Whenever the WA ALP MP Martin Whitely gets a mention on the front page of The Australian, the story is sure to be one that I'll find interesting. In the editorial comment about this story the possible consequence of new NHMRC guidelines on the treatment of ADHD in which Australian parents could potentially be referred to child protection if they refuse to medicate a child diagnosed with ADHD has been compared to the world of Orwell's dystopian novel 1984.
Medicate ADHD kids or else, parents told.
by: Sue Dunlevy
The Australian
November 21, 2011
http://www.theaustralian.com.au/national-affairs/medicate-adhd-kids-or-else-parents-told/story-fn59niix-1226200652633
Commonsense deficit disorder
Editorial
The Australian
November 21, 2011
http://www.theaustralian.com.au/news/opinion/commonsense-deficit-disorder/story-e6frg71x-1226200557444
Monday, November 21, 2011
Saturday, November 12, 2011
Another addition to the war of words over early psychosis
GP David Shiers and bipolar disorder expert Prof. Jan Scott, both from the UK, are both quoted in this report in the Weekend Australian, and they both lend support to the vision of early intervention in psychosis that has been promoted by Prof. Patrick McGorry. I have a few comments about the content of this article. Dr Shiers is quoted as claiming that new early intervention services, presumably in the UK, save money by lowering the rate of hospital readmissions. Where's the published study that demonstrates as much? There is no reference to any published study in this newspaper report, so I've got to assume that there isn't one.
Professor Scott's assertion that "...there is no medical disorder in which the outcome is better if you delay treatment" is presented in this article as a supporting argument for McGorry's early intervention program, but it fails, for two reasons. Firstly, it doesn't really address the previously expressed fears of Dr Allen Frances that McGorry's early intervention plans for a condition that is characterised as pre-psychosis will probably misdiagnose young patients who are not genuinely developing cases of psychosis. There is simply no value in intervening early with patients who are not geuninely ill. Secondly, Prof. Scott's assertion fails as a supporting argument because it simply isn't true. I can easily think of medical diseases, disorders and conditions in which the best medical practice is either watchful waiting or delaying treatment for a specified period. Some mild infections are best left untreated but with monitoring if it is not clear that antibiotics are necessary, and I know of at least one birth defect in which self-correction can happen in infancy, and therefore the best medical proctice is to delay surgery till the age at which the chances of spontaneous healing are negligible. I also believe that best medical practice for some cases of prostate cancer might be watchful waiting. Most cases of stuttering (a speech disorder) in early childhood remit spontaneously, and the last time I checked there was virtually nothing in way of credible published evidence that the treatment program used by most speech pathologists works better than no treatment, so the argument for doing nothing, at least in the early years, makes sense. When a medical doctor makes such a questionable and dogmatic statement I believe we should take that as a hint that an interventionist bias combined with an insufficient regard for all of the options and all of the evidence about outcomes could be operating, which is the last thing that we need in the vexed and heated dispute over how to treat Australian youths who may, or may not, be developing a serious mental illness.
At odds over early psychosis.
by: Sue Dunlevy
From:The Australian
November 12, 2011
http://www.theaustralian.com.au/news/health-science/at-odds-over-early-psychosis/story-e6frg8y6-1226191802632
Professor Scott's assertion that "...there is no medical disorder in which the outcome is better if you delay treatment" is presented in this article as a supporting argument for McGorry's early intervention program, but it fails, for two reasons. Firstly, it doesn't really address the previously expressed fears of Dr Allen Frances that McGorry's early intervention plans for a condition that is characterised as pre-psychosis will probably misdiagnose young patients who are not genuinely developing cases of psychosis. There is simply no value in intervening early with patients who are not geuninely ill. Secondly, Prof. Scott's assertion fails as a supporting argument because it simply isn't true. I can easily think of medical diseases, disorders and conditions in which the best medical practice is either watchful waiting or delaying treatment for a specified period. Some mild infections are best left untreated but with monitoring if it is not clear that antibiotics are necessary, and I know of at least one birth defect in which self-correction can happen in infancy, and therefore the best medical proctice is to delay surgery till the age at which the chances of spontaneous healing are negligible. I also believe that best medical practice for some cases of prostate cancer might be watchful waiting. Most cases of stuttering (a speech disorder) in early childhood remit spontaneously, and the last time I checked there was virtually nothing in way of credible published evidence that the treatment program used by most speech pathologists works better than no treatment, so the argument for doing nothing, at least in the early years, makes sense. When a medical doctor makes such a questionable and dogmatic statement I believe we should take that as a hint that an interventionist bias combined with an insufficient regard for all of the options and all of the evidence about outcomes could be operating, which is the last thing that we need in the vexed and heated dispute over how to treat Australian youths who may, or may not, be developing a serious mental illness.
At odds over early psychosis.
by: Sue Dunlevy
From:The Australian
November 12, 2011
http://www.theaustralian.com.au/news/health-science/at-odds-over-early-psychosis/story-e6frg8y6-1226191802632
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