Background: The Australian journalist Ray Moynihan called "shaping diseases (" disease-mongering "in English) cited by the blog Pharmacritique: http://pharmacritique.20minutes-blogs.fr/ archive/2008/05/19/psychotropes-des-le-berceau-le-faconnage-de-maladies-disease.html # more): "The business strategies that aim to broaden the definition of a treatable disease, to increase the amount of treatments sold or distributed "
Change the criteria for defining a disease can increase the number of patients treatable. Osteoporosis, previously defined by the criterion of bone fractures, is now defined by measurements of bone density.
Changing the course of a disease to chronicity is economically profitable for producers of drugs: treatment of patients living with revenues even more important that treatment starts early. The authors mention the depression, a disease once considered acute, which is increasingly presented as a chronic disease.
Pharmacritique According to the blog: "For many conditions for "mental health", the boundaries between "normal life" and "mental illness" are vague. And the question of the influence of the strategy of "shaping diseases" in the definition of "psychiatric disorders" arises. For example, in North America, recognized the prevalence and drug treatment of three of these conditions, intensely publicized, have increased dramatically in children and adolescents in recent years: the syndrome of hyperactivity with attention deficit ("attention deficit hyperactivity disorder (ADHD) in English) depression, bipolar disorder.
To read in French:
http://www.prescrire.org/docus/ConferencePiluleMintzes.pdf
Is this risk exists for cyclothymia?
I think yes without any hesitation.
Why?
For the concept of "cyclothymia" is too broad, not specific enough in its current definition which enables easy diagnosis of people who are more into "personal disposition" (Kraepelin ) than in the bipolar offset.
The moment a person does not feel well and she consults, it is fairly easy to convince his "disease" even in the absence of solid evidence of disease (hospitalization, suicide attempt, severe occupational dysfunction, etc. ...). Many people living with cyclothymia have always felt a malaise frequently without knowing real mixed episodes, hypomanic or depressive. They are in a complex situation that the therapist should be approached with great prudence, discretion and ethics. And as recommended by the Canadian experts from the University of British Columbia "must be examined case by case patients because there is a lack of clear evidence to help doctors treat patients with bipolar" ("There Is a paucity of sound evidence to help guide clinicians Treating BP II patients). : Http://www.ncbi.nlm.nih.gov/pubmed/14996137 .
This blurred boundary between normality and "real" cyclothymia - but different from the BP-II is a boon for "diseasemongerer" (Webster's: A Person Who promotion has spécifié activity, situation, or feeling, esp. One That Is Undesirable or discreditable: rumormonger would be "pure" cyclothymic (Akiskal classification), level II or "true" cyclothymic which falls within the bipolar spectrum, while the other two could be considered as "personality disorders (Axis II) or" temperament at risk. " As I mentioned earlier, why not return to the previous International Classification associating cyclothymia and pathological personality (p.185 FC: Professor Bourgeois, in "Mania and Depression", 2007) because in the prelude to the mildest forms of manic-depressive or "eintleitung" of Kraepelin, there is a vast space. The latter acknowledged that the "constitution cyclothymia "deserved special attention and special treatment. Yes but which ones?
But I want to stand in view of" disease mongering "over and see a conspiracy organized by the Financial laboratories (and if there are responsible as Barber says, that some doctors are those who take the Hippocratic Oath), because the concept of spectrum Akiskal and Angst is right and proven by the number of patients misdiagnosed and mistreated if I may say so. But the problem is the discernment and ethics in the diagnoses and treatments. I am struck by the number of patients receiving treatment without a diagnosis fairly heavy precise (and cyclothymia what intensity?, BP II or I? Other?) and people that are described generically cyclothymic but belong to different categories, which require follow-up educational and psycho-pharmacological or appropriate especially if basis. In all cases identified, the overriding question is: a treatment for how long? What treats does it work? Episode and "recovery" for 6 months or a year later? And of course, how the environment will influence my cyclothymia?
should be in the United States concerned that psychiatrists say the money received by the laboratories each year and what kind of contribution. Requires that the state regulates or funds (if possible!) In-service training, conferences psychiatric literature "scientific" or information that are too often in the direction of drug use proposed by laboratories ("chronicity beneficial" for the whole partnership psychiatrist laboratory).
Legislation being set up in the U.S., patients are becoming more and more "experts" and independent doctors will hear their voices, so there is every reason to be optimistic because this trend will happen sooner or later France. Those who speak English and can type in keywords such as "bipolar" "ADHD," "depression" in the search of the New York Times and see that many citizens and U.S. doctors are beginning to express doubts about a certain practice of psychiatry and marketing "creative" in this laboratory area.
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