Another Psychiatrist Gives up His License

As reported in the Bangor Daily News. Looks like the doctor has taken an attitude similar to Alfred E Neuman of Mad Magazine fame: "What? Me worry?" Surely the complaint heard in some quarters of the decline of psychiatry cannot be helped by some many giving up their license.

After complaints about his professional conduct, longtime Bangor psychiatrist Takeo Kawamura has voluntarily surrendered his license to practice medicine in Maine, according to the state’s Board of Licensure in Medicine. Kawamura’s loss of licensure took effect on Jan. 8 and is permanent.

The complaints include an allegation that Kawamura mismanaged one patient’s medications and failed to competently treat another patient who ultimately committed suicide.

In a public document obtained from the medical licensing board, Kawamura neither admitted nor denied allegations of incompetence and professional misconduct. But he conceded that the board had sufficient evidence to "reasonably conclude" he failed to adequately monitor the medical care and medications of two patients, behavior that "could amount to incompetence and unprofessional conduct, and constitutes grounds for discipline of his Maine license."

In a complaint received by the board in March 2006, a female patient alleged she suffered side effects from her medication because of Kawamura’s failure to adequately monitor the amount of medication in her blood. According to the public document, Kawamura asserted he had treated the patient appropriately.

In March 2007, the board received information about another patient who had committed suicide while under Kawamura’s care. After its review of the case, the board initiated a complaint alleging incompetence. Kawamura denied providing incompetent care to the patient, according to the public document.

In the consent agreement signed Jan. 8, Kawamura agreed to surrender his license permanently in order to resolve the complaints without further board proceedings.

In 2006, Kawamura signed another consent decree that required him to take a board-approved course in medical ethics each calendar year and to obtain ongoing therapeutic counseling himself. He also was required to discontinue treating family members unless they were in joint therapy.

Kawamura is a 1958 graduate of Chiba University in Japan and had been licensed in Maine since 1962. He served as the chief of psychiatry at Eastern Maine Medical Center in Bangor and as the head of outpatient services at Acadia Hospital in Bangor.

Kawamura’s office was closed Monday because of the snowstorm. An answering service operator said Kawamura had "resigned" but had no further information. The call was not immediately returned. Kawamura’s home phone number is unpublished.

Psychiatrist denies murdering her teenage daughter

As reported in the Irish Independant

A jury of nine women and three men has been selected to hear the trial of a psychiatrist charged with murdering her teenage daughter.

Lynn Gibbs (46), a psychiatrist from Killure in Gowran, Co Kilkenny, is charged with murdering her 16-year-old daughter Ciara at Killure, in November 2006.

Mrs Gibbs denied the charge when she appeared at the Central Criminal Court at Dublin yesterday morning.

The court heard the trial will start today and turns on a single issue that will be determined by expert psychiatric evidence.

Brendan Grehan, for the Director of Public Prosecution, said the case is expected to take between one and one-and-a-half days.

Mrs Gibbs is represented by Patrick Gageby.

262 freed from Irish psychiatric hospitals in the past year.

Around 20 Irish psychiatric patients are now being released every month after pleading their case before special tribunals. They were originally detained in mental hospitals against their will, and now have the option of independent tribunals. The mental health tribunals were set up over a year ago to allow patients who were the subject of involuntary detention orders to make their case to have it lifted. Previously, they had to rely on the sympathy of psychiatrists to deem if they were suitable to have the order lifted. Apparently, there was an obvious need for this sort of procedure in the name of ordinary justice and human rights. From the Irish Idependent

New figures from the Mental Health Commission show that 262 involuntary patients had the orders removed after appearing before the tribunals between December 2006 and November 2007. There have been a total of 2,227 hearings to date.

The tribunals are made up of doctors, members of the public and psychiatrists. The patient is able to appear in person to put their case forward.

There were 1,504 people detained against their will during that time -- down on the previous year following the introduction of more complex procedures for admission.

The detainee can opt for a Mental Health Commission-appointed solicitor and can appeal a tribunal ruling in the circuit court.

Since the beginning of the new legislation, 216 children have been detained in adult psychiatric facilities because of a lack of beds. Five of these children were detained against their will, and 12 were aged between 13 and 14.

However, psychiatrist Dr Patricia Casey said this situation was unacceptable.

"The HSE and also the Department of Finance need to be reminded that this situation is in breach of all international standards for the treatment of children with mental health issues. Children need facilities of their own," she said.

SSRIs and Dangerous Drug combinations

As seen in this quick article, SSRIs can be dangerous when used used in certain combinations with other drugs. The article also covers other drugs, but we have selected the quote on the psychiatric use of SSRIs.

Dangerous Drug combinations are putting many people at risk, a fact few realize. As Americans take more and more medications for everything from upset stomachs to depression, drug clashes have fueled a new epidemic of unexpected, sometimes dangerous side effects and complications. One recent study suggested that at least 1.3 million Americans have prescriptions for drugs that could cause problems if taken together—and that only counts people with health insurance. Although the overall toll is unknown, it’s undoubtedly huge, experts say. And growing. Taking many medications at the same time, or large doses of a few, can result in a conflict according to Marietta Anthony, PhD, associate director of the Center for Education Research and Therapeutics at the University of Arizona. Common items like drugstore pain relievers can clash with other meds.

SSRIs (selective serotonin reuptake inhibitors can conflict with a triptan drug used to treat migraines because triptans and SSRIs both increase serotonin levels and too much serotonin can cause serotonin syndrome resulting in mania, increased heart rate, seizures, and death.

Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause bleeding ulcers and other stomach troubles. Adding an SSRI increases this risk since serotonin encourages blood platelets to stick together, but because platelets soak up less serotonin when one is on an SSRI, they may have trouble clumping together to form clots and prevent excessive bleeding.

Of course, as documented elsewhere on this site, SSRIs are dangerous all by themselves, due to various other side effects.

An Open Letter to Dr. Phil

Hopefully this should be the last nail in the coffin of the Dr. Phil and Britney Spears fiasco. But knowing Hollywood, the crazy train hasn't even left the station yet. That said, this open letter by shrink Patricia a Farrell nicely sums ups some of the issues.

The news about Britney Spears and her many problems hasn’t been good and now there’s another problem and it is related to ethics, a person’s right to privacy and their legal right to decide who they want visiting them in a hospital.

Then there’s the HIPPA (Health Insurance Portability and Accountability) matter where hospitals and their personnel aren’t supposed to reveal anything about any patients or even that someone is a patient there.

If they don’t follow HIPPA regs, they leave themselves open to a lawsuit. Of course that only applies to licensed professionals and you're not licensed. Numerous violations seem to have been committed, perhaps, by ignorance. So, let’s set some of the record straight.

Phil, if you look back to the time when you were a licensed psychologist in Texas (which you’re not now because the California licensing board has decided you’re an “entertainer” not a psychologist), you probably remember that confidentiality was the backbone of the field. No psychologist would reveal anything about their patients, but since you’re not a psychologist anymore, I guess talking to the media about someone’s psychiatric problems is permissible. I mean, for an entertainer it is, isn’t it?

You might also remember that after about the age of 16 (depending on the state), everyone has a right to make certain decisions free from the wishes of their parents. That might have been something you ran across when scheduling guests for your entertainment TV show.

So, Britney really should have been the one to invite you to her hospital room, or you should have asked her permission to come to see her. Didn’t you think you were blindsiding her by showing up that way and did any of your prior clinical experience not kick in?

To use a phrase of which you are quite fond: What were you thinking?

Now that the chance to really help Britney has gotten a bit more difficult and has been pushed so publicly away, give your actions some thought and forget about the entertainment value of all this. Britney doesn’t deserve to be dogged the way she is being presently and she doesn’t need to be fed up and served to an audience in all her vulnerability.

Final word: Don’t kick someone when they’re down. It’s really a cheap thing to do and shows no class.

Also of interest is this blog item reflecting on the Britney Spears case:

Actress Frances Farmer came to my mind as I was driving home. She was a famous actress in the '30s and '40s and she was haunted by how cruel the tabloid press could be. She was an easy target. Like Britney, Francis Farmer was drawn to alcohol and drugs and therefore prone to mental illness and self destruction. Farmer had a mother who used her and betrayed her according to her sister's biography. Farmer was in and out of mental institutions her whole life. The tabloid-Hollywood-press loved her tirades and pictures of her often alcohol induced inappropriate behavior garnered top dollar.

What kind of people use the personal carnage of another for entertainment without a thimble full of sympathy? We have devolved into a strange fruit indeed. During one famous episode when Frances Farmer was taken away in hand cuffs, she yelled at the police, "Haven't you ever had a broken heart?" Clearly some part of Britney's heart is broken.

Julia Roberts was recently quoted as saying she knows what it's like to be hounded by paparazzi. Regarding Britney she said, "I just want to hug her." Apparently Britney threw Dr. Phil out of the hospital room 10 minutes after his arrival. So Julia and anyone else with a heart that Britney might listen to, now is the time for the hugs.

