issuesdaily.com staff article
I have been involved in dog training for some time and as such, I spend a great deal of time researching new findings in how dogs learn. Developments are fast and furious in the realm of dog behavior with major studies usurping our traditional ideas of how dogs think and why they do what they do. From University of Pennsylvania’s current year-long study into dog aggression to the American Veterinary Medical Association’s stand on acceptable training methods…it is a field in transition.
So it is with some interest that an article featured in the Los Angeles Times today regarding current deliberations going on over the DSM – V, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. It was one of those headlines which caught my eye and made me think, of course, why shouldn’t it be updated?
If we are publishing changes in our thinking on the subject of canine brains, isn’t it a certainty that we need to revamp our thinking on the human brain? Advances in research, technology and a change in our society should be reflected when dealing with the topic of human mental functioning.
According to the La Times article, this will affect what services people will be eligible for, anti-discrimination laws, and what insurance companies will cover. Medicalizing mental disorders will bring about a wider range of care.
The DSM-V is expected to go into more detail and also take into consideration many different factors such as age, race, gender, culture and physical health.
The DSM-V has been under scrutiny because of ties to the pharmaceutical industry. The New England Journal of Medicine commented on May 7 that “56% of DSM-V task force and committee members have industry ties.” Committee members are required to abide by conflict-of-interest rules with caps on the amount they can receive from the pharmaceutical industry while serving on committee.
I think it is a development well worth keeping an eye on. With all the changes in our ideas about addiction, developments in brain imaging and genetics, as well as the increasing occurrence of conditions such as autism and bi-polar disorder, it will be interesting to see how these changes will be reflected in the revised edition. With the care of so many dictated by the DSM-V and services approved or denied based on its guidelines, we can only hope that the promise of a more science-based measuring tool will soon become a reality.
It is cause for some concern that the so-called ‘bible of psychiatry’ is not as dynamic as the fields of technology which surround it. As psychiatrists spend the next 18 months debating the issues to be addressed in the new edition, one has to wonder at its relevance in a world in which technology is moving forward so quickly.
Los Angeles Times Article:
http://www.latimes.com/news/nationworld/nation/la-sci-mental-disorder26-2009may26,0,3081443.story
US researchers call off controversial autism study
Date: 9/17/2008 8:32 PM
By CARLA K. JOHNSON
Associated Press Writer
CHICAGO (AP) _ A government agency has dropped plans for a study of a controversial treatment for autism that critics had called an unethical experiment on children.
The National Institute of Mental Health said in a statement Wednesday that the study of the treatment — called chelation — has been abandoned. The agency decided the money would be better used testing other potential therapies for autism and related disorders, the statement said.
“There will be parents who are disappointed,” said Richard Nakamura, the scientific director of NIMH. “We recognize that for children there is a fine line for the risk-benefit ratio. You have to be pretty certain of the overall safety of the procedure.”
The agency wasn’t confident enough in the procedure’s safety, Nakamura said.
The study had been on hold because of safety concerns after another study published last year linked a drug used in the treatment to lasting brain problems in rats.
Chelation (kee-LAY’-shun) removes heavy metals from the body and is used to treat lead poisoning. Its use as an autism treatment is based on the fringe theory that mercury in vaccines triggers autism — a theory never proved and rejected by mainstream science. Mercury hasn’t been in childhood vaccines since 2001, except for certain flu shots.
But many parents of autistic children are believers in the treatment, and NIMH agreed to test it.
The researchers had proposed recruiting 120 autistic children ages 4 to 10 and giving half a chelation drug and the other half a dummy pill. The 12-week test would measure before-and-after blood mercury levels and autism symptoms.
The study outline said that failing to find a difference between the two groups would counteract “anecdotal reports and widespread belief” that chelation works.
Autism is a spectrum of disorders that hamper a person’s ability to communicate and interact with others. Most doctors believe there is no cure.
In canceling the study, the agency noted it would take another year to review the study and three years to do it. In the meantime, the agency said, it was likely that other research would “provide deeper understanding of the causes of autism and more refined avenues for developing treatments.”
NIMH should reconsider its decision to cancel the chelation study, said Rebecca Estepp, national manager of Talk About Curing Autism, a support group for families with autistic children.
“By discontinuing this study, the NIMH will not prove the effectiveness of chelation therapy one way or another. Instead, they have merely left parents with more unanswered questions,” Estepp said in a statement.
