dilluns, 15 de març de 2010

¿Puede la psiquiatría ser una ciencia?

Os dejo un interesante y brutal artículo que he encontrado en The New Yorker. Provocativo y transgresor. Pone en duda toda la psiquiatría actual con un nuevo punto de vista. Personalmente no creo que todo sea acertado pero tampoco va tan desencaminado. Un nuevo varapalo a la medicación, mejor dicho, a la sobremedicación de nuestros pacientes.
Nos cuentan que los estudios se realizan con placebo y algunos pacientes curan con placebo, que cada antidepresivo funciona de forma diferente en cada paciente, la obsesión de "inventar" enferemedades para "colocar" nuevos tratamientos...
El artículo es largo, pero si estás interesado en el tema merece la pena.

Head Case
Can psychiatry be a science?
by Louis Menand

You arrive for work and someone informs you that you have until five o’clock to clean out your office. You have been laid off. At first, your family is brave and supportive, and although you’re in shock, you convince yourself that you were ready for something new. Then you start waking up at 3 A.M., apparently in order to stare at the ceiling. You can’t stop picturing the face of the employee who was deputized to give you the bad news. He does not look like George Clooney. You have fantasies of terrible things happening to him, to your boss, to George Clooney. You find—a novel recognition—not only that you have no sex drive but that you don’t care. You react irritably when friends advise you to let go and move on. After a week, you have a hard time getting out of bed in the morning. After two weeks, you have a hard time getting out of the house. You go see a doctor. The doctor hears your story and prescribes an antidepressant. Do you take it?

However you go about making this decision, do not read the psychiatric literature. Everything in it, from the science (do the meds really work?) to the metaphysics (is depression really a disease?), will confuse you. There is little agreement about what causes depression and no consensus about what cures it. Virtually no scientist subscribes to the man-in-the-waiting-room theory, which is that depression is caused by a lack of serotonin, but many people report that they feel better when they take drugs that affect serotonin and other brain chemicals.

There is suspicion that the pharmaceutical industry is cooking the studies that prove that antidepressant drugs are safe and effective, and that the industry’s direct-to-consumer advertising is encouraging people to demand pills to cure conditions that are not diseases (like shyness) or to get through ordinary life problems (like being laid off). The Food and Drug Administration has been accused of setting the bar too low for the approval of brand-name drugs. Critics claim that health-care organizations are corrupted by industry largesse, and that conflict-of-interest rules are lax or nonexistent. Within the profession, the manual that prescribes the criteria for official diagnoses, the Diagnostic and Statistical Manual of Mental Disorders, known as the D.S.M., has been under criticism for decades. And doctors prescribe antidepressants for patients who are not suffering from depression. People take antidepressants for eating disorders, panic attacks, premature ejaculation, and alcoholism.

El artículo completo aquí.
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