THE JOYFUL REDUCTION OF UNCERTAINTY

Tag Archives: psychiatry

HPPD And The Specter Of Permanent Side Effects

I recently worked with a man who took LSD once in college and never stopped hallucinating. It’s been ten years now and it’s still going. We can control it with medication, but take the meds away and it starts right … Continue reading

In Search Of Missing US Suicides

[Content warning: suicide. Thanks to someone on Twitter I forget for alerting me to this question] Among US states, there’s a clear relationship between gun ownership rates and suicide rates, but not between gun ownership rates and homicide rates: You … Continue reading

Should Psychiatry Test For Lead More?

Dr. Matthew Dumont treated a 44 year old woman with depression, body dysmorphia, and psychosis. She failed to respond to most of the ordinary treatments, failed to respond to electroconvulsive therapy, and seemed generally untreatable until she mentioned offhandedly that … Continue reading

Mental Health On A Budget

Everyone knows medical care in the US is expensive even with insurance and prohibitively expensive without it. I have a lot of patients who are uninsured, or who bounce on and off insurance, or who have trouble affording their co-pays. … Continue reading

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Navigating And/Or Avoiding The Inpatient Mental Health System

Apology and disclaimer This is in response to questions I get about how to interact (or not interact) with the inpatient mental health system and involuntary commitment. The table of contents is: 1. How can I get outpatient mental health … Continue reading

SSC Journal Club: Friston On Computational Mood

A few months ago, I wrote Toward A Predictive Theory Of Depression, which used the predictive coding model of brain function to speculate about mood disorders and emotions. Emotions might be a tendency toward unusually high (or low) precision of … Continue reading

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God Help Us, Let’s Try To Understand Friston On Free Energy

I’ve been trying to delve deeper into predictive processing theories of the brain, and I keep coming across Karl Friston’s work on “free energy”. At first I felt bad for not understanding this. Then I realized I wasn’t alone. There’s … Continue reading

SSC Journal Club: Cipriani On Antidepressants

I. The big news in psychiatry this month is Cipriani et al’s Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. It purports to be … Continue reading

Powerless Placebos

[All things that have been discussed here before, but some people wanted it all in a convenient place] The most important study on the placebo effect is Hróbjartsson and Gøtzsche’s Is The Placebo Powerless?, updated three years later by a … Continue reading

Book Review: Madness And Civilization

[Content warning: Severe mistreatment of the mentally ill. Through this post, I’ll be following Foucault in using the politically incorrect term “madness” rather than the more modern “mental illness”, because a big part of his point is worrying about the … Continue reading