Rorschach Tests, a blot on the scientific landscape

An article on an exhibition devoted to the work of Hermann Rorschach, father of the test that bears his name. The exhibition celebrates the 50th anniversary of the Rorschach archive at the University Library in Bern. The archive, the only one in the world devoted to Rorschach, was founded by the Bernese psychiatrist Walter Morgenthaler in 1957 and was substantially enriched seven years ago by bequests from the psychiatrist's estate.

"Hermann Rorschach: a Swiss psychiatrist between science and intuition" is running at the University Library, Bern, from December 6 to February 23.

Of interest is that despite beliefs to the contrary, the test is scientifically useless:

Pseudoscience

While the Rorschach test continues to be defended and used by psychologists, its one not insignificant flaw is that it is scientifically virtually worthless.

In the United States in the 1940s and 1950s even mentioning inkblots got psychologists drooling like Pavlov's dogs, thanks to seemingly miraculous personality readings by Rorschach experts.

Under controlled studies however these "experts" failed miserably and it wasn't long before more critical scientists realised that Rorschachians were simply, and most probably subconsciously, using cold reading, a technique used by fortune-tellers and others posing as psychics and mediums.

"The readings say more about [the examiners] than the subjects," to quote Anne Anastasi, the noted differential psychologist.

The exhibition glosses over these negative aspects, but it does provide a fascinating profile of one of the most influential, if misguided, psychologists of the 20th century.

Thus it is of interest to those who wish to see how badly people can go wrong.

Pfizer Nigeria Vice President , Managing Directors on the run, Medical Director arrested in Nigeria

Nigeria has sued Pfizer for over $8.5 billion, alleging the U.S. drug company caused the death of Nigerian children when it conducted a clinical trial in the country. As Reported by BrandWeek N RX. Apparently the Nigerian government is also going after the executives of the psych drug maker Pfizer, who apparently decided that using Nigerian children as experiment subjects for drug tests was a good idea. The Nigerian Government has decided that this is a Bad Idea^(tm). You know that what you did was bad when the Nigerian government is coming after you, especially since they have become sensitive to internet scams originating form their country.

According to All Africa, Dr. Dogunro, a former medical director of Pfizer Inc, has been arrested by the police and the managing director for Pfizer Nigeria, Ms. Ngozi Oluwatoyin Edozien is on the run.

A federal High Court in Abuja, Nigeria issued the warrant for the arrest of eight former directors of Pfizer Nigeria.

Those affected were directors on the board of Pfizer Nigeria when the controversial Trovan clinical trial took place in Kano in which over 200 persons, mostly children, died allegedly as a result of the unapproved trial.

Among the eight directors are former Pfizer CEO William Steere, Samuel Ohuabunwa, A.Dogunro, Isa Dutse , Scott Hopkins, Mike Dunne, Debra Williams and Robert Buhl.

It is common among multinational corporations for the CEO to also be a director of each foreign subsidiary, which also results in certain legal responsibilities, and this is how the high-profile Mr. Steere was pulled into this criminal matter.

NgoryPfizer's Managing Director Ngozi, who is now on the run, is also Regional Director East, Central, and Anglo-lusophone (ECAWA) in Africa. She was born in Nigeria but grew up in the U.S. and went to Harvard Business School.

She then became a McKinsey consultant and worked in the UK and France. After McKinsey she spent about five years as a Pfizer Vice President in New York, responsible for planning and business development.

Here is the All Africa report:

A federal High Court in Abuja yesterday issued a warrant of arrest for eight former directors of a pharmaceutical giant, Pfizer Specialties Ltd.

Those affected were directors who were on the board of the company when a controversial Trovan clinical trial took place in Kano in which over 200 persons, mostly children, died allegedly as a result of the unapproved trial.

Already, a former medical director of the company, Dr. Dogunro, has been arrested by the police.

Others affected by the warrant of arrest, including the immediate past managing director, Ngozi Edozien, are said to be on the run.

LEADERSHIP checks revealed that the corporate headquarters of Pfizer in Lagos was padlocked throughout yesterday, while most of its management staff refused to turn up at their duty post, apparently to avoid being picked up by security agents.

Both the federal and Kano State governments had instituted criminal charges against Pfizer over its alleged role in the deaths of the children who received the drug during a meningitis epidemic in 1996.

They are claiming $700 million in damages and restitution from Pfizer.

On its own side, the government had alleged Pfizer researchers selected 200 children and infants from crowds in Kano and gave about half of the group an untested anti-biotic, Trovan, without any approval from any authority.

The criminal charges had also named Pfizer Nigeria subsidiary and the eight former senior staff.

Trovan came to public disclosure in 2000 when The Washington Post published the result of a year-long investigation into pharmaceutical testing in the developing world.

And Nigerians who were confronted with the shocking views went to the streets demonstrating and demanding for investigation.

The families of the children who Pfizer used allegedly as laboratory guinea pigs were led to believe and in fact understood that the defendants were providing their children with voluntary relief, clearly focused humanitarian medical intervention and nothing more, the suit had said.

Although Pfizer is currently contesting the case, but the investigating committee into Pfizer drug trial in Kano earlier raised by then minister of health, Dr. Tim Menakaya, and headed by Dr. Abdulsalam Nasidi had indicted Pfizer, which instituted a legal case at the Federal High Court to quash the investigation committee's report.

Pfizer's insistence that it is innocent has not prevented accusation and counter-accusation from flowing.

The company has consistently maintained that all necessary approvals were sought and obtained from relevant federal and state agencies before administering the drug in Kano State.

"We did the right thing and we answered the country's call," the then managing director, Ms. Ngozi Edozien, told LEADERSHIP recently.

But the Federal Ministry of Health, Kano State Ministry of Health and NAFDAC have denied approving the administration of the drug in Kano.

The case comes up today.

The Lives They Left Behind: Suitcases from a State Hospital Attic

An exhibit in New York City that exposes the recent dark ages of psychiatry in the 20th Century. From the NYC City guide

When an old ramshackle New York hospital, once known as the Willard Asylum for the Insane, closed in 1995, workers found a long-forgotten door tucked under pigeon-infested rafters. They pried it open and discovered a roomful of suitcases, covered in cobwebs and bird droppings, seemingly untouched for many years.

The luggage revealed surprising and touching stories about the patients who lived and died at the hospital. Working for nearly a decade, two mental health officials pieced together a dozen of their stories.

What emerged was The Lives They Left Behind: Suitcases from a State Hospital Attic, a free public exhibit, on view December 4, 2007 to January 31, 2008 at The New York Public Library’s Science, Industry and Business Library, 188 Madison Avenue.

The exhibit is presented by the National Alliance on Mental Illness of New York City Metro, The New York Public Library and the New York City Department of Health and Mental Hygiene, with generous support from the New York Community Trust.

[...]

"Hundreds of thousands of people ended UP in mental institutions before the mid-20th century and almost nothing was known of them," said Suitcases co-curator Peter Stastny, a psychiatrist and professor at Albert Einstein College of Medicine. "It was virtually a mass grave. This was really a unique opportunity to learn about their personal and medical histories side by side. That’s incredibly rare."

Suitcases presents a riveting, often appalling slice of psychiatric history in the United States, from the patients' point of view. Two dozen panels feature the stories of patients such as Miss Madeline #22040, a beautiful young Frenchwoman drawn to the occult, who fought her institutionalization for decades, and whose haunting photograph after years of confinement betrays intense suffering. And there was Mr. Lawrence #14956, an immigrant window washer who was institutionalized after being overheard singing loudly, praying and claiming to hear the voice of God. During his time at Willard, Mr. Lawrence dug more than 600 graves until his death at age 90, when he himself was buried in an unmarked grave.

[...]

The materials on display include photographs, panels depicting the patients' stories and cases of their belongings, including clothing and toiletries.

Not that things have gotten all that much better, as our site documents. An Exhibit that people should look into, but be aware that there is some positive spin regarding the "advances" of the modern era.

Washington D.C. Bill Could Require Licenses for Drug Reps

As seen in the WSJ Health Blog. This not only looks promising, but it seems to be a reasonable solution for an area where their have been multiple problems. We'll need to see how this works out, but it might be useful in other jurisdictions.

Drug sales reps could soon join cosmetologists, plumbers and funeral directors in line to get licenses to practice their trade in Washington, D.C. The D.C. council passed a bill yesterday that would require licenses and compliance with a set of rules governing professional practices for reps.

The bill explicitly bars reps from “any deceptive or misleading marketing of a pharmaceutical product, including the knowing concealment, suppression, omission, misleading representation or misstatement of any material fact.” It also prohibits promoting drugs for unapproved uses. New reps would be required to have a college degree. And bill would allow the D.C. Board of Pharmacy to collect information from reps regarding their interactions with health care providers.

[...]

The bill would also create a so-called “academic detailing program” in D.C. Academic detailing is a sort of ‘unsales pitch‘ that uses drug reps’ techniques to teach doctors when a cheap generic drug is as good as a more expensive branded one.

The bill must be signed by the mayor, who the Washington Post says supports the measure. Congress also has veto power over D.C.’s local ordinances — though given the skepticism toward pharma in Congress these days, it seems unlikely that a veto will come into play here.

[...]

Former Santa Barbara County psychologist going to trial for sex crimes

From this report on KSBY channel 6 in California

The case against a former Santa Barbara County psychologist accused of sex crimes will go to trial.

