The Medical Model in Mental Health - explains what it is and how it compares in
#psychiatry
with internal
#medicine
for the effectiveness of its treatments and the value of its diagnostic constructs- now on sale all over the world
@misterhsk
They are not us down south ? What a pile of BS. I’m Scottish and I live “down South”. As a Glaswegian I find I have more in common with people in Liverpool and Manchester than people in other parts of Scotland. We have ties of family, history & culture with the English
Many people including doctors in other medical specialties forgot how hard primary care medicine is. There said to be 10,000 conditions in medicine. Anyone of them can come through the door and the GP has to recognise many of them in 10 minutes & initiate appropriate treatment
People may ask why I tweeted and RT a lot about J Taylor’s comments on ADHD & autism in women. Answer: In my ADHD clinic I see women whose missed ADHD diagnosis has led to major problems in their lives. I encounter similar with women with autism. Most cases not caused by trauma.
The problem with getting clinical information from people with unclear clinical qualifications is that you might be being told codswallop as this is here
@DrJessTaylor
@fgh07_
Sorry to intervene but I only just saw this. Unlike JT I’m a qualified clinician. I specialise in treating psychosis. My advice to you is to see a clinician you trust & discuss with them Don’t take advice from non clinicians on Twitter. 4
The complaints I get from white psychologists for being “disrespectful” for offering blunt but accurate criticism of their ideas reflects their colonialist heritage & mindset - I’m supposed to genuflect before their self perceived superiority
It’s a common mistaken assumption amongst antipsychiatry psychologists that they got a free medical degree in their studies They then plague the rest of us with
@BadMedicalTakes
Due to be published tomorrow - my book on explaining and evaluating the medical mode in mental health - useful for mental health professionals and students as well as patients and carers and philosophers with an interest in health
My joint favourite Moncrieff paper along with her clozapine meta analysis which showed clozapine was superior to other antipsychotics Congratulations to her for publishing results that contradict her prior views - excellent science
"In people with recurrent psychosis or schizophrenia, we found no evidence to support our hypothesis that a gradual reduction of antipsychotic medication improved social functioning at 2-year follow-up."
New research Article
@joannamoncrieff
I punched the air this morning when I read the news that instead of doling out inhalers for asthmatics that doctors should prescribe deep breathing in fresh air and to move to the country instead
✍️"I punched the air this morning when I read the news that doctors should stop routinely doling out antidepressants and offer patients therapy, meditation or exercise instead," writes
@RachelKellyNet
Very concerning that over 6% of the antipsychotic discontinuation group died in the course of the study - double the rate of the medication continuation group. As in the Lancet CBT for psychosis study, mortality is higher in psychosis without antipsychotics
When people use terms like “mind altering” to criticise psychiatric medication I think well since it’s being used to help a condition effecting the mind aren’t we using the medication to have some benefit for the mind? I mean what else is it supposed to alter? The feet?
Breaking silence to say this is totally unacceptable This is unacceptable
@rcpsych
If the person who asked these questions is an RCPSYCH member then action needs to be taken.
Today I gave a talk for the
@rcpsych
on gender inclusive healthcare. Attendees were, as I understand it, health professionals. The Q&A section had over 45 transphobic questions, ~80% of questions. To keep control of my emotions as I presented I had to dig my nails into my hand.
What does
@BPSOfficial
think of a psychologist without clinical qualifications giving clinical advice to someone with a potentially serious condition especially when this advice isn’t backed up by the evidence base ?
By the time someone has come to see a psychiatrist it’s usually because they have been unwell for a long period of time or there is risk involved or no other treatments have worked in other words the time for watchful waiting has passed
79% of psychiatrists recommend immediate treatment with an antidepressant to an outpatient with depression, but only 39% of psychiatrists would immediately take an antidepressant if they personally had depression, while 61% would prefer watchful waiting
My MA thesis in Philosophy of Mental Health - why Early Intervention in Psychosis teams should use a narrow psychosis construct based on nosology & prognosis
Interesting to learn that at a forensic psychiatry hospital with lots of patients diagnosed with borderline personality disorder none of the psychologists are trained to offer best evidence based therapies in that condition such as DBT. Skills/ need mismatch
This paper by
@joelpetch
and I discusses classification of psychosis from the POV of clinical practice rather than research It’s in
#BJPSYCHAdvances
@TheBJPsych
short thread 1
Withdrawal of warmth is not justified when trying to help people - this is from a book about psychotherapy for people diagnosed with personality disorder
Medical students and doctors - remember when u see “interesting cases” - these are people - ask how they are - look at and empathise with the person who has fears and worries and who you are lucky to be learning from
Dementia has such terrible effects on people’s moods, behaviours, personality that those who say it is not a mental illness do not understand what mental illness is
It will surprise no one that Dr Taylor is both conceptually and empirically wrong here and relies on appealing to the authority of the listed experts. Her beliefs are irrelevant.A mental illness isn’t always permanent. There IS evidence of dopamine dysfunction in psychosis.
