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Quote: " ... a breakthrough approach that provides the first objective, scientific diagnosis for depression." Wait ... an "objective, scientific diagnosis" tha

by lutusp 12y ago

Quote: " ... a breakthrough approach that provides the first objective, scientific diagnosis for depression." Wait ... an "objective, scientific diagnosis" that doesn't identify the cause of the ailment? If I visited a doctor and she said, "You're running a fever, and your blood has cooties," I wouldn't think of that as the height of medical expertise, and it's certainly not science. In science, we establish causes and then measure effects. This test measures effects. No one knows what causes depression, therapy is indistinguishable from the placebo effect, and existing medications have a terrible reputation. This claim is way ahead of the evidence, evidence that in principle would identify the source of depression, offer an explanation to replace these many descriptions, and (at long last) craft a meaningful treatment. EDIT: Okay, before you people downvote my completely accurate post, read this: http://en.wikipedia.org/wiki/Scientific_theory http://en.wikipedia.org/wiki/Scientific_theory Quote: "Scientific theories are testable and make falsifiable predictions. They describe the causal elements responsible for a particular natural phenomenon, and are used to explain and predict aspects of the physical universe or specific areas of inquiry (e.g. electricity, chemistry, astronomy)." Feel free to drop by the source and downvote it too, while you're banging your mouse in ignorance.

dragonwriter 12y ago
> In science, we establish causes and then measure effects. No, in science, we observe and measure phenomena, then form hypotheses about relations between them, then attempt to falsify those hypotheses, and then use the hypothesized relations which we have not yet falsified as a basis for inferring likely causes from observed effects and inferring likely effects from observed causes and inferring likely co-occurrences that are the results of common (and potentially unknown) causes from the other co-occurring phenomena. "Establish causes and then measure effects" is not only wrong, its non-sense. To even be able to establish the likelihood of a causal relation you must first measure effects and the phenomenon hypothesized as the cause.
- lutusp 12y ago
  > "Establish causes and then measure effects" is not only wrong, its non-sense. All right, so you don't understand science. It's not fatal, and you're hardly alone. From Aristotle, through Francis Bacon, to the present, the centerpiece of science has been the establishment of causes, explanations, not merely observations and descriptions as you're suggesting. Observations often lead to the shaping of a theory, then confirmation of that theory -- that explanation -- through the prediction of phenomena not yet observed, and observations that confirm the predictions (or that falsify the theory). http://en.wikipedia.org/wiki/Scientific_theory http://en.wikipedia.org/wiki/Scientific_theory Quote: "Scientific theories are testable and make falsifiable predictions. They describe the causal elements responsible for a particular natural phenomenon, and are used to explain and predict aspects of the physical universe or specific areas of inquiry (e.g. electricity, chemistry, astronomy)." I could provide hundreds of quotes similar to that above, but I can't repair your education in a short post. You must accept responsibility for those things you don't understand, but that you feel comfortable reciting to other people in a public show of narcissism.
DanBC 12y ago
> Wait ... an "objective, scientific diagnosis" that doesn't identify the cause of the ailment? If I visited a doctor and she said, "You're running a fever, and your blood has cooties," I wouldn't think of that as the height of medical expertise, and it's certainly not science. GPs will tell you that this is wha they say to most patients. Why do you think antibiotics were overprescribed by so much for so long? To treat cooties. Plenty of illnesses have weakly defined causes but are treated anyway. Your refusal to subject physical health treatments to the same level of rigour that you subject mental health treatments is one sign of your kookery on this subject. > therapy is indistinguishable from the placebo This is nonsense. Perhaps you're confused? We know that "counseling" doesn't work. But no one credible suggests counseling as treatment, they suggest things like CBT. Here's a meta-meta-analysis. Given the evidence for CBT is so strong and the evidence for counseling is so weak it's telling that you recommend "chat's with your aunt" as being an effective treatment - totally misreading the literature. http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Therapy-Butler06.pdf http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Th... > This review summarizes the current meta-analysis literature on treatment outcomes of CBT for a wide range of psychiatric disorders. A search of the literature resulted in a total of 16 methodologically rigorous meta-analyses. Our review focuses on effect sizes that contrast outcomes for CBT with outcomes for various control groups for each disorder, which provides an overview of the effectiveness of cognitive therapy as quantified by meta-analysis. Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. Effect sizes for CBT of marital distress, anger, childhood somatic disorders, and chronic pain were in the moderate range. CBT was somewhat superior to antidepressants in the treatment of adult depression. CBT was equally effective as behavior therapy in the treatment of adult depression and obsessive-compulsive disorder. Large uncontrolled effect sizes were found for bulimia nervosa and schizophrenia. The 16 meta-analyses we reviewed support the efficacy of CBT for many disorders. While limitations of the meta-analytic approach need to be considered in interpreting the results of this review, our findings are consistent with other review methodologies that also provide support for the efficacy CBT. D 2005 Elsevier Ltd. All rights reserved. It should be obvious why you don't see placebo controlled studies for CBT - it is unethical to provide patients no therapy and so it's hard to get studies approved and it's hard to creat a sham talking therapy that would blind the patient and therapist. > and existing medications have a terrible reputation Medication is not recommended as front line treatment anymore. Medications for any illness can be unpleasant. I'm not convinced that anti depressants are any worse than any other medication. Comparing anti-depressants with placebo shows similar rates of drop-out.