Fernando Cordero faces 12 felony counts, including rape, as well as two other misdemeanor counts. There are seven alleged victims so far.

On Monday, Judge Zel Canter raised Cordero's bail to $1.1 million dollars.

Fernando Cordero has had a psychology license since 1990. He most recently worked at Santa Barbara County Alcohol, Drug, and Mental Health Services. Now, he will stand trial to see if he abused that power.

Once believed to be a trusted doctor in the country, Fernando Cordero now will stand trial for the alleged rape, sodomy, and forced oral sex against former patients and even a former student.

An Allan Hancock College spokeswoman confirmed the former court appointed psychologist taught courses there. That included human sexuality, psychology, and race and ethnic relations, from Spring 2005 and Fall 2007.

This news, a shock to education student, Heather Brown.

"It's really creepy, to know that there's a teacher here that could possibly be doing that kind of stuff," Brown said. "It's kind of scary, but I'm glad I wasn't in his classes."

Deputies arrested Cordero at his Orcutt home back in November. With seven alleged victims so far, district attorney Ann Bramsen isn't ruling anything out.

"I think there's a potential for more victims, and I hope if there are, that they call the Sheriff's Department and come forward and report because it's very important that we stop him from any future victims," Bramsen said.

A sheriff's spokesman says many of his patients at Alcohol, Drug, and Mental Health Services were afraid of reporting Doctor Cordero for fear of not being believed, going to jail, or being deported.

"I hope that we have justice for the victims," Bramsen said.

That answer, soon to be left to a chosen jury.

Action News was unable to reach Cordero's attorney today. However, in previous interviews with Action News, Michael Scott says his client is a "well respected professional" and hopes that he does return to his practice.

Cordero remains in custody. He will appear in court next week on a bail hearing.

Satire - Restraining Order Filed Against Psychiatrist Dr. Phil.

Yet another satirical piece about Dr. Phil from The Spoof:

Just moments after a representative for the Spears family, appeared on the "Today" show, accusing Dr. Phil of betraying Britney and the Spears' family trust, lawyers for the Spears filed for a temporary restraining order (TRO) in the Los Angeles Superior Court against him.

Filings ask the court to order Dr. Phil to say at least 100 yards away form anyone of the Spears family members, including the unborn child Jamie Lynn Spears is carrying to term.

According to court pleadings, the Spears family alleges that Dr. Phil has been stalking them for months now under the guise of treating their dysfunctional family for various substance additions and disorders.

"At first we welcomed Dr. Phil into our homes, hearts and minds," read the Spears' court documents. "We trusted him implicitly with all our secret drug addictions, alcoholism, underage pre-martial sex with male adults, acute stage mom syndrome, mass hysteria and delusions of grandeur, but he betrayed us."

Dr. Phil was just using the Spears family to forward his own career as psychiatrist to the stars and bring up the ratings on his show, according to the documents.

"We first began to suspect Dr. Phil of stalking us when he kept on insisting on asking us for our autographs after each and every session," stated the court papers. "He said it was his fee for his services rendered, but we knew what it was really for. He was collecting our signatures on the checks we wrote to him to sell on ebay."

Canceled checks written to Dr. Phil from the Spears family were submitted to the court as evidence for the TRO.

Even more startling is the Spears' allegation that Dr. Phil is a serial celebrity stalker. The Spears' reason that Dr. Phil was really using his professional medical training to help celebrities not just stalk them, they would have been cured by now.

"He is using his professional medical training just to get close to Hollywood movie stars, which he really has no intention of helping or curing," the Spears' accuse. "Why just take a look at us, we have been under his care for several months now, and we're worst off than before. Britney still lost custody of the kids, had a breakdown and Lynn has a bun in the oven from a guy who should be in prison for statuary rape."

We also remind people, that, as documented in Wikipedia, Dr. Phil McGraw is NOT licensed to practice psychology:

The Texas State Board of Examiners of Psychologists imposed disciplinary sanctions on McGraw on January 27, 1989 for an inappropriate "dual relationship" reported in 1988 by a therapy client/employee from 1984. McGraw was ordered by the Board to take an ethics class, pass a jurisprudence exam, complete a physical evaluation, undergo a psychological evaluation and have his practice supervised for one year in order to continue his private practice in Texas. McGraw admits to giving the client a "job" at his office (which is not allowed), but denied carrying on a sexual relationship with the 19 year old, who says their relationship was "sexually inappropriate."[11][2][12] As of 2008, McGraw has not completed the conditions imposed by the Board of Examiners of Psychologists and he is not licensed to practice psychology.[13]

And in something that is not satire, but could very well be, Dr. Phil tackles the toughest subject of all: Trash talk and "racism" on Xbox Live. Too bad Xbox Live has had a 95% downtime so far this year. Gamers around the world are snickering at this one, and Dr. Phil is becoming famous as the next Jerry Springer

Spears Family Attacks Dr. Phil: You Totally Betrayed Us!

As seen on the Today show, complete with this video (8+ minutes long, spokesman starts at 2min09sec into the piece)



There is also this extended written news report

TMZ Sums it up this way

Jamie and Lynne Spears slammed -- and we mean slammed -- Dr. Phil this morning, calling the way he handled his contact with Britney a betrayal, inappropriate and a total breach of their trust.

Spears family rep Lou Taylor told Meredith Vieira on the "Today" show that Dr. Phil actually broached the subject of doing a show about Britney, but that they nixed the idea, only to have Phil try to set up the show anyway. Taylor scorched Phil, saying it was even "inappropriate" for Phil to bring up doing a show, and that the family thought it would be detrimental to Britney.

What's more, Taylor said that the family felt "betrayed" that Phil would issue any kind of statement after meeting with Brit, and that nobody had given him any authority to say anything, much less bellow on and on like he did.

It's a total smackdown.

Fake head shrinker to have head examined pending sentencing.

A followup to an odd story from over a year ago:

Fake Head Shrinker Sued for Leaving Mind Unshrunken, and Endangering a Life.

We recently received word that ex-ghost hunter Susan Crites was not only sued, but was charged with crimes, was been found guilty, and was set to be sentenced. But this has been put on hold pending a court order to have the fake head shrinker's head examined.

Here is the news story originally posted December 18th, 2007

The sentencing of Susan R. Crites, the former head of the now defunct Hedgesville-based West Virginia Society of Ghost Hunters, was postponed Monday after a judge ordered her to undergo a 60-day psychological evaluation.

Crites, 57, was convicted on three misdemeanor counts of practicing medicine without a license and five counts of practicing counseling without a license in September following a jury trial in Berkeley County Circuit Court. A separate but related charge of delivery of a controlled substance was later dismissed by the state.

Crites had originally been scheduled to be sentenced last Monday but it was continued because Crites’ then-attorney, Heidi Myers, was unable to attend because of a medical emergency.

The court’s order to have Crites undergo a 60-day psychological evaluation came as a surprise to both the prosecution and the defense, which was only made of aware of the evaluation order by Berkeley County Circuit Court Judge Gray Silver III on Monday morning.

“Note my objection on behalf of Miss Crites,” Myers told Silver.

Silver also granted a motion recently filed by Myers requesting she be allowed to withdraw from the case and a new lawyer be appointed to represent the local ghost hunter and published author. Myers filed the motion at the behest of Crites who recently decided to seek new representation.

“My services have been terminated,” Myers said.

Berkeley County Prosecutor Pamela Games-Neely argued that the evaluation and the appointment of a new attorney for Crites would only delay sentencing, further inconveniencing the victims in the case, but Silver supported an objection by Myers, who argued that Crites would need an attorney to be able to present arguments to the court during the sentencing phase.

“Miss Crites is requesting new counsel. I am concerned that the right to counsel is a constitutional right and sentencing is still a critical stage,” said Silver, adding appointing a new attorney for Crites would not delay sentencing since the court intended to order the 60-day evaluation anyway, something Silver said would aid the court in its sentencing.

Crites will now be represented by the Berkeley County Public Defenders’ Office. The earliest Crites might be forced to undergo the evaluation is three weeks. In the meantime, Silver told Crites her newly appointed attorney could present arguments to the court against the evaluation order if she wished.

After granting Myers’ motion to withdraw, Silver was later presented with a motion by Crites she said a friend helped her draft to continue sentencing. She was stopped by Silver, who indicated Crites should wait until her new attorney was appointed before attempting to present an argument before the court.

“We don’t want you putting yourself in a position where you say something that could possibly hurt your case,” Silver said.

No new sentencing date was scheduled Monday. For each of the three misdemeanor counts of practicing medicine without a license, Crites could face fines of as much as $10,000, imprisonment terms as long as 12 months, or both. For the five counts of offering counseling without a license, Crites stands to face fines as much as $500, imprisonment as long as six months, or both.

Actually the West Virgina Society of Ghost Hunters continues under new leadership, it seems. And to their credit they have a full webpage going over all of the gory details of the scandal.

