Quick dip: Schizophrenia genes, dark nighties of the soul, et alia

I must keep my nose on the not-beta, hidden-till-last-minute, writing-Not-For-FREE grindstone, where it’s getting shredded to bits — but in the meantime, wanted to pass on these worthy web distractions, worthy of full engagement if you’ve the time:

Vaughan Bell peeks at The long dark nightie of the soul and wonders “why mentally distressed women are always portrayed in their nighties.” Separately, he considers some strange security concerns raised by the growing use of brain implants.

Much interesting attention to schizophrenia this week: A big study parsing the genetics of schizophrenia, which came up with not much, gets judicious attention from the Times’ Nicholas Wade, who agrees that if the finding is (as hyped) “a landmark,” then it’s “the kind that says you have 10,000 miles yet to go.” Kevin Mitchell, meanwhile, who’s keeping a fine new blog called Wiring the Brain, finds significant silver lining to the cloudy view of this study.Separately, Carl Zimmer, writing in Newsweek, takes a broader look at how gene studies are so far raising more questions than they are answering. Brainblogger wonders — and Jonah Lehrer riffs — on why schizophrenics smoke more than other people.

Do ADHD Drugs Take a Toll on the Brain?

Scientific American has a good story by Edmund S. Higgins suggesting that might be the case. As the story notes, the evidence for such a toll is still preliminary. But the story’s opening, which tells of a parent seemingly overeager to medicate a child who didn’t need it, gives an idea of why the question is more important than we might like.:

At the time of this visit, the boy was off the medication, and I conducted a series of cognitive and behavioral tests on him. He performed wonderfully. I also noticed that off the medication he was friendly and playful. On a previous casual encounter, when the boy had been on Adderall, he had seemed reserved and quiet. His mother acknowledged this was a side effect of the Adderall. I told her that I did not think her son had attention-deficit hyperactivity disorder (ADHD) and that he did not need medication. That was the last time I saw her.

DSM-V Psych Bus hits more big potholes; passengers bail

As prominent neuroscientist Jane Costello resigns in protest from the DSM-V committee, Danny Carlat says the process near meltdown:

The Fifth Coming of DSM threatens to rend the fabric of American psychiatry. Let’s hope some cool heads in the APA’s leadership can find a way out of this mess.

Stay tuned. The DSM isn’t just a workbook; it’s the theoretical framework and the de-facto prescription guideline for American psychiatry. This level of disagreement and polarization only deepens my belief that the discipline is at crisis point and a crossroads — and in the nasty, scratchy fight over who gets to drive, the question of where to actually go may get a rather rushed answer.

Top Neuron Culture posts from June

In case you missed them (or miss them, and want to read again …)
The (Illusory) Rise and Fall of the “Depression Gene”
DIY circumcision with nail clippers Go figure.
Oliver Sacks meets Jon Stewart
Wheels come off psychiatric manual; APA blames road conditions
Alarming climate change chart of the day
Swine flu count in US hits 1 million; can’t wait till flu season!
Will government involvement drive up health-care costs?
What if you could predict PTSD in combat troops? Oh, who cares…

When fighting insurgents, eat with the locals

Spencer Ackerman explores and explains the importance of eating the local food when fighting an insurgency:

One of the things that struck me when I embedded with U.S. troops in Iraq and Afghanistan is how little local food I ate. When I met some friends for drinks in April 2007 after coming a month in Baghdad and Mosul, one of the first questions I got was about local Iraqi delicacies. Man, I said, I ate king crab legs with a plastic fork on a huge base around the Baghdad airport, courtesy of KBR. Or rather I tried, since you can%u2019t eat king crab legs with a plastic fork.When I went unembedded in Iraqi Kurdistan in 2006, I got the real deal, a wonderful interplay of Persian, Arab, Turkish and other influences, at every meal. Lots of pickled beets. Lots of grilled lamb and fish. Something I%u2019ve never had before or since %u2014 tender beef meatballs in a pomegranate and beet broth, almost like a Kurdish version of matzoh ball soup. At the fake Sheraton in Irbil, the second floor hotel features a Chinese restaurant, where short-order Kurdish cooks interpret Chinese food through their own prism of anise. My chow fun tasted like the end of American hegemony.

“There’s a reason that counterinsurgency mantras include Get Off The FOB and Don’t Commute To The Fight. The greater the distance — not just physically, but also culturally — from a populace, the fewer opportunities U.S. troops have to demonstrate to that populace that U.S. actions are in their interest.”

Do read the whole thing. It’s fabulous.
hat tip from @ezraklein

CJR: The health-care reform debate as Groundhog Day

It’s been 26 years since health-care reform failed. Does the debate reflect anything that’s happened since?

From The Columbia Journalism Review:

“The idea that we’ve made a great breakthrough just isn’t so,” says Jonathan Oberlander, a health-policy expert at the University of North Carolina. “Most of the plans today are direct descendants of what was proposed for the ’93-’94 debate. The debate reminds me of one of my favorite movies, Groundhog Day.

With few exceptions, like the fine series last summer by NPR that explained how a number of other countries handle health care, the press has done little to challenge this reality or help to broaden the health-care debate. Rather, it has mostly passed along the pronouncements of politicians and the major stakeholders who have the most to lose from wholesale reform. By not challenging the status quo, the press has so far foreclosed a vibrant discussion of the full range of options, and also has not dug deeply into the few that are being discussed, thereby leaving citizens largely uninformed about an issue that will affect us all.