by lutusp 12y ago

dragonwriter 12y ago

> In science, we establish causes and then measure effects. No, in science, we observe and measure phenomena, then form hypotheses about relations between them, then attempt to falsify those hypotheses, and then use the hypothesized relations which we have not yet falsified as a basis for inferring likely causes from observed effects and inferring likely effects from observed causes and inferring likely co-occurrences that are the results of common (and potentially unknown) causes from the other co-occurring phenomena. "Establish causes and then measure effects" is not only wrong, its non-sense. To even be able to establish the likelihood of a causal relation you must first measure effects and the phenomenon hypothesized as the cause.

lutusp 12y ago
> "Establish causes and then measure effects" is not only wrong, its non-sense. All right, so you don't understand science. It's not fatal, and you're hardly alone. From Aristotle, through Francis Bacon, to the present, the centerpiece of science has been the establishment of causes, explanations, not merely observations and descriptions as you're suggesting. Observations often lead to the shaping of a theory, then confirmation of that theory -- that explanation -- through the prediction of phenomena not yet observed, and observations that confirm the predictions (or that falsify the theory). http://en.wikipedia.org/wiki/Scientific_theory http://en.wikipedia.org/wiki/Scientific_theory Quote: "Scientific theories are testable and make falsifiable predictions. They describe the causal elements responsible for a particular natural phenomenon, and are used to explain and predict aspects of the physical universe or specific areas of inquiry (e.g. electricity, chemistry, astronomy)." I could provide hundreds of quotes similar to that above, but I can't repair your education in a short post. You must accept responsibility for those things you don't understand, but that you feel comfortable reciting to other people in a public show of narcissism.

DanBC 12y ago

> Wait ... an "objective, scientific diagnosis" that doesn't identify the cause of the ailment? If I visited a doctor and she said, "You're running a fever, and your blood has cooties," I wouldn't think of that as the height of medical expertise, and it's certainly not science. GPs will tell you that this is wha they say to most patients. Why do you think antibiotics were overprescribed by so much for so long? To treat cooties. Plenty of illnesses have weakly defined causes but are treated anyway. Your refusal to subject physical health treatments to the same level of rigour that you subject mental health treatments is one sign of your kookery on this subject. > therapy is indistinguishable from the placebo This is nonsense. Perhaps you're confused? We know that "counseling" doesn't work. But no one credible suggests counseling as treatment, they suggest things like CBT. Here's a meta-meta-analysis. Given the evidence for CBT is so strong and the evidence for counseling is so weak it's telling that you recommend "chat's with your aunt" as being an effective treatment - totally misreading the literature. http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Therapy-Butler06.pdf http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Th... > This review summarizes the current meta-analysis literature on treatment outcomes of CBT for a wide range of psychiatric disorders. A search of the literature resulted in a total of 16 methodologically rigorous meta-analyses. Our review focuses on effect sizes that contrast outcomes for CBT with outcomes for various control groups for each disorder, which provides an overview of the effectiveness of cognitive therapy as quantified by meta-analysis. Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. Effect sizes for CBT of marital distress, anger, childhood somatic disorders, and chronic pain were in the moderate range. CBT was somewhat superior to antidepressants in the treatment of adult depression. CBT was equally effective as behavior therapy in the treatment of adult depression and obsessive-compulsive disorder. Large uncontrolled effect sizes were found for bulimia nervosa and schizophrenia. The 16 meta-analyses we reviewed support the efficacy of CBT for many disorders. While limitations of the meta-analytic approach need to be considered in interpreting the results of this review, our findings are consistent with other review methodologies that also provide support for the efficacy CBT. D 2005 Elsevier Ltd. All rights reserved. It should be obvious why you don't see placebo controlled studies for CBT - it is unethical to provide patients no therapy and so it's hard to get studies approved and it's hard to creat a sham talking therapy that would blind the patient and therapist. > and existing medications have a terrible reputation Medication is not recommended as front line treatment anymore. Medications for any illness can be unpleasant. I'm not convinced that anti depressants are any worse than any other medication. Comparing anti-depressants with placebo shows similar rates of drop-out.