Sunday 6 March 2011

Are psychiatric treatments like Google?

In that they do everything?

I've just skimmed the abstract of this paper on somatic symptoms interventions.
http://www.bmj.com/content/325/7372/1082.1.full

"
Results: Sixty one studies were identified; 20 were classified as primary care and 41 as secondary care. For some interventions, such as brief psychodynamic interpersonal therapy, little research was identified. However, results of meta-analyses and of randomised controlled trials suggest that cognitive behaviour therapy and behaviour therapy are effective for chronic back pain and chronic fatigue syndrome and that antidepressants are effective for irritable bowel syndrome. Cognitive behaviour therapy and behaviour therapy were effective in both primary and secondary care in patients with back pain, although the evidence is more consistent and the effect size larger for secondary care. Antidepressants seem effective in irritable bowel syndrome in both settings but ineffective in chronic fatigue syndrome.
"

Antidepressants work for irritable bowel syndrome. That's a surprising result on the surface. The same is the possibility that CBT and BT can work for physical problems. BT - behavioural modification - is a talking technique which works for a physical problem.

It's not so strange. The biopsychosocial model of cause for all illness (even not real ones like mental illness) is the one which works but the sciene of medicine is unable to use.

http://bjp.rcpsych.org/cgi/content/full/bjprcpsych;195/1/3

Even physical illness is a complex thing.

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"