Notable Links & Miscellanea - Sep 15, 2024
Notable Links & Miscellanea - Sep 15, 2024
The Interdisciplinary Center for Psychiatry, Psychotherapy & Philosophy, Amsterdam University, is holding a virtual workshop on “The Identity Crisis in Psychiatry” on Sep 24-25, 2024. I’m one of the speakers (along with Dan Stein, Jennifer Radden, Damiaan Denys, Rachel Cooper, and Serife Tekin). For details, see the event page. And for registration, email Roy Dings at r.p.j.m.dings@amsterdamumc.nl
Niall Boyce (
) discussed and critically examined my recent paper, “Psychiatric Diagnosis: A Clinical Guide to Navigating Diagnostic Pluralism” for the Mental Elf. Many thanks to Niall Boyce. (You can read the paper here, and see some excerpts in a previous post.)I was on the podcast A Therapist Can't Say That with Riva Stoudt (episode here) discussing, among other things, my Substack post “Borderline Personality and Self-Understanding of Psychopathology.”
I reviewed the book “Mind the Science: Saving Your Mental Health from the Wellness Industry” by Jonathan Stea (
) for Psychiatric Times.Book launch webinar dedicated to discussing John Sadler’s ground-breaking book Vice and Psychiatric Diagnosis, a detailed historical and philosophical analysis of the vice-laden nature of certain psychiatric diagnostic categories. October 3, 2024. Register here.
Angie Voyles Askham in the Transmitter. Reconstructing dopamine’s link to reward. The field is grappling with whether to modify the long-standing theory of reward prediction error—or abandon it entirely.
Ashar et al. Open-Label Placebo Injection for Chronic Back Pain With Functional Neuroimaging.
“In this randomized clinical trial of 101 adults with chronic back pain, an open-label subcutaneous placebo (saline) injection led to significant improvements in pain intensity, mood, and sleep at 1 month posttreatment compared with usual care. The placebo treatment also led to reduced somatomotor activity and increased medial prefrontal activity during evoked back pain and to increased medial prefrontal-brainstem functional connectivity during spontaneous pain.”
Meyer & Desai (2015). Accepting Pain Over Comfort: Resistance to the Use of Anesthesia in the Mid-19th Century. (I came across this article thanks to Max Wolff on Twitter/X, @trpwolff, who made an analogy between early resistance to anesthesia and contemporary resistance to psychedelics)
“At least seven major objections to the newly introduced anesthetic agents were raised by physicians and patients. Complications of anesthesia, including death, were reported in the press, and many avoided anesthesia to minimize the considerable risk associated with surgery. Modesty prevented female patients from seeking unconsciousness during surgery, where many men would be present. Biblical passages stating that women would bear children in pain were used to discourage them from seeking analgesia during labor. Some medical practitioners believed that pain was beneficial to satisfactory progression of labor and recovery from surgery. Others felt that patient advocacy and participation in decision making during surgery would be lost under the influence of anesthesia. Early recreational use of nitrous oxide and ether, commercialization with patenting of Letheon, and the fighting for credit for the discovery of anesthesia suggested unprofessional behavior and smacked of quackery. Lastly, in certain geographical areas, notably Philadelphia, physicians resisted this Boston-based medical advance, citing unprofessional behavior and profit seeking.”
A creative analysis of “unmasking bias” in psychoactive RCTs in a preprint by Balázs Szigeti et al. Can functional blinding in MDMA trials produce a large enough effect to potentially account for the therapeutic effects seen in phase 3 trials? Szigeti et al. use data from ketamine and escitalopram trials to estimate the magnitude of functional unblinding. For instance, comparing saline placebo vs midazolam placebo against ketamine, they calculate unmasking bias of 1.1 SMD associated with ketamine for depression.
“Our results show that unmasking bias is larger than the treatment vs control effect size for MDMA. These findings do not prove that effects of MDMA-AT are entirely or even partially due to unmasking, however, our findings do indicate that MDMA-AT’s effect sizes are not too large to be due to unmasking.”
Colwell et al. Direct serotonin release in humans shapes aversive learning and inhibition.
“we use a now-accessible approach to directly increase synaptic serotonin in humans (a selective serotonin releasing agent) and examine its influence on domains of behaviour historically considered core functions of serotonin. Computational techniques, including reinforcement learning and drift diffusion modelling, explain participant behaviour at baseline and after week-long intervention. Reinforcement learning models reveal that increasing synaptic serotonin reduces sensitivity for outcomes in aversive contexts. Furthermore, increasing synaptic serotonin enhances behavioural inhibition, and shifts bias towards impulse control during exposure to aversive emotional probes. These effects are seen in the context of overall improvements in memory for neutral verbal information.”
A large pre-registered study from Switzerland finds essentially a null effect for the association between lithium levels in tap water and suicide rates. (The senior author is Martin Plöderl, whom I’ve interviewed on the topic of antidepressants and suicidality. See also: Reflections on the Recent Controversy Around Lithium and Suicide Risk.)
Sarah An Myers writes about her experience at a psychiatric facility for Schizophrenia Bulletin. We All Want to Be in Music Videos, Honey (See also: guest post by Sarah An Myers, Second-Generation Psychosis: A Brave New World of Recovery)
Sharp & Miller. Head-to-Head Comparisons of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section II and Section III Personality Disorder in Predicting Clinical Outcomes (spoiler: the Alternative Model of Personality Disorders in Section III wins)
Science. Genomic inference of a severe human bottleneck during the Early to Middle Pleistocene transition. “human ancestors went through a severe population bottleneck with about 1280 breeding individuals between around 930,000 and 813,000 years ago. The bottleneck lasted for about 117,000 years and brought human ancestors close to extinction. This bottleneck is congruent with a substantial chronological gap in the available African and Eurasian fossil record.”