits back in The Australian

US no model for mental health
Patrick McGorry and Alison Yung
The Australian.
June 15, 2011.
http://www.theaustralian.com.au/national-affairs/commentary/us-no-model-for-mental-health/story-e6frgd0x-1226075227181

Patrick McGorry returns fire in psychosis dispute.
Sue Dunlevy
The Australian.
June 15, 2011.
http://www.theaustralian.com.au/national-affairs/patrick-mcgorry-returns-fire-in-psychosis-dispute/story-fn59niix-1226075253784

Prof. McGorry has written that "The $400m focused on youth mental health and early psychosis has little to do with prevention and nothing to do with the "psychosis risk" windmill that Frances attacks." Well, if it is true that McGorry's services are little concerned with prevention and not concerned with identifying risk, why does the "about us" page at the website of EPPIC say this: "EPPIC also has a dedicated service for people thought to be at risk of developing a psychotic disorder, the PACE team." and why does it say this in the EPPIC clinical guidelines: "All individuals assessed as having an ‘at risk’ mental state are referred to the PACE clinic at EPPIC"? Seems to me that you lie like a rug, professor.

I thought it was a great joke that McGorry has tried to paint his critics as deniers with "vested interests" in the same league as climate change deniers and tobacco industry supporters. My readers should be very clear about who it is that has the vested interests and the beneficial relationship with powerful corporations. We're looking at you, doc.

References

EPPIC About Us
http://www.eppic.org.au/about-us

EPPIC Clinical Guidelines
http://www.eppic.org.au/eppic-clinical-guidelines

On the front page of today's Australian .....

US expert slams Patrick McGorry's psychosis model
EXCLUSIVE: Sue Dunlevy
The Australian
June 14, 2011.
http://www.theaustralian.com.au/national-affairs/us-expert-slams-patrick-mcgorrys-psychosis-model/story-fn59niix-1226074544901

and there is also this very recent article in an Australian medical professional magazine which apparently includes a critical quote form the former president of the Royal Australian College of Psychiatrists, Louise Newman, but unfortunately is only available for doctors to read:

McGorry's early intervention model slammed.
Australian Doctor.
June 14th 2011.
http://www.australiandoctor.com.au/thisWeek.asp

and there's also these:

"On the face of it, Australia's sudden and massive investment in the EPPIC program seems far excessive and decades premature. EPPIC may indeed work, but it represents a huge and reckless bet seemingly based more on blind faith in one man than on a substantial foundation of research and experience."
- Dr Allen J. Frances

"Clearly pre-emptive/preventive treatment is an important component of the EPPIC model, and potential recipients are being actively recruited."
- Melissa Raven, psychiatric epidemiologist and member of Healthy Skepticism, in comments on the article by Dr Frances in Psychology Today

Continuing Controversy On Australia's Mental Health Experiment: Seven questions for Dr McGorry.
Allen J. Frances
Psychology Today Blogs.
June 13, 2011
http://www.psychologytoday.com/blog/dsm5-in-distress/201106/continuing-controversy-australias-mental-health-experiment
[with most interesting comments from Prof. Henry Jackson and Melissa Raven]

Australia's Reckless Experiment In Early Intervention: prevention that will do more harm than good.
Allen J. Frances
Psychology Today Blogs.
May 31, 2011
http://www.psychologytoday.com/blog/dsm5-in-distress/201105/australias-reckless-experiment-in-early-intervention

Some quotes about Australian politics from this week

OK, so, one year on almost from the killing Kevin episode Julia Gillard’s net satisfaction rating is precisely where his was before he was knifed.

- Lenore Taylor, from the Sydney Morning Herald speaking on Insiders TV show broadcast on ABC1 June 5th 2011



I don’t accept that my country is a pissant country.

- Professor Ross Garnaut speaking at the launch of the updated Garnaut Review of climate change at the National Press Club, May 31st 2011.



Order, order, ORDER!, order, order......

- Harry Jenkins, Speaker of the House of Representatives, who came close to resigning this week following a failure to win a vote to have a backbencher suspended for alleged rowdy behaviour

Prof. Pat McGorry and the disclosure of conflicts of interest - what a friggin' joke!

I had to laugh out loud today when I noticed the disclosure statement next to an article written by the Australian psychiatrist, former Australian of the Year and influencer of politicians Professor Patrick McGorry about suicide that was published on April 15th 2011 at a website titled The Conversation beta, which looks like something from Australia that has aspirations to seriousness. The blurb next to the disclosure statement says:

"Our goal is to ensure the content is not compromised in any way. We therefore ask all authors to disclose any potential conflicts of interest before publication."

Well, the folks at The Conversation can ask all they like, but the prof only disclosed this much:

"Pat McGorry receives funding from the NHMRC."

I have serious doubts that this statement covered everything. This online article was published in April 2011 only a month after the publication in March 2011 of a piece by Prof. McGorry and another author was published in the medical journal Australian Family Physician, which included this rather fuller disclosure statement:

"Funding and support: Professor McGorry receives funding from the
Colonial Foundation, and from a program grant and a Clinical Centre
Research Excellence Grant from the National Health and Medical
Research Council of Australia. He has also received research grant
support from Janssen Cilag, Eli Lilly, Pfizer, Novartis and Astra Zeneca."

I guess someone might try to pose the question of how long does it take for a medical researcher to live down a professional conflict of interest. I'd say it would have to be a lot longer than a month, and I'm sure that some would say that there is no "use by" date for conflicts of interest.


References

McGorry, Patrick (2011)
The sort of conversation we should be having about suicide. The Conversation (beta). April 15th 2011.
http://theconversation.edu.au/the-sort-of-conversation-we-should-be-having-about-suicide-663

McGorry, Patrick D. and Goldstone, Sherilyn (2011) Is this normal? Assessing mental health in young people. Australian Family Physician. March 2011 Vol 40, (3) 94-97.
http://www.racgp.org.au/afp/201103/41499

Rudd at the Club

Today an edited version of an address to the National Press Club by Kevin Rudd was broadcast. His speech was delivered in a brisk pace and it was followed by an attentive question session. Kevin Rudd quoted many impressive-sounding statistics. He counted things out on his fingers, for added visual impact. He pointed at something that wasn't there. He employed some favourite phrases, such as "in due season". In a mood that looked like defiance Rudd refused to apologise for something, as is his habit. He used a word that was possibly his own invention, and doesn't pass my spellchecker unnoticed ("thugged"). Rudd interrogated himself and gave some sensible-sounding answers to his own probing questions. He adjusted his glasses, even though they had looked perfectly straight. He made his case energetically, confidently and convincingly, and all is right in the world.

The Hon Kevin Rudd MP
Minister For Foreign Affairs
National Press Club of Australia
June 1, 2011
"Australia's United Nations Security Council bid: Why it matters"
http://www.npc.org.au/speakerarchive/kevin-rudd-010611.html