A Transcript From Dr. Phil’s Cancelled ‘Britney’ Episode

In a hopefully final note, we came across this satire of Dr Phil and his handling of the Britney Spears case:

In case you missed the memo, today’s episode of “Dr. Phil,” which was supposed to be a full hour devoted to Britney and her current situation, was yanked from the air and replaced by a repeat at the last minute because Dr. Phil felt the situation was “too intense.”

Just so we don’t go home completely empty-handed, here’s an artist’s conception of what we missed.

DR. PHIL: Welcome to the show. Today, we’re spending the entire hour talking about Britney Spears with those who know her best — these random tv psychologists who we managed to book at the last minute.

PSYCHOLOGIST GUY WHO LOOKS A LITTLE LIKE THE BRITISH JUDGE ON “DANCING WITH THE STARS”: Glad to be here, Dr. Phil.

DR. PHIL: Let’s talk about Britney. I mean, what is her deal, yo? [AUDIENCE CHUCKLES AT COMFORTABLE, GOOD-NATURED UNPROFESSIONALISM] I mean, what the hell, dammit?

PSYCHOLOGIST: Let me start by saying that numerous layers of psychological, emotional, spiritual, and even frenological factors come into play when you’re dealing with a celebrity of this magnitude.

[CHYRON APPEARS - “Dr. James R. Stephenson, Blazer-Wearing Man Who Has Heard Of Britney]

DR. PHIL: But damnit, at what point is enough enough??

[AUDIENCE APPLAUDS AFTER 1.5 SECONDS OF APPLAUSE-MILKING SILENCE]

PSYCHOLOGIST: We see this all the time in celebrities. I spent two years reading about Loni Anderson back when that whole thing was going on, so I know how tough it can be, there simply is no quick fix.

DR. PHIL: We all know Britney has a terrific, supportive family, but at some point you have to say, you know, “What the hell am I doin’? I need to knock it off!”

[ONE PERSON IMMEDIATELY STARTS APPLAUDING REALLY LOUDLY, REST OF AUDIENCE FOLLOWS SUIT]

DR. PHIL: We’ll be right back.

[LAME ACOUSTIC GUITAR OUTRO. THE OPTIMUM ONLINE TRIPLE PLAY COMMERCIAL PLAYS SEVEN TIMES. LAME ACOUSTIC GUITAR INTRO]

DR. PHIL: We learned a lot today about Britney’s situation — probably 10, 15 percent of this we didn’t even cover the last time we devoted an entire hour-long episode to Britney.

The point is, the harder I try to draw psychological paralells between Britney’s craziness and general, everyday advice for our viewers, the more clear it becomes that these Britney episodes are completely irredeemable ratings ploys. Not that that’s a secret or anything, but damnit, why the hell does it have to be so obvious??

[AUDIENCE APPLAUDS]

Dr. Phil: Tomorrow, we’ll bring Dick Masterson and that black woman who hates blacks into the studio to discuss the psychology of lesbian threesomes, and whether or not troubled pop star Britney Spears would go for one. The episode will be so technological and informative, simply watching it qualifies your for 9 Psych credits at any state university. So stay tuned.

[LAME ACOUSTIC GUITAR OUTRO LONG VERSION PLAYS, TURNS INTO ROCKIN’ ELECTRIC GUITAR OVERTOP APPLAUSE AND THE CREDITS. NINETY MINTUES OF THE OPTIMUM ONLINE TRIPLE PLAY AD PLAYS ON A LOOP.]

One Flew Over the Cuckoo's Nest: Nurse Ratchet Alive and Well in Australia

From a report in the Sydney Morning Herald

The Tasmanian government is under pressure to resolve allegations of bullying and sexual assault at a Launceston hospital following a report finding abuse complaints were ignored.

An independent investigator was called in to audit Launceston General Hospital's acute mental health unit - Ward 1E - after new claims of patient sexual abuse last June.

The report, by Australian College of Mental Health Nurses president Peter Santangelo, found complaints were either ignored or dismissed as trivial.

It also found staff had inconsistent views about what constituted a complaint or incident for review.

"Of particular concern were disclosures of sexual assault, the subject of recent allegations, which were reported to be either ignored or dismissed as trivial or unreliable because of the mental state of the client making the allegation," Mr Santangelo said in the report.

He said patients feared retribution if they reported abuse.

The audit is the second critical report on Ward 1E in three years.

It also exposed a culture of staff bullying, led by a small, powerful group of psychiatric nurses who were "resistant to change, self-serving, breached rules and regulations and ignored clients".

"No one dares complain about them for fear of retribution," the report said.

Mr Santangelo found 22 of the 26 recommendations made in a 2005 report on 1E by the Health Complaints Commissioner had been implemented.

He made 38 further recommendations, which Tasmanian Health Minister Lara Giddings has committed to adopt.

They include better complaints handling, clinical supervision for staff and staff education and training in relation to workplace harassment policies.

Whistleblower and former mental health nurse Leila Rossiter said she was disgusted there had been two investigations in three years and the problem had not been resolved.

"It's absolutely soul destroying what's happening there," she told ABC Radio.

"I remember when it all came out a few years ago, like trying to tell people that it was the tip of the iceberg ... and it's very disappointing to see that it's still happening at 1E."

[...]

Israeli Miliatry Psychiatrist Convicted in Espionage Case

As reported in in the Israeli paper Ha'Aretz and elsewhere

A Tel Aviv court on Wednesday convicted Israel Defense Forces psychiatrist Captain David Shamir (Res.) with making contacts with a foreign agent, espionage, and attempting to harm national security.

Sentencing has not begun, but the charges carry penalties of up to a combined 25 years in prison.

The conviction came as part of a plea bargain that reduced the severity of the charges facing Shamir.

According to the original indictment, Shamir attempted to make contact with the Iranian Foreign Ministry, Hamas officials, and the Russian intelligence service the FSB, with the intention of selling them classified information he was exposed to during his military service.

The information reportedly included Medical Corps guidelines for emergency situations, the deployment and status of the Medical Corps, and guidelines for evacuating citizens in case of a missile attack.

Mental Health Worker accused of lewd behavior

From the Saint Petersburg Times:

A residential aide at Pinellas Emergency Mental Health Services has been charged with two counts of lewd and lascivious exhibition in front of children under 16.

Marissa Rodriguez, 42, was accused of exposing herself twice to a group of juvenile girls at the facility, where she worked as a temporary employee.

The incidents happened Friday and again Sunday, according to an arrest affidavit.

In Friday's incident, Rodriguez showed a nipple piercing to several girls and "told them afterward not to tell any of the other staff," according to an arrest report.

On Sunday, Rodriguez confronted some of the patients because they had told staff members in a group session, and, in front of another staff member and juveniles, exposed her right breast, police said.

Police said they learned of the incidents when they went to the facility at 1614 Palm Way in Largo regarding an allegation of abuse. That complaint was found to be unfounded, but in the course of investigating it, they learned of the incidents involving Rodriguez, police said.

Rodriguez, of Gulfport, is being held in the Pinellas County Jail in lieu of $20,000 bail.

The Presidential Political Contributions of Big Pharma in 2007

As Reported on Brandweek N RX weblog, who also credits PharmaLot and the political research site Open Secrets

“I don’t believe you can sit at a table and negotiate with drug companies, insurance companies, oil companies and hope that they will voluntarily give their power away,” John Edwards said, according to the Chicago Tribune. “We will get their power out of their hands when we take their power away from them.”

“I’ve taken on the drug companies,” Hillary Clinton said, according to the New York Times. “I’ve taken on the health insurance companies; I’ve taken on the oil companies, and I intend to keep doing it.”

Funny thing, the drug companies seem to love the people who are going to crush them . . . here's what they donated, according to Open Secrets. Even Edwards got some . . .

Perhaps the safest bet is that not much will change after the election? After all they're all bought and paid for:



Click on diagram for full size image

METHODOLOGY: The totals on these charts are calculated from PAC contributions and contributions from individuals giving more than $200, as reported to the Federal Election Commission. Individual contributions are generally categorized based on the donor's occupation/employer, although individuals may be classified instead as ideological donors if they've given more than $200 to an ideological PAC.

NOTE: All the numbers on this page are for the 2008 election cycle and based on Federal Election Commission data released on Monday, October 29, 2007. Feel free to distribute or cite this material, but please credit the Center for Responsive Politics.

The Political Contributions of the Pharmacutical Industry

As Reported on Brandweek N RX weblog, who also credits PharmaLot and the Political research site Open Secrets

APA Partial Disclosure - Conflicts of Interest in Writing DSM-V

Via The Alliance for Human Research Protection website, a report from the health section of US News and World Report:

In what is arguably the most important mental-health development since the early 1990s, the American Psychiatric Association will spend the next five years producing a new edition of the psychiatrist's "bible," the official guidebook for diagnosing mental problems. The Diagnostic and Statistical Manual of Mental Disorders, as it is known, is hugely influential because it determines what is and is not a mental disorder. In turn, it is responsible for much of the sales growth in prescription drugs.

The most recent edition of the DSM, published in 1994, drew controversy because it turned what had once been a thin guidebook into an 886-page tome that significantly expanded the definition of mental illness. Traits once associated with shyness, for example, became symptoms of "social anxiety disorder." And drug companies went on to spend millions promoting medicines for those problems. Eyebrows were further raised in 2006 when a study showed that more than half of the researchers who worked on the manual had at least one financial tie to the drug industry.

