What’s wrong with psychiatric research and the strict syndrome approach?

PLEASE, PLEASE, PLEASE could the new mental health research fund be used to find effective treatment for suicidal ideation? Currently it is a sub measure in depression research (and BPD?) but not a sole measure. As a consequence there is no specific clinical guidance (NICE can’t commission research).

Also, a retrospective meta analysis of the effect on hallucinations alone from major tranquiliser medication. Again, this is a single but important complaint lost amongst other measures. Patients often accept medication so their hallucinatory voices will diminish or cease but (as far as I’m aware) no research exists to select the best drug. (PANSS – a schizophrenia measure – has a lot of submeasures).

These are two problems caused by the snydrome approach versus looking at simple measures. There’s another problem. Depression research uses strict criteria to be scientific. Self-report of mental unwellness alone is disregarded unless it also presents within the operational cluster of symptoms approach (ie at least 5 of 9 or 10 symptoms). Someone displaying non-standard symptoms (eg men – please see Mind’s campaign for more info) or 4 or less symptoms is deemed not to be experiencing clinical depression. In practice a doctor either uses the strict diagnosis which means some patients reporting mental distress won’t be treated or the doctor listens to the patient but in this case the scientific results don’t apply. Respectively these approaches are based on considering depression to be a biomedical syndrome (so the science applies) or the idea that depression is the medicalisation of misery. The latter is what the public expect but they also expect doctors to offer scientific solutions. What I’m saying is there’s a difference between research, clinical practice and patient expectations which needs to be addressed in suicide treatment, treatment of hearing voices and depression as the medicalisation of misery.

Expensive research is failing to meet patient expectations.

Drug paranoia

Does the lack of a retrospective meta analysis of major tranquillisers effect on hallucinations mean research psychiatrists knew there was no there was no antipsychotic quality. They just render people docile.