MARTIN WHITELY (Trancript of speech in the Legislative Assembly, Parliament of Western Australia, 25 September 2012): I want to use this opportunity to talk about some very serious concerns I have about the direction of the mental health policy in Australia. My basic contention is that personalities, rhetoric and charisma are driving the direction of mental health rather than science and evidence.
“Patrick McGorry’s Orygen Youth Health, CAARMS training video on how to diagnose ‘Attenuated Psychosis’ demonstrates how not to carry out a psychiatric interview and interact with young people.”
As identified by Martin Whitely in his commentary about the CAARMS training DVD, describing Nick as being at ultra-high risk of psychosis (UHR) fails the common-sense test. Even more concerning is that Nick is labelled as having Attenuated Psychosis – in ordinary language, he is already mildly mad.
On May 2, 2012, the American Psychiatric Association announced changes to its proposed DSM5.[1. see http://www.dsm5.org/Pages/Default.aspx ] Psychosis Risk Syndrome, or as it was officially proposed to be called, Attenuated Psychosis Syndrome, has been dropped. This is great news because as has been highlighted on this website numerous times, Psychosis Risk Disorder was a flawed concept with the potential to be an iatrogenic health disaster. In addition most of the dangerous changes proposed for the already absurdly broad ADHD diagnostic criteria have been abandoned. Four extra ADHD criteria had been identified for inclusion in the DSM5. They were:
Following Professor McGorry’s blog is my response which details his past advocacy of the pre-psychosis use of antipsychotics, welcomes his recent change of heart but challenges him to join with his long term research partner, Dr Alison Yung, and oppose the inclusion of a Psychosis Risk Disorder in DSMV.
For over a decade Patrick McGorry has expirimented with or advocated the prescription of antipsychotics to adolescents on the hunch that they may later become psychotic. However, in response to last week’s blog a spokesperson for Professor McGorry told the West Australian he does “not recommend this (pre-psychosis drugging) as a standard treatment for clinical care because there are other treatments that are safer, like cognitive behavioural therapy and fish oil….there has been a substantial amount of research and we do change according to the research.”  (The full article can be read here: Mental health guru stumbles into public policy minefield.)
To the best of my knowledge this is the first time Professor McGorry has publicly declared that he has abandoned his support for the use of antipsychotics to prevent psychosis. His change of position is welcome. However, history tells it will not be enough to prevent a tide of pre-emptive drugging if Psychosis Risk Syndrome is included in DSMV, the next edition of the American Psychiatric Associations handbook of psychiatry.