Transparency. This time around, pledging to avoid even the appearance of conflicts, the APA has instituted screening procedures for the 27 members of its DSM task force, asking them for detailed financial information about stocks, honoraria, and consulting fees from drug interests. It calls the effort the "most transparent" in the medical industry.

Yet the summaries of the disclosure statements that were recently released to the public are remarkably spare; they show only the existence of corporate connections, not their dollar amount or their duration. The result is a document that even an APA board member suggested is not very revealing. In a 2006 memo to the board obtained by U.S. News, William Carpenter wrote: "Simple listing of all relationships is not very informative and does not identify potential conflicts that may need to be resolved."

Critics say the limited information violates the spirit of disclosure. "There is disclosure, and then there is disclosure," says Daniel Carlat, a psychiatrist and former consultant to drug companies. "There is a big difference between $500,000 and $500. It is one thing to disclose in a generic way, to say that a psychiatrist has had some consulting with a company, but that doesn't tell you a number of things."

Documents reviewed by U.S. News, including sec filings and patent requests, also show connections between doctors and drug companies that don't necessarily turn up in the disclosures. In general, the disclosures paint an incomplete picture of the degree to which the corporate and clinical worlds are increasingly enmeshed. In other cases, they simply reflect mistakes.

For example, Dilip Jeste, a professor of psychiatry at the University of California-San Diego, had consulting ties that did not appear on his disclosure form. Yet during the reporting year of 2003, he was a consultant to Pfizer and AstraZeneca and received honoraria from Pfizer, according to documents. Jeste called the error "unintentional," saying he had relied on memory. The APA said that Jeste would submit a new disclosure. APA President Carolyn Robinowitz said that task force nominees "were on the honor system" and acknowledged that the association had made no effort to check their accuracy.

The APA itself erred in its public summary for Jan Fawcett, a professor of psychiatry at the University of New Mexico and chair of the DSM's mood disorders work group. The summary lists no directorships or corporate positions for Fawcett. But a 2005 sec filing shows that he was a member of the board of directors for Berman Health and Media, a company that is poised to "exploit opportunities in the female sexual medicine industry." [He has since resigned from the board.] The APA said that Fawcett had disclosed the connections in private filings but that its staffers accidentally omitted them from the public disclosure form.

Critics say the APA's disclosures are inadequate in other ways. Carpenter, for instance, is listed as a "co-inventor" on two patents filed in the past three years for "methods for screening, diagnosing and treating schizophrenia." The applications list pharmaceutical giant Novartis as the holder of at least one of the patents. The APA said, and Carpenter confirmed, that Carpenter did not need to disclose the connection because he has pledged to receive no financial benefit from the patents at any time.

Likewise, David Kupfer, the task force chair, reported multiple consulting arrangements with communications companies that "sponsored pharmaceutical meetings & editorial work." His public form, however, does not reveal that income from two of these companies, Prescott Communications and Innovative Medical Education, came from work for Forrest Pharmaceuticals and Pfizer, respectively. The APA said Kupfer did not need to disclose the ties because he was not paid directly by drug companies.

Industry support. The existence of drug company links does not necessarily mean the individuals reporting them are biased. In most instances, the APA says, the relationships merely underscore a simple truth: that in the absence of adequate government support, more than two thirds of all medical research funding comes from pharmaceutical companies.

Yet studies have repeatedly shown a connection between authors who received income from drug companies and published papers favoring the firms' products. The papers also tend to underreport negative side effects.

In acknowledgment of such problems, the APA's vetting procedures are stronger than those of other medical organizations. And the sacrifices required of task force members are hardly insignificant: Before being appointed, members pledged to limit their aggregate income from pharmaceutical sources to $10,000 a year. If their income exceeded that amount, they were required to reduce it or sever ties.

But critics say that loopholes weaken the policy. One is that task force members can undertake new financial arrangements after being appointed. Second, task force members are not asked to disclose "unrestricted research grants," which often go straight to one's department or institution. Lisa Cosgrove, a clinical psychologist at the University of Massachusetts-Boston, describes such grants as a "hollow open-door policy" giving pharmaceutical companies strong influence. "If your department has a $500,000 unrestricted grant from a drug company, with the potential of getting $2 million, it is disingenuous to assume that there are no potential conflicts."

Some APA members have asked association officials to strip voting privileges from all DSM committee members with industry ties. "If someone's expertise is deemed necessary, they can serve as consultant but not as a voting member," says Amy Brodkey, a professor of psychiatry at the University of Pennsylvania. Of the 27 task force members, eight had no ties to the industry.

APA officials say such changes are unnecessary since several APA groups have to approve the DSM before it's published. "What you've got is several layers of protection," says APA Medical Director James Scully. One layer to watch: the more than 150 people who will fill out the DSM work groups. Scully said the appointments should be complete by early 2008. And they will be asked to disclose ties.

Psychiatrist Accused of Endangering the Public

As seen in this report from the Cornish Guardian, a psychiatrist is accused of endangering the public. From our own observations of reports here, we must say that there does seem to be a streak of evil within psychiatry where psychiatrists place their own interests above public safety and the care of patients. While this trait does not infect all psychiatrists (there are some good doctors out there), this is a disturbing trend

A psychiatrist accused of failing to arrange emergency care for a dangerous schizophrenic days before he killed a neighbour has appeared before the General Medical Council (GMC).

Dr Howard James is said to have ignored letters expressing concern from the patient's GP and psychiatric team after he was caught flashing at neighbours and starting fires outside his home.

Dr James is also said to have failed to visit the patient - Mr A - at his home or arrange an assessment while under his care at Plymouth's Derriford Hospital.

Days after Dr James received the letter from Mr A's GP, the drug addict killed his neighbour in a vicious attack. He was later sectioned after being convicted of manslaughter.

In January 2001, Mr A was convicted of dangerous driving and Dr James was asked to write a psychiatric report. Thanks to Dr James' assessment, Mr A was put on probation for a year, provided he underwent supervised treatment with Dr James. However, Mr A soon began to miss appointments.

In April 2001, Mr A's probation officer wrote to Dr James for an update which he did not reply to, it is claimed. Four months later, Mr A's new probation officer also requested an update. Dr James wrote back saying he was hard to get hold of.

In November 2001, Mr A's community psychiatric nurse wrote to Dr James saying he had not seen the patient for three months - the GMC says the letter was ignored. Mr A's GP, Dr Brian Pollard, wrote to Dr James on May 1, 2002, expressing concern that he had not seen the man for nine months and had not issued any medication for seven months.

Selva Ramasamy, representing the GMC said: "By this time it's clear that Mr A's condition was deteriorating. His neighbours had seen him flashing and he was starting fires in the courtyard.

"He [Dr James] did not call Dr Pollard for clarification. He did not alert other members of the team. He did not arrange an emergency mental health assessment. He did not make a visit to Mr A's home.

"He failed to recognise the situation as a psychiatric emergency and failed to record any plan of action.

"Things were left to lie and tragically on May 12, Mr A attacked and killed a neighbour 11 days after the GP wrote a letter to James expressing his concerns."

Cambridge-educated Dr James admits the majority of the charges but denies ignoring the letter from Mr A's original probation officer. He denies not replying to a letter from Mr A's community psychiatric nurse and not alerting other members of the team.

He further denies failing to recognise the situation as an emergency and failing to make a record of an action plan. He also denies failing to bring up Mr A's situation during a team meeting just before the killing.

James denies his actions were unprofessional and denies misconduct. The hearing continues today.

Woman committed suicide after release from psychiatric hospital

A woman who was released from a mental hospital due to a legal difficulty took her own life by leaping from a balcony five days later.

Carrie Lyons (26) died at the Mater Hospital on July 19, 2006, hours after sustaining a severe head injury when she leaped from a third-floor balcony at flats in Morning Star Avenue, Dublin.

Three hospital assessments in the previous week had found she was not at risk of suicide.

Speaking outside the court, Ms Lyon's father, Patsy Lyons, expressed anger that his daughter had been released from hospital.

"I can't understand why she was released. She had lost a baby at two-and-a-half and that was the start of her problem.

"She was in the Central Mental Hospital for about three weeks. I didn't get word she was released.

"I'm sad and so angry that I wasn't informed she was released. I feel I should have been notified and I wasn't."

Dublin City Coroner's Court heard Ms Lyons had been detained at the Central Mental Hospital suffering from paranoid beliefs after being arrested for shoplifting.

But she was released from the facility on July 14 when the Prison Service informed the hospital that Ms Lyons had to be discharged because there was no bench warrant for her.

She was brought directly to the Mater Hospital where she was assessed by a psychiatrist who found she had no thoughts of self-harm or psychotic symptoms, the inquest head.

Ms Lyons, of Lurgan Street, Dublin 7, discharged herself while the doctor was on the phone to her grandmother.

She returned to A&E on July 15 and 17 and reassessments found she was neither suicidal nor homicidal. She was given an appointment for an out-patients' clinic on July 20.