But several scientists praised the decision, including the lead author of the rat study, which found lingering problems in animals that did not have elevated lead levels.
“I think they’re making the right decision not to go forward with the study,” said Barbara Strupp, a professor of psychology and nutritional sciences at Cornell University.
“Our data raise concerns about administering (the chelation compound) to children who do not have elevated levels of heavy metals,” Strupp said.
Dr. Paul Offit, chief of infectious diseases at the Children’s Hospital of Philadelphia, agreed with the decision to cancel.
“Suppose that a child suffers a severe side effect from chelation,” said Offit, author of “Autism’s False Prophets,” a new book on autism research. “Without any evidence it’s helpful, I think it’s unethical.”
The chelation drug proposed for the study, DMSA, can cause side effects including rashes and low white blood cell count.
“This was a wise and careful decision,” said Ellen Silbergeld of Johns Hopkins University’s Bloomberg School of Public Health, who had been invited to comment on the study during an earlier review, in an e-mail.
___
On the Net:
National Institute of Mental Health: http://www.nimh.nih.gov/
Copyright 2008 The Associated Press.
By CARLA K. JOHNSON
Associated Press Writer
CHICAGO (AP) _ A government agency has dropped plans for a study of a controversial treatment for autism that critics had called an unethical experiment on children.
The National Institute of Mental Health said in a statement Wednesday that the study of the treatment — called chelation — has been abandoned. The agency decided the money would be better used testing other potential therapies for autism and related disorders, the statement said.
“There will be parents who are disappointed,” said Richard Nakamura, the scientific director of NIMH. “We recognize that for children there is a fine line for the risk-benefit ratio. You have to be pretty certain of the overall safety of the procedure.”
The agency wasn’t confident enough in the procedure’s safety, Nakamura said.
The study had been on hold because of safety concerns after another study published last year linked a drug used in the treatment to lasting brain problems in rats.
Chelation (kee-LAY’-shun) removes heavy metals from the body and is used to treat lead poisoning. Its use as an autism treatment is based on the fringe theory that mercury in vaccines triggers autism — a theory never proved and rejected by mainstream science. Mercury hasn’t been in childhood vaccines since 2001, except for certain flu shots.
But many parents of autistic children are believers in the treatment, and NIMH agreed to test it.
The researchers had proposed recruiting 120 autistic children ages 4 to 10 and giving half a chelation drug and the other half a dummy pill. The 12-week test would measure before-and-after blood mercury levels and autism symptoms.
The study outline said that failing to find a difference between the two groups would counteract “anecdotal reports and widespread belief” that chelation works.
Autism is a spectrum of disorders that hamper a person’s ability to communicate and interact with others. Most doctors believe there is no cure.
In canceling the study, the agency noted it would take another year to review the study and three years to do it. In the meantime, the agency said, it was likely that other research would “provide deeper understanding of the causes of autism and more refined avenues for developing treatments.”
NIMH should reconsider its decision to cancel the chelation study, said Rebecca Estepp, national manager of Talk About Curing Autism, a support group for families with autistic children.
“By discontinuing this study, the NIMH will not prove the effectiveness of chelation therapy one way or another. Instead, they have merely left parents with more unanswered questions,” Estepp said in a statement.
But several scientists praised the decision, including the lead author of the rat study, which found lingering problems in animals that did not have elevated lead levels.
“I think they’re making the right decision not to go forward with the study,” said Barbara Strupp, a professor of psychology and nutritional sciences at Cornell University.
“Our data raise concerns about administering (the chelation compound) to children who do not have elevated levels of heavy metals,” Strupp said.
Dr. Paul Offit, chief of infectious diseases at the Children’s Hospital of Philadelphia, agreed with the decision to cancel.
“Suppose that a child suffers a severe side effect from chelation,” said Offit, author of “Autism’s False Prophets,” a new book on autism research. “Without any evidence it’s helpful, I think it’s unethical.”
The chelation drug proposed for the study, DMSA, can cause side effects including rashes and low white blood cell count.
“This was a wise and careful decision,” said Ellen Silbergeld of Johns Hopkins University’s Bloomberg School of Public Health, who had been invited to comment on the study during an earlier review, in an e-mail.
___
On the Net:
National Institute of Mental Health: http://www.nimh.nih.gov/
Copyright 2008 The Associated Press.
