I'm not going to take the obvious tack to consider research versus practice or clinical use. That's more comedy, in the sense of it's rubbishness but still assumed to be scientific, than I care to cry about right now.
What I'm talking about is shit like ECT. There was no good evidence to support the use of electricity to induce seizures as any good medical treatment. The modern psychiatric movement seem thankful of this but are biased because they believe ECT is amazing.
The evidence, based on a high quality meta-analysis, is ECT is as effective as a sham treatment where the patient thinks they're getting shocked while unconscious but no electricity is used and no seizure is induced, at least in pretty much all trials which compare followup rather than just the effect of a mental health treatment during the treatment period.
I don't understand the paradigm of medicine well enough to consider if a treatment is only effective during its use is it considered a treatment, and in this sense a cure, or not.
I think protangonists of ECT might suggest such evidence might mean ECT should be banned. I'd agree in one sense, but say that the effect needs to be understood.
ECT or sham-ECT is a last resort. Many ECT studies have exckuded a true control group because the refusal of treatment to those who really need it is immoral. It's why there are very few if any modern (in the last few, say 3, years) trials of antipsychotics versus a placebo for first episode psychosis.
Oh shit. I made it to the point I'm making in some drunk, stoned rant.
As the title suggest and the current discourse I've gone a fair bit off the point.
A segue to where I started from. Psychiatry fucks up with psychosis. World health organisation studies which show that small or non-existent psychiatric systems in poor nations offer better results than those in developed world nations.
This isn't a paradox. Not for anyone who's stayed outside the system.
Ugh. New thought process. How terribly insane of me.
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