Ms Lyons died on July 19 after she jumped from a balcony at Kevin Barry Flats, near the Regina Ceoli hostel where she was a resident.

She told staff at the hostel earlier that day she wanted to call an ambulance, but was persuaded to contact the community mental health nurse, who spoke with Ms Lyons and advised her to see her GP and to then come immediately to see her at Norman Connolly House, the court heard.

A nurse from the service had seen Ms Lyons at the hostel two days before her death and had been in contact with the hostel with regard to her condition earlier that day.

A resident in the area, Patrick Gilmore, told the court he was returning home with his daughter on July 19 when he saw a person with a leg and an arm hanging over the balcony of Kevin Barry Flats.

"Within a couple of seconds she got her other leg over and let go," he said.

The Dublin City Coroner Brian Farrell recorded a verdict of death by suicide.

Antipsychotic drugs worse than sugar pills

As seen in this report regarding a recent Medical Study published in the medical journal The Lancet:

Antipsychotic drugs which are commonly used to treat aggression in people who are intellectually disabled have been revealed to be ineffective.

The researchers say such candidates should not be prescribed these drugs as placebos seem to do a better job.

A study by researchers at Imperial College, London has found that when two antipsychotic drugs haloperidol and risperidone were compared with a placebo, the placebo reduced aggression by nearly 80 percent compared with 50 percent to 60 percent for the drugs.

In order to gauge aggression the researchers used a widely accepted measuring scale.

The research was conducted on 86 non-psychotic patients with aggressively challenging behaviour at 10 centers in England and Wales and one in Australia.

All but one of the patients was in a community setting, more than half were men, and the majority had mild or moderate intellectual disability.

The researchers say at no point was the placebo significantly worse than risperidone or haloperidol, nor was there a difference in response for the small group of patients with autism spectrum symptoms.

Despite little evidence to support their use, antipsychotic drugs are prescribed from 22% to 45% of inpatients in this population and to about 20% of those in the community.

Risperidone is sold under the brand name Risperdal and is a popular schizophrenia drug, Haloperidol is an older drug marketed as Haldol and both are manufactured by drug company Johnson & Johnson.

According to Dr. Peter Tyrer, a community psychiatrist, who led the study, such drugs have been used to treat aggression in people who are not psychotic for 60 years.

Dr. Tyrer says in most circumstances people should not be given these drugs because there is no indication they work; he says their study shows that a placebo is more effective.

Tyrer says about 1.5 percent of the population have IQ's below 70 and are defined as disabled because of their lower intelligence; these people often have difficulty expressing themselves and are often aggressive when trying to do so.

Experts in the U.S. say the study is important because there is little evidence on the effectiveness of the drugs in treating aggression for people with lower-than-normal intelligence who are a highly vulnerable group.

Tyrer says the study is the first to be carried out which was not been funded by the pharmaceutical industry.He suggests one of the reasons the placebo works so well is the simple psychological effect these often ignored patients gain from the attention of a doctor when given the treatment.

Both drugs cause dry mouth, dizziness, constipation as well as serious side effects such as tremors, and Tyrer suggests these problems possibly offset any psychological benefits the drugs might have.

The medication used in the study was provided by Janssen-Cilag and the study was supported by Mencap and the National Coordinating Center for Health Technology Assessment; it is published in the medical journal The Lancet.

Even Psychiatrists hit out at Dr Phil’s hospital visit to Britney Spears

There seems to have been some professional criticism of Dr. Phil in his conduct with Britney Spears. Imagine That. As seen here

Psychiatrists have hit out at Dr Phil McGraw’s hospital visit to troubled Britney Spears - saying that the hospital should not allow any doctor who does not have in-patient privileges into a patient’s room, unless that patient has given prior consent.

According to TMZ, the Toxic singer was blissfully unaware the TV shrink was coming to her room - and when he arrived, she became agitated and walked out. She eventually came back in and he “pretty much did all the talking for around 15 minutes”.

One psychiatrist deemed Phil’s actions “intrusive and inappropriate.” Another psychiatrist said the hospital “is supposed to be a safe place. If the patient doesn’t want to see someone, that person doesn’t get in - period.”

Another doctor - who said he was “outraged and disgusted,” added, “It is incredible that the hospital allowed Dr. Phil in her room. It’s a total violation of her rights.”

One shrink said staff at the hospital were “star struck” and let the 57-year-old TV doctor’s profile override their judgment.

Dr. Phil gained notoriety following appearances on The Oprah Winfrey Show, and is the host of the psychology themed television show Dr. Phil.

Meanwhile, Britney’s parents are reportedly set to appear on McGraw’s show on Tuesday - but their troubled daughter has refused to take part.

The television psychologist warned that Spears was in “dire need” of medical help after he visited her in hospital on Saturday.

It had been thought that he was trying to persuade the chart star to go on his nationally syndicated programme this week.

Here is the link to the TMZ Story:

Eight psychiatrists tell TMZ they are shocked Cedars Sinai Medical Center let Dr. Phil go up to Britney Spears' room without her prior knowledge or consent.

The shrinks had various things to say about Dr. Phil's visit to Brit's room, but the theme was unified -- that the hospital should not allow any doctor who does not have in-patient privileges into a patient's room, unless that patient has given prior consent. TMZ has learned Britney had no idea Dr. Phil was coming to her room and indeed when he walked in she became agitated and walked out. She eventually came back in and he pretty much did all the talking for around 15 minutes.

One psychiatrist called it "intrusive and inappropriate." Another shrink told us the hospital "is supposed to be a safe place. If the patient doesn't want to see someone, that person doesn't get in -- period."

Another shrink, who said he was "outraged and disgusted," added, "It is incredible that the hospital allowed Dr. Phil in her room. It's a total violation of her rights."

One doc surmised bluntly the hospital was "star struck" and let the TV doctor's profile override its judgment.

We're told early yesterday the show wanted to book Brit for a TV intervention that is being taped on Monday. We're told she wants nothing to do with it, and the show will not have her on. We're also told Brit's parents, who wanted Dr. Phil to visit Britney, had agreed at least initially to be on the program.

One shrink said splashing a private medical matter on TV and saying it's an intervention -- especially without the proper medical diagnosis -- is no way to run a railroad.

Now it makes sense, he wanted to sign her up for the show. Apparently his motive was profit, not to actually help her.

---

UPDATE: It now seems that Dr. Phil has suffered an attack of an ethical conscience, and has decided to cancel the previously planned Britney Spears show.

Dr. Phil has canceled his upcoming special on Britney Spears.

In a statement, he tells Entertainment Tonight:

"We had planned to tape a Dr. Phil Now show tomorrow, focusing not on the tabloid side of Britney's latest problems, but instead on the very serious issues surrounding this case. Clearly, it is not just Britney's family struggling to find a way to protect adult children who cannot be ordered or compelled to seek help.

"Because the Spears situation is too intense at this time, and out of consideration to the family, I have made the decision not to move forward with the taping at this particular time. Britney and her family are in our prayers and we ask that they be in yours."

He says details of his hospital visit with Spears "will, of course, remain private."

He visited her shortly before she was released Saturday.

He said on CBS' The Early Show this morning that Lynne Spears initially called him to intervene.

Why oh why was this under consideration in the first place? To borrow some of the doctor's colorful language, you don't have to fall off a turnip truck to figure out that this might be a Bad Idea^(tm). This is not rocket science, and it is NOT brain surgery.

Can Britney get an honest opinion? - Dr. Phil's Media Whore Publicity Stunt.

It seems that we are not the only people to wonder about the lunacy of Hollywood shrinks, and Hollywood in general. We came across this post that is worth quoting

Is it any wonder that pop singing sensation Britney Spears is apparently experiencing psychological problems? It seems everyone in her immediate vicinity is trying to capitalize on Spear's media attention or is trying, in some manner, to get on the gravy train.

She apparently is enabled and stroked by all those who are attempting to cash-in at Britney's expense.

In my humble (ok, not so humble) opinion, those who are seeking to promote their own agendas on the back of Spear's misfortune are despicable. Yes, I do recognize my apparent hypocrisy in mentioning this in my blog -- but like I have said on numerous occasions, this blog is my reaction to otherwise shouting at the television screen or pounding the dashboard of my car. (check the very end of this blog before judging)

Britney is physically located between two world-class hospitals, Cedars-Sinai Hospital and the UCLA Medical Center. Also nearby is St. John's Hospital in Santa Monica. All of which have resident and outpatient medical and psychological services.

Enter Dr. Phil...

While Dr. Phil does have a Ph.D. in clinical psychology from North Texas State University, he also is the host of a talk show based on fast, pop-psychological cures similar to the "rapid diagnosis and generalized advice" of the late Dr. David Viscott who was convinces that all you had to do to cure your problems was recognize your problem and then resolve to do something else.

[...]

Known for his confrontational style and physically intimidating stance, one questions whether or not any association between Dr. Phil and Britney Spears could be beneficial given that Dr. Phil may not be able to devote the type of time and attention that Britney deserves.

For more about the Oprah Winfrey-created "pop psychologist" Dr. Phil McGraw, it is suggested that you read the Wikipedia article here. It is not as flattering as one might believe from Dr. Phil's publicity.

