Comments on: “One in four”: the anatomy of a statistic http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/ Fri, 03 May 2013 09:13:06 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Joanna http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-511630 Joanna Sun, 01 Apr 2012 14:09:35 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-511630 Totally agree with you David. It also doesn't address the biggest source of discrimination - central government Totally agree with you David.
It also doesn’t address the biggest source of discrimination – central government

]]> By: David http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-503232 David Thu, 22 Mar 2012 19:05:30 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-503232 I think this sort of campaign that uses the one in four figure (or any other prevalence figure) is difficult because in making mental illness seem 'normal' they somehow also make people with severe mental illness seem like they are making a fuss about nothing or being scroungers if they can't just pull themselves together and get on with life, so I think simplistic campaigns about mental illness can do more harm than good. I think this sort of campaign that uses the one in four figure (or any other prevalence figure) is difficult because in making mental illness seem ‘normal’ they somehow also make people with severe mental illness seem like they are making a fuss about nothing or being scroungers if they can’t just pull themselves together and get on with life, so I think simplistic campaigns about mental illness can do more harm than good.

]]> By: Seaneen http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-493849 Seaneen Tue, 13 Mar 2012 15:44:07 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-493849 Thank you for this! I find it incredibly annoying. Partly because it seeks to normalise something to make it acceptable; as if only something normal should be. Thank you for this! I find it incredibly annoying. Partly because it seeks to normalise something to make it acceptable; as if only something normal should be.

]]> By: Joanna http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-484911 Joanna Sun, 04 Mar 2012 19:38:39 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-484911 It's a pointless figure for pointless campaigning It’s a pointless figure for pointless campaigning

]]> By: kurt http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-483846 kurt Sat, 03 Mar 2012 01:06:19 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-483846 wat keeps the brain alive an working wat keeps the brain alive an working

]]> By: Mark Saxton http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-481864 Mark Saxton Wed, 29 Feb 2012 18:23:08 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-481864 Can you tell anyone there is a one in four chance of them getting something that's impossible to diagnose accurately? Is is in the patient's best interests? Who gains? Can you tell anyone there is a one in four chance of them getting something that’s impossible to diagnose accurately?
Is is in the patient’s best interests?
Who gains?

]]> By: Kat http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-480976 Kat Tue, 28 Feb 2012 23:28:27 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-480976 In a related "statistical frenzy" story: http://bmjopen.bmj.com/content/2/1/e000850 Since I have worked in psychopharmacology, I've been fielding questions about the "Ambien causes cancer" study. Some of my concerns about the data are mirrored in the published reviews - since the article was released pre-publication - and some of my own concerns are related to the diverse nature of temazepam and zolpidem, the only two drugs for which actual data was provided. Specifically, temazepam being a benzodiazepine, a class of drugs that has not been historically associated with a higher incidence in cancer mortality rates - or any mortality rates, really, aside from polypharmacy, whereas zolpidem, being a "z-like benzodiazepine hypnotic" is not a true comparative drug. While they examined multiple sedative-hypnotics, that information was not included in the publication. They also apparently examined barbiturates but did not provide data based on drug class, and it is well-known that barbiturates alone have an extremely high mortality rate. Moreover, there's something else that's "off" about the statistical analyses - aside from not taking polypharmacy into account or (especially) the lack of information on specific drug class as well as on psychiatric diagnoses and associated pharmacotherapy - but my statistical capabilities are weaker than they once were when I worked in research so I can't pinpoint precisely what it is about this data that makes me feel uneasy. I was hoping you could take a look and provide some perspective on these findings, which have led to some mass hysteria on the part of my friends/family members. I have also sent this to two other psychiatry blogs and am really hoping that - whether the conclusions are valid or not - someone will examine the data more closely than the media has done. If it is a valid analysis, then I'm more curious about the nature of the mortality link than "is Ambien going to kill me?" but I'm having trouble accepting this study as valid. In a related “statistical frenzy” story:

http://bmjopen.bmj.com/content/2/1/e000850

Since I have worked in psychopharmacology, I’ve been fielding questions about the “Ambien causes cancer” study. Some of my concerns about the data are mirrored in the published reviews – since the article was released pre-publication – and some of my own concerns are related to the diverse nature of temazepam and zolpidem, the only two drugs for which actual data was provided. Specifically, temazepam being a benzodiazepine, a class of drugs that has not been historically associated with a higher incidence in cancer mortality rates – or any mortality rates, really, aside from polypharmacy, whereas zolpidem, being a “z-like benzodiazepine hypnotic” is not a true comparative drug. While they examined multiple sedative-hypnotics, that information was not included in the publication. They also apparently examined barbiturates but did not provide data based on drug class, and it is well-known that barbiturates alone have an extremely high mortality rate.

Moreover, there’s something else that’s “off” about the statistical analyses – aside from not taking polypharmacy into account or (especially) the lack of information on specific drug class as well as on psychiatric diagnoses and associated pharmacotherapy – but my statistical capabilities are weaker than they once were when I worked in research so I can’t pinpoint precisely what it is about this data that makes me feel uneasy.

I was hoping you could take a look and provide some perspective on these findings, which have led to some mass hysteria on the part of my friends/family members.

I have also sent this to two other psychiatry blogs and am really hoping that – whether the conclusions are valid or not – someone will examine the data more closely than the media has done. If it is a valid analysis, then I’m more curious about the nature of the mortality link than “is Ambien going to kill me?” but I’m having trouble accepting this study as valid.

]]> By: Frontier Psychiatrist http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-477439 Frontier Psychiatrist Sat, 25 Feb 2012 13:44:29 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-477439 I don't think that it's easy to answer this question - the answer depends on how you choose to define mental disorder. Taylor and Chave (1980 or so, and quoted in Clare's <a href="http://www.amazon.co.uk/gp/product/0415039428/ref=as_li_qf_sp_asin_tl?ie=UTF8&tag=frontiepsychi-21&linkCode=as2&camp=1634&creative=6738&creativeASIN=0415039428" rel="nofollow"><em>Psychiatry in Dissent</em></a>) <blockquote>The size of the catch depends on the size of the mesh of the net that is used; mental institutions find the least, community studies more, and direct interviews find the most. Indeed, the over-enthusiastic psychiatric diagnostician can find evidence of psychiatric ill-health in most human beings; such findings tell us more about the observer than the observed</blockquote> I don’t think that it’s easy to answer this question – the answer depends on how you choose to define mental disorder.

Taylor and Chave (1980 or so, and quoted in Clare’s Psychiatry in Dissent)

The size of the catch depends on the size of the mesh of the net that is used; mental institutions find the least, community studies more, and direct interviews find the most. Indeed, the over-enthusiastic psychiatric diagnostician can find evidence of psychiatric ill-health in most human beings; such findings tell us more about the observer than the observed

]]> By: Noel Bell Psychotherapist http://frontierpsychiatrist.co.uk/%e2%80%9cone-in-four%e2%80%9d-the-anatomy-of-a-statistic/comment-page-1/#comment-477000 Noel Bell Psychotherapist Sat, 25 Feb 2012 00:35:26 +0000 http://frontierpsychiatrist.co.uk/?p=1596#comment-477000 Thanks for the post. Yes, the methods used often have shortcomings but is the rate higher or lower? Thanks for the post. Yes, the methods used often have shortcomings but is the rate higher or lower?

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