Since neurodiversity can’t be easily bent into a trauma causes everything or sole
#PTMF
framework it must be eliminated no matter the scientific evidence nor that it is a useful concept
99% of statistics are made up (not a factual statement) but this thread is full of errors. Propranolol helps some people with anxiety presumably by blocking somatic symptoms of anxiety like racing heart which people can find unpleasant not by affecting thoughts directly
I completely disagree with Boris Johnson and everything he has done and his policies but that doesn’t mean on a human level I can’t wish him well and hope he recovers.
Mathew Parris is a remarkably cruel commentator on mental health He’s a typical Tory - if he likes or supports something or directly benefits from it he comes across as liberal If he’s hostile to it then he becomes unpleasant
If Jess Taylor can prove that schizophrenia was only diagnosable in black people ie that only black people were diagnosed with schizophrenia in the UK or US then I will tweet a picture of me in a Man U shirt
plain foolishness from Garson- lacks an understanding of the compelling nature of psychotic experiences- for people deep in the throes of psychosis it’s not a question of coolly weighing up options This is an example of where lived experience can blind one to others experiences
I agree with Dr Jess Taylor - in mental health many of those who claim to be critical thinkers are blinkered to their prejucides and make empirically false statements or logically fallacious arguments
Disappointed that MH professionals have reacted so badly to a potentially promising treatment- early days only one success - because it’s not psychotherapy and are much upset as it involves biology & using scare tactics in their language It’s not Orwellian to help sev depression
Many patients present to primary care in emotional distress. This
#BMJInfographic
summarises an approach to helping patients make manageable changes that can lead them to more positive behaviours
@will_s_t
Antipsychiatry and far right wing politics go together like a horse and carriage Akathisia is a recognised side effect of SSRIs but are used all over the world Trying to blame them for mass shootings in the US is a way to avoid gun control
I hate it when people say western medicine- it’s just medicine It erases the important contributions of the East to the history of medicine and the massive impact of non Westerners to medical research and as practitioners
Ear infections are usually self limiting; brief and not fatal. Depression can last months or longer, can be fatal and has greater impact on QOL/ functioning. There are various options to be tried. Therapeutic nihilism a la Moncrieff is cruel & unwarranted
Well had a fun 36 hours of a lynch mob of antipsychiatry psychologists and critical psychiatrists sizing me up for a tree. But I had pizza. Read an interesting book. Walked my dogs. And I’m still here. Uppity as always. Fight the power ✊🏾
Final finished my
#psychopharmacology
textbook as recommended by
@RealJesseLuke
I thought it was an interesting book with a biopsychosocial model of causation and intervention
DNA rate for my EIT clinics has halved since we moved to a more accessible location - sometimes clients not engaging with the service is due to service factors not the client!
Making a mountain out of a linguistic molehill Why not focus on relieving the suffering ? Saying “have depression” is short hand for patient is suffering in a state that meets criteria for depression … …
@DrJessTaylor
@fgh07_
It’s not petty You should have pointed out the evidence base for them and how it compares to antipsychotics to show their strength as an alternative Why give clinical advice when you are not trained to ?
The data showed antipsychotics halved mortality, more than halved relapse rates and didn’t worsen social functioning albeit with side effect burden . That’s good news for patients who take them. It’s bad news for Antipsychiatry professionals. McFilin can’t interpret data
Davies clearly having a dawning realisation that the critical psychiatry anti psychiatry discourse has been taken up by the right wing as they have been warned by many others that this would happen
Very little sleep doing my on call last night - too knackered to go in and do my routine work - in my salad days could work 36 hours or more on the trot but I conk out now at 24 hours
#Bonnie
is concerned
It’s also important to state the journalist set out to deceive the assessing doctors. In medicine we tend to assume the patient is telling the truth as they see it about their experience (if we don’t calamity often occurs)
While this has made a lot of people upset and angry, the essential point - that a diagnosis of ADHD should be made properly, after full and competent consideration of the patient and possible differential diagnoses - is a fair one. People deserve and are helped by good diagnoses.
@wdpsychiatry
This is dangerous advice You should delete it Only medication has good evidence to reduce bipolar episodes (even psychosocial interventions to be effective encourage medication use as part of package) Lithium reduces suicide Please delete
There is no conflict between the psychological approach and the medical model. There is conflict between some professionals but that is about guild warfare rather than necessary conflict of approaches