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I am wondering if these authors will next be capitalizing on the art of children who witnessed the WTC terrorist attacks. Seems like a logical follow-up to this book, although I hope they have the morals to handle the material in a less sensational, self-serving way.
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It is simply astonishing how Koplewics ignores the mountains of evidence in his own book that childhood problems have non-biological causes (relationships, life events, cultural factors) and real physical causes (e.g., hormones) and instead pushes pills - without offering a shred of evidence that these kids have bad brains. Of course, in this regard he displays a common trait of psychiatrists - the dismissal of the obvious in favor of the hypothetical and untestable.
Just so no kid misses his or her pharmocological treat, there are the multitude of different types of depression followed by the all encompassing caveat: "none of this is etched in stone." In other words, don't be discouraged if your kid doesn't meet all the criteria. We've got a diagnosis for everyone. (One is reminded of the statement in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)(xxii): "In DSM-IV, there is not assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or from no mental disorder." Imagine a real doctor saying diabetes is not a distinct entity with boundaries dividing it from cancer, an infection or complete health.)
There are the unquestioned and unexamined platitudes: "adolesence is demoralizing almost by definition." Understandable feelings are redefined as "symptoms" of illness. A fear of the future (we're all so confident of the future, aren't we?) becomes "Generalized Anxiety Disorder." Fears of the family well-being (imagine a kid being concerned about that!) become "Separation Anxiety Disorder."
Koplewics writes, "It's the duration of the symptoms that tell if a teenager has crossed the line into depression." Says who? Psychiatrist Nancy Andreasen, editor-in-chief of the American Journal of Psychiatry, has written (Science, vol. 275,14 March 97), "thresholds based upon duration ... are boundaries of convenience ... not boundaries with any inherent biological meaning."
Koplewics attitude towards children is often patronizing. One girl's description of a horrible childhood is described by Koplewics as "the product of the drama of adolescence."
Questionable "facts" and outright untruth abound in the book. According to Koplewics, the newer antidepressants (SSRIs) "have fewer side-effects" and "have always been found to be more effective than placebos." Not so. In his 1999 textbook, The Fundamentals of Clinical Neuropsychiatry, Dr. Michael Alan Taylor writes, "It is a mistake to think that one class of drug is 'safer' or has 'fewer' side effects .... Taylor specifically cites claims about the SSRIs
A July, 2002 analysis by George Washington University's Thomas Moore of 47 studies used by the FDA in approving six antidepressants found that in over half the studies, the drugs were no better than placebo. The overall slight benefit antidepressants had over placebo were found to be "not meaningful for people in clinical settings."
Koplewics ignores the side-effects of drugs and the withdrawal effects. Failed treatment is excused because, of course, one never recovers from psychiatric "illness." Typical is this statement: "That Jesse [treated with drugs as an adolescent] has depression as an adult is not a surprise."
Ho-hum. Failed treatment is all part of a days work.
Thank you Dr. Koplewicz.
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