Absent from the debate are not only single-payer systems like the ones in England and Canada, but other systems with multiple payers, like ones in Germany and Japan–or, for that matter, any discussion of why a system that relies on competition among private insurers in The Netherlands hasn’t resulted in lower prices for consumers, as advocates claimed. What’s common to all these systems is that everyone is entitled to health care and pays taxes to support the system, and medical costs are controlled by limits on spending. The specter of a system that takes a significant bite out of stakeholder profits in the U.S. is the real reason the debate is so restricted.

Will government involvement drive up health-care costs?

Opponents of a public health-insurance plan pose two main objections: that it will create an ‘unlevel playing field’ that will harm the private market for insurance (an odd objection, since that playing field already tilts quite sharply away from patients’ pockets and health and toward the wallets of the health-insurance industry); and that government involvement will raise costs. 
These objections seem to hold sway to the degree we limit our discussion to what already exists in the U.S. As with squabbles about the problems with our educational (non)system, the picture gets clearer if we step back and test this argument against the larger world.
In an article in Forbes, Bruce Bartlett brings some clarity by doing just that:

We spend $7,290 per person on average versus $2,964 among all OECD countries. Norway, the nation with the second most expensive health system on a per capita basis, spends $4,763. (Currency conversions based on purchasing power parity.)
Of course, Americans know that they pay a lot for health; the rising cost of health insurance for employers is the main reason why wages have been stagnant for years. [NB from DD: Actually, many Americans manage to ignore this, because they don’t feel the connection; they know their wages aren’t going up, but because they never see the money that the employers pay for premiums, they don’t really feel the loss. Put it in their hands and take it out again — the experience I have as a freelancer — and you damn well feel it.] But they also fear that any further expansion of government involvement in the health care system will only make it more expensive. This is a key objection to the health care reform bill now working its way through Congress.
The international data, however, show no evidence that increasing government’s share of health care expenditures raises health spending as a share of GDP. The top five countries with the highest government share of total health outlays spend almost exactly the same percentage of GDP on health as the lowest five countries excluding the U.S.: 8.2% of GDP on average for the former versus 8.3% of GDP for the latter. (I left out the U.S. because it skews the data; the bottom five countries including the U.S. spend 9.7% of GDP on health on average.)

Swine flu digs in

Helen Branswell delivers some sobering news:

Swine flu viruses are missing at least two key features seen in all flu viruses present and past that transmit well among people and yet the viruses are spreading quite efficiently, two new studies suggest.

The research groups which produced the work differ slightly in their views of the degree to which the novel H1N1 virus is spreading, with one finding transmission isn’t yet as efficient as with human flu viruses while the other finding transmission rates are in lockstep with those of seasonal flu cousins.

There is no disputing the evidence, though – the virus is spreading around the globe, claiming at least 332 lives so far. And it is doing this without all the tools scientists would expect a flu virus to need to become a successful human pathogen.

“The take-home message is that a virus that does not have some of the features that we have previously recognized as hallmarks of adaptation of flu in humans was able to establish itself in humans and cause disease,” said Dr. Daniel Perez, an influenza virologist with the University of Maryland.

“Regardless of what the virus might do, I believe it is here to stay either as a whole virus or with some of its gene. It may be able to outcompete and-or co-circulate with seasonal flu strains.”

from Swine flu transmission studies suggest new virus is here to stay, by Helen Branswell

Loss aversion and the rough road for health care reform

An article from the Standard ponders why, despite widespread recognition that the country needs health care reform, we may not get it.

The relatively new field of behavioral economics–a blending of psychology and economics–helps makes sense of these clashing views. One major tenets of this sub-discipline is that people value a “loss” about twice as much as they value a “gain.” And as a result, people are more risk averse than might be suggested by traditional, rational economic theory. In other words, instead of “rationally” weighing risks and rewards equally and then forming a judgment, behavioral economics has found risk and pain count more than benefits and rewards.

People might see some gains in reforming the overall system, but fear of changing what they have counts more. And while open to promises of health reform, they’re concerned the government might mess things up.

Blumenthal quotes the Kaiser Foundation’s pollster, Mollyann Brody, who argues, “it is really easy to scare people into thinking that reform will make their own situations worse off.” But at the same time, as Blumenthal noted in a Pollster.com post last week, “people are also very anxious about their costs and future coverage under the status quo. It is that latter anxiety–much less than any altruistic desire to help out Americans without health care coverage–that drives the huge general desire for change and reform.”

from Fear and Loathing in Health Care Reform – CBS News

Quick dip: Free firefight; digital dumbness; scijourno conference; doctors that don’t talk

What’s been distracting me lately from the big story I really really need to finish writing …
A splendid, rich fracas over Chris Anderson’s Free, set off particularly by a pan from Malcolm Gladwell in the New Yorker. The net fairly exploded — search, and ye shall find — with many noting that a pot was calling a kettle black. E.g., It’s like War of the Speaker’s Bureaus and a more gently titled but equally damning (to Gladwell) post by Anil Dash. ,And one young writer accused Anderson of being a feudal lord. Anderson himself has been remarkably unfiltered in his tweet-pointers to reviews, pointing to many that scorch him. Pick those up by visiting his Twitter page. (You needn’t be a twitter user to get there or use the links.)
What else?
Vaughan Bell whacks the idea that computer use makes you stupid. See his post here or download the remarkably concise and convincing powerpoint of his talk.
Ed Yong has been tweeting seemingly most of the big meetup of sci journos in London. His tweet string makes a nice look at the conference. He’s keeping this up even after being feted last night as “best newcomer” by the Brit Assn of Sci Journalists — and then tweeting his tipsy way home. Many other good tweets from the conference at the #wcsj twitter tag.
And with much health-care-reform attention being given to the savings to be had from collaborative medical care — that is, doctors actually communicating with each other about patients they’re treating (here’s a frightening example of what happens when they don’t, KevinMd notes that such lack ofe communication also kills patients.
Now back to work.