Tuesday, April 14, 2009

Link Roundup

I have several long, unfinished, fairly involved posts backed up in my draft queue --- some have been there since February --- but I'm really not up to writing anything substantial yet.

There are, however, a number of things other people have written that really struck a chord with me recently, so I am going to point you guys toward them as well.

First, a couple of short pieces on a perennial favorite topic of mine, sex differences within autism. Mike Stanton of Action for Autism ponders the significance of autism's lower prevalence but greater severity in women and girls, and Elesia Ashkenazy discusses some of the ways in which autistic females don't fit the usual picture of what autism is, and thus are probably overlooked in diagnosis.

There's also this terrific guest post on Shakesville by Meowser, who blogs at Fat-Fu, which I discovered via Shiva's and Hexy's blogs.

In more general non-neurotypical news, Virginia Wood has an interesting and informative post about gender policing in psychiatry. (She follows it up with a discussion of why she does not consider religious-conversion-based therapies useful).

Finally, via the What Sorts of People? blog, a couple of posts about this Current Psychiatry editorial listing six predictions about what the future of psychiatry will be like. The prediction that alarmed all three bloggers is the prospect of "prodromal" diagnosis and treatment --- i.e., diagnosing a mental disorder not on the basis of symtoms but on the basis of likelihood of developing symptoms in the future.

Jonah at Alchemical Musings discusses the implication of this development that most worries me, which is its potential for use in social control:
The trend towards prodromal mental diagnoses is frightening precisely because it cedes even more power to an already cold and inhumane apparatus, which fails to listen to the voices of the people it claims to treat. The risks of preemptive discipline and prescriptive moral judgment reek of eugenics, and are simply too great and horrifying for this practice to continue. Patients are being indicted on the basis of hereditary factors, thought crimes, and innocuous deviant behavior.
Philip Dawdy at Furious Seasons takes another, equally relevant, perspective, questioning the proposed expansion of antipsychotic use to prevent potential cases of schizophrenia on the basis that antipsychotics are powerful and dangerous drugs:
[S]ome in psychiatry believe they can identify people at-risk [sic] for developing psychosis and zap them with antipsychotics and, then, they'll never develop schizophrenia. But the one big trial of this approach --- the PRIME study at Yale --- was a disaster. I wrote about it in 2006. About half the patients bailed from the study, mostly due to side effects of Zyprexa. Overall, only about one-quarter of the 60 original participants experienced psychosis, which perhaps calls into question the power of initial assessments.


hexy said...

Hrmm. I'm torn.

I was someone who displayed pre-schizophrenic symptoms, only they weren't spotted for what they were until after I manifested schizophrenia. I have to admit, I find myself leaning towards preventative care for kids ID'd as pre-schizophrenic.

But pre-schizophrenic use of anti-psychotics on kids and teens? Not so much. It's a shame they're looking at the idea of pre-schizophrenic treatment through a purely medicinal lens... my pshrink is fairly certain that my life could have been made easier with an understanding of my high-risk status for full blown schizophrenia, but he's never suggested I should have been medicated as a child!

Lindsay said...

Yeah, I also thought there were some potentially really good things about identifying severe mental disorders (the article mentioned mood disorders, like depression and bipolar, along with schizophrenia) before they've manifested. Not least, if you've gotten some warning that you might develop one, and been able to discuss the possibility with a doctor/therapist/whomever and formulate a plan, you'd probably be a lot less scared and desperate if or when the disorder *DID* manifest.

Gonzo said...

Thanks for pointing towards that post on Shakesville!
I love that blog, but they update it so often, I keep missing stuff.
Gonna check out the other links, too.