With a lot more at the original link, but we need to add this advice paraphrased from later in the post:

Should you be experiencing any medical or psychological symptoms, always consult an appropriate medical professional who is bound by the doctor-patient privilege and will not further increase your apparent distress by publicizing your condition.

It is far smarter to start with [...] a medical doctor who can rule out physiological causes before proceeding on to counseling with a psychotherapist.

Be wary of accepting advice from any professional who seems more show-biz promotional than professional. Buying self-help books or potions from these characters is often worthless [...]

Be extremely wary of accepting the advice from anyone being billed as a "something professional to the stars." One need only open their eyes to see how screwed up these stars may be once the cameras stop rolling and they are confronted with dealing with their privileged and pampered life. Most are malignant narcissists who believe that "everything is about them." If they hit your car, they often become irate and question why are you inconveniencing them by being in the wrong place at the wrong time?"

Recognize that most professionals who have turned into performers are driven by an agenda that only tangentially concerns their subjects... and only to the extent where their subject's association and success is reflective of their activities.

Drug companies spend nearly double on marketing compared with research

As first seen in the Canadian Press

Drug companies spend almost twice as much on marketing and promoting their products than on research and development, says a new study.

In their analysis of data from two market research companies, Marc-Andre Gagnon and Joel Lexchin of Toronto's York University found that American drug companies spent US$57.5 billion on promotional activities in 2004.

By comparison, spending on industrial pharmaceutical research and development in the United States was $31.5 billion in the same year, according to a report by the National Science Foundation, which included public funding for industrial research.

The types of marketing included in the US$57.5 billion figure, compiled using data from market research companies IMS and CAM, included free samples, direct-to-consumer drug advertising, meetings between company representatives and doctors to promote products, e-mail promotions and direct mail, said the study.

The findings, published this week in the journal Public Library of Science Medicine, confirm "the public image of a marketing-driven industry," say the study authors.

It's not a surprising conclusion, says Steve Morgan, an expert on the economics of the pharmaceutical industry at the University of British Columbia.

"It's been known for a long time that manufacturers of prescription drugs spend more money on marketing than they do on research and development," says Morgan, who heads the program in pharmaceutical policy at the university's Centre for Health Services and Policy Research.

Still, the conclusions are alarming, says one of the authors.

"It is common knowledge that drug companies spend a lot on promotion," Joel Lexchin said in an interview.

"But even I didn't realize that the figure was as high as we estimate it is."

The pharma industry has for decades promoted itself as innovative and research-driven. Critics, however, contend that drug companies have acted based on market-driven profiteering.

The gulf in spending in 2004, the latest year for which figures were available, has been reported for previous periods, says Morgan.

"This goes back to commissions of inquiry that were held in Canada and the United States in the 1950s," he said.

In the late 1950s, then-Democratic Senator Estes Kefauver launched a public review of the business dealings of the prescription drug industry through the U.S. Senate's anti-trust and monopoly subcommittee.

The senator accused the industry of predatory pricing, extravagant cost increases brought on by excessive marketing and selling new products that were no more effective than drugs already widely established on the market.

The issue was studied in depth again in the 1960s and 80s.

However, there hasn't been a comprehensive study of drug industry profits and spending in more than a decade, giving governments very little new information on research spending.

In the United States, direct-to-consumer marketing of prescription drugs is allowed, and drug companies buy television, radio and print ads to promote products directly to the public.

But in Canada the rules are stricter and so-called "reminder advertising" or disease-awareness ads are more prevalent, without direct mention of drug difficulties, such as "may cause abnormal bleeding," or "may cause dizziness."

In the United States, drug companies also spend more on advertising to doctors, so they aren't caught off guard by patients demanding a certain type of prescription after having seen the drugs on television or elsewhere.

Canadian firms also tend to underspend on research, compared with other developed countries.

"Canada has long been a relatively low performing country in terms of pharmaceutical research and development," said Morgan.

"Against our international comparisons, and particularly against the United States, manufacturers spend a smaller percentage of sales on research and development in Canada than they do in other countries."

But the ratio of spending on marketing versus research in Canada is likely similar to that of the United States - it's just that drug companies spend a lot more on both in the U.S., says Morgan.

In their analysis, called The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States, Gagnon and Lexchin suggest that governments should force the industry "in the direction of more research and less promotion."

"Health Canada and the (U.S. Food and Drug Administration) could promote research if they change the criteria for how they approve drugs," said Lexchin.

"Then the drug companies would be forced to put their money into more innovative research, and the drugs that would come out of that would not be the ones you need to promote so much."

However, altering the way drug firms spend on promotion "would require profound changes, not just in industry practice," said Morgan.

Consumers and the medical profession are the true drivers behind the research-based pharmaceutical industry, Morgan contends, not the drug companies themselves.

"The reality is that firms behave in ways that we provide them incentives to behave," said Morgan.

"It's not really their responsibility to change practice as much as it's the responsibility of people who pay for drugs, and in particular doctors who prescribe them and patients who request them," he said.

"It's those persons' responsibilities to change the incentives - to change the way we reward manufacturers and start putting more emphasis on rewarding truly innovative products rather than rewarding products that are just promoted intensively."

Psychologist, implicated in home invasion, sent for psychiatric evaluation

Naturally, the guy's lawyer is blaming the victim in this case. From the Flint Journal

A psychologist who allegedly attacked a family on Christmas Eve will likely be sent to a state facility next week for forensic testing himself.

But attorney Michael B. Haley, representing William L. Harshman, said the victim's financial dealings with his client, including a mortgage about a year ago, may have led to the attacks.

Harshman, 50, is charged with first degree home invasion and two counts of assault with intent to murder in the Dec. 24 incident.

Police and prosecutors said Harshman went to 8259 Pine Hollow and stabbed Lisa Heintz and a Edward Lapine, 17, who was helping the Heintz's move from their residence.

Haley told Central District Judge Larry J. Strecco that he would be asking him to approve a motion Wednesday to have his client sent to the Center for Forensic Psychiatry near Ann Arbor for testing for criminal responsibility and competency for trial.

Outside the court, Haley said Harshman's alleged actions are out of character and he wants to determine his client's mindset before proceeding with the case.

"For someone with his background and the respect he commands, I need an expert to determine if he is psychologically sound," Haley said.

Harshman, shackled in court, said nothing during the short hearing.

Haley alluded to business dealings and refinancing transactions with Harshman and others that have led to about two dozen pending civil actions against the Heintz's in Genesee County Circuit Court involving breach of contract.

Haley said others who have been involved with the Heintz's "are victims."

Haley said the Heintz and Harshman families vacationed together in the past, at Traverse Coty and Florida, and that their children were together on Halloween.

Court records indicate Harshman was an instructor at Mott Community College for 14 years and a therapist at Oakland Psychological.

Harshman, who completed his doctorate and has no prior felony convictions, is being held without bond in the Genesee County Jail on the assault charges.

And you would think that a psychologist would be an excellent judge of human character, if his friends drove him to this point.

The tragic psychiatric misdiagnosis of Sopis Mirza led to her death

Someone sent in this link to another tragic case where a valid medical condition was misdiagnosed, and the woman involved was committed to a psychiatric hospital for treatment of her non-existent mental disease. Unfortunately, the woman died a few short days after returning home of the very real disease she had contracted.

The woman's name is Sophia Mirza, and her full story can be read online here The medical condition is Myalgic Encephalomyelitis, and you can read more about this condition here.

The World Health Organisation has classified Myalgic Encephalomyelitis as a neurological illness, as defined by ICD-10-G93.3, separate from the psychological illnesses classified under ICD-10-F48

ME/CFS - Doctors disbelief kills young woman



ME/CFS - A Hidden National Scandal Exposed

Dad on murder charge 'cleared by doctors'

More on the tragic case from Australia in which a man tortured, raped, and then killed his own daughter, after having been released by psychiatrists who felt he was safe.

For us, this raises many questions on the basic ability of psychiatrists to fulfill their public safety function. Apparently, it wasn't just a single psychiatrist that passed him for release, it was a whole team.

The solution is not to drug everyone just in case something weird might happen. The solution is not some diagnosis based on unscientific subjective tests. You should be able to use a combination of objective tests (blood chemistry, etc) to make a factual diagnosis. And Psychiatry has no such set of procedures.

As seen in this report from the Sydney Morning Herald.

A mentally ill man who was discharged from hospital before allegedly raping and murdering his 10-year-old daughter would likely have been cleared by a team of medical professionals.

The 39-year-old Bardon man, who cannot be named, appeared in Brisbane Magistrates Court on Wednesday charged with the rape, murder and indecent treatment of his daughter, who was found dead in a Bribie Island house earlier this week.

He was remanded in custody awaiting a mental health assessment at a correctional centre.

The man's solicitor, Neil Lawler, said his client had been under an involuntary treatment order for mental illness and was released from the Royal Brisbane and Women's Hospital on December 22.

A senior psychiatrist at the Royal Brisbane Hospital yesterday said the treatment of patients on involuntary treatment orders (ITOs) was usually administered by a team of psychiatrists, registered mental health nurses, trainee psychiatrists, clinical psychologists and social workers.

