The Review on Antidepressant Withdrawal That Cochrane Won’t Publish

https://www.madinamerica.com/2020/02/review-cochrane-wont-publish/

 

I see little reason to trust anyone involved in this. If Cochrane recognise that the history of comments from someone like Gøtzsche might mean he is not the best person to author a review on this (with some legitimate reason - I've not followed all of the details enough to have an opinion on much of these controversies, but it seems Gøtzsche can be drawn to hyperbole) then doesn't that make the decision to publish Larun's exercise review even more damning, given her history? I guess CFS patients are less deserving of concern?

 

It seriously appears as if a subset of psychiatry has achieved a stranglehold on all medical institutions about their sacred cows, almost acting more like a mafia than anything resembling science. What a complete mess. And sadly it will likely be a major boon to scientology and further harm trust in medical expertise, sadly rightfully.

Problem is it seems to threaten to expose that almost all research and clinical evidence on mental health, especially surrounding depression and anxiety, is nothing but a bunch of guesstimates and assumptions with no actual substance. The approach to "diagnosing" depression these last few decades has consisted mostly of: "do you feel depressed?" "guess so" "let's try anti-depressants, if they work it means you do have depression, if they don't it still means you have depression". Same with anxiety. Most of the "mental health crisis" resides right there, in the suspension of disbelief over just how unreliable the entire process, hell the entire profession, is.

The problem here was never a drug-based approach or a biomedical approach, as many love to profess, but rather that most of the concepts in mental health are vague and non-specific and that we do not have any tools to make reliable assessments of what mental health consists of in the first place. The field is still stuck in its starting position, not even close to be ready for clinical practice. The problem was jumping many steps thanks to a "this looks better than nothing on questionnaires" approach that can make anything people want to seem better than nothing if they want to.

And it really looks as if what this will lead to is making the exact same mistake but with behavioral interventions instead, because the real failure is not acknowledged and magical thinking is just too attractive to resist.