Dr David Acorn said he could not speak specifically about the 39-year-old's case but usual procedure at the hospital meant a number of health professionals were required to authorise a patient's discharge.

"The decision would be made in a team context, or if not the whole team, the senior psychiatrist in consultation with a trainee psychiatrist and other professionals," Dr Acorn said.

He said the treatment of patients on ITOs was a staggered process that involved regular monitoring.

"It involves a process of not only their clinical state but also their risk factors - their risk factors to themselves and their risk factors to other people.

"As their illness settles ... we would then give them small amounts of leave - intially grounds leave in the grounds of the hospital - to see how the patient responded to that," he said.

A patient would then get longer and longer periods of leave, including day-leave, before being disharged from hospital on the advice of a senior psychiatrist and other professionals, Dr Acorn said. He made the comments as acting Premier Paul Lucas announced an over-arching, independent inquiry into the 10-year-old girl's death.

Mr Lucas said Children's Commissioner Elizabeth Fraser would conduct the probe and the heads of all relevent government departments would be instructed to cooperate.

"I told (Ms Fraser) I want a proper job, not a rush job," he said.

Queensland Health on Wednesday said it did not alert the Department of Child Safety about the 39-year-old man's mental health problems because he was not seen as a potential risk.

The Department of Child Safety said it knew the family as a result of "low-level concerns", which did not meet the threshold for an official notification.

However, it had no knowledge of the father's mental health status.

Health Minister Stephen Robertson yesterday said if a systemic problem was found as part of his department's review, the Health Quality and Complaints Commission, crime watchdog the Crime and Misconduct Commission (CMC) or the Queensland Medical Board could be called in.

"As far as Queensland Health is concerned, this matter will be exhaustively and appropriately investigated,'' Mr Robertson said.

ABC News Report on Paxil Addiction

As Broadcast on December 9th, 2004. Here is a clip from that episode

The Connection of AntiDepressants and Suicide

From a comment by Dr. Seth Roberts, seen on the blog site of Ashworth University. Napoleon is famous for the maxim that one should not look for evil intent when incompetence will suffice. But situations like this make one wonder.

Can Antidepressants Cause Suicide? Many parents have said yes.

David Healy, a Scottish psychiatrist, prompted by those stories, did a small experiment in which undepressed persons took anti-depressants. About 10% of them started having suicidal thoughts.

Drug companies and the University of Toronto (where Healy had been offered a job) reacted very badly to this information, as Healy describes in Let Them Eat Prozac.

An article in the latest issue of the American Journal of Psychiatry by David Leon, a biostatistician on the FDA oversight panel, describes why he voted to extend a warning about this from children (< 18 years old) to young adults (18-24 years old).

This was the main data:



What’s shown is the odds ratio for a report of suicide ideation or behavior, comparing those who got anti-depressants with those who got placebos. An odds ratio of more than 1 means greater risk in those who got anti-depressants. The red bar is from a different study.

When different ages are lumped together there is no increase in risk but that hides opposing tendencies at high and low ages.

The article contains this curious sentence: “The results did not provide definitive evidence of risk, yet they failed to demonstrate an absolute absence of risk.” No possible results could “demonstrate an absolute absence of risk” so it is unclear what Dr. Leon meant.

Later he writes: “My vote to extend the black box warning to young adults was based on concern that risk of suicidality could not be ruled out and, given the widespread antidepressant use, even a small risk must not be ignored.”

Yes, he has it backwards: The data do not “fail to rule out” suicide risk (no possible data could “rule out” such risk, i.e., show the risk is zero); they manage to overcome a barrier to show it’s there.

And yes, he’s congratulating himself (”even a small risk must not be ignored”) for doing his job.

Uh-oh.

That someone — a biostatistician, no less — in such a powerful regulatory position fails to understand basic concepts is bad enough; to make things worse, Dr.
Leon has received money from three of the companies (Eli Lilly, Organon, and Pfizer) he oversees.

Psychiatrist sets man free days before he tortures, rapes, and kills his daughter

We presuppose that there is a public safety function for detaining people who are disturbed. We also have noted many times that ineffective and/or harmful treatments, especially due to the marketing of modern snake oil, contributes to the problem. We now have a report where we are moved to ask again, do these folks even know what they are doing? A report from the Courier Mail in Australia

A man was cleared by a psychiatrist to leave a Brisbane hospital's mental health unit just nine days before he allegedly raped and murdered his 10-year-old daughter.

But Queensland Health did not report the man – who had spent two weeks as an involuntary patient in the hospital's mental health unit – to the Department of Child Safety. This was despite him having sole custody of his four children aged between six and 10.

The family was known to Child Safety after complaints in previous years from neighbours as well as by a teenage child in the family.

The man, 39, sat expressionless in the dock of the Brisbane Magistrate's Court yesterday when he appeared on charges of rape, murder and indecent treatment.

It is believed the Bardon man – who cannot be named for legal reasons – lost his job as a funeral director several weeks ago and had since been unemployed.

The gruesome rape and murder – during which the girl was bound and her head roughly shaved – allegedly took place in a bedroom of the family's rented holiday home on Bribie Island on New Year's Eve.

Defence lawyer Neil Lawler told the court his client had been subject to an involuntary treatment order but did not currently need to be transferred to a mental health facility.

The Courier-Mail has learned the man was admitted to the Royal Brisbane and Women's Hospital as an involuntary patient on December 8 after police picked him up at Brookside Shopping Centre during a "manic" episode. He had tried to charge $17,000 on a credit card with a much lower limit, and had to be subdued by capsicum spray after becoming aggressive.

An officer was injured during the incident, receiving bruising to his back and to his neck.

Until this incident, the man had been unknown to mental-health authorities.

A psychiatrist at RBWH assessed the man as fit for discharge on December 22.

His family had reported him as being "back to normal" during two days' leave as part of his treatment and he had returned to the hospital for further observation before being released.

The release of all patients subject to involuntary treatment orders is assessed by the Mental Health Review Tribunal. It was unclear last night whether the man's case had come before the tribunal.

He had previously suffered throat cancer, a condition which – in some cases – can be linked to manic episodes.

The man was released on medication, including an anti-psychotic drug known as Risperidone, but it was unknown whether he continued to take the drug after discharge.

Child Safety last night insisted it was unaware of the man's mental health problems. But doctors said they were under no obligation and had no reason to report the man to Child Safety authorities.

A Child Safety spokesperson said the family was known to authorities as a result of "low-level concerns which did not meet the threshold for an official notification".

It is understood that two of the complaints about the father came from an older child in the family.

The Courier-Mail was told that a small group of neighbours had met two years ago to discuss concerns about the level of verbal abuse that the children allegedly suffered from their father.

A neighbour said Child Safety was contacted and departmental officers had visited the house. The department last night did not answer questions put to it about the neighbours' alleged concerns.

The department's handling of the case will be reviewed and an independent child death review will be conducted.

The review will then be scrutinised by the Child Death Case Review Committee, chaired by the Commissioner for Children and Young People, Elizabeth Fraser.

But acting Opposition Leader Mark McArdle said: "I'm not satisfied with an internal investigation.

"There is now an overwhelming case for a full investigation into the department and for any inquiry to be held."

Outside the court yesterday, Mr Lawler said the man had been assessed by a mental-health worker after the murder but further investigation would be needed into his mental state.

Magistrate Chris Callaghan adjourned the case for another mention on March 10 when the accused man will not have to appear.

He was remanded in custody and must apply to the Supreme Court if he wants bail.

The man will be housed at the Arthur Gorrie Remand and Reception Centre in the meantime, where he will be psychiatrically assessed and treated.

"It's a near certainty that (this case) will proceed to the Mental Health Court and that it will take some significant time for that to be arranged," Mr Lawler said.

It is understood the man was divorced from the dead girl's mother – who still lives in Brisbane – and that he has cared for their children for several years.

The mother is believed to have a serious criminal history.

The three surviving children – boys aged seven and nine and a girl aged six – are in the care of their grandparents.

Child victim 'sweet and lovely'

A 10-year-old girl allegedly murdered by her father was "a sweet and lovely child" and a "peacemaker", according to her school deputy principal.

"She was really loved by all the teachers and students," the teacher said. "She was a real peacemaker on the playground. If anyone was having problems she would run to us because she didn't like any disruption.

"She loved coming to school and was always punctual, always happy to be there. She will be very sadly missed."

The girl, who cannot be identified in Queensland, was yesterday mourned by neighbours in the inner-city suburb of Bardon.

One neighbour said she had often seen the children playing together at the front of the house they had lived in for three years, and described her as "full of life".

"She was a happy little thing always jumping and skipping – she was just lovely," the neighbour said.

"The children were beautiful young children, they always played happily together and they were a lovely lot of kids.

"It came as a big blow to all of us – we never thought it would come to anything like this."

A mother at the primary school the girl attended said she was a kind child whose face would always light up when she was spoken to.

Another neighbour said that she and two other people from the street had become concerned about the children and contacted the Department of Child Safety.

"The kids were little when they first came here, but we didn't get to know them," she said. "We did finally between us notify Family Services because we were concerned."

An Education Queensland spokesman said their thoughts were with the family.