If prayer helped a lot with depression the evidence would be much more clear cut.
It doesn’t have to be “a lot” to be better than the 1.80 points for SSRI’s.
You have depression caused by a testosterone deficiency?
Do you have an estimate for the detection rates? How many people who have depression due to testosterone deficiency do you think do get accurately identified by our system?
Let alone people who have depression due to lead poisoning. I would estimate most of those not being identified by our present system.
And if you count religious practice as a remedy, you should count the time and sacrifice it requires, as well as the wrong beliefs it entails, as side effects as well.
Last week I spoke to a person who went to a Freudian psychologists for four years. Partly multiple times per week. They thought it didn’t bring them much forward.
It doesn’t have to be “a lot” to be better than the 1.80 points for SSRI’s.
For a single individual, no. But to beat 1.8 points on average across multiple studies with hundreds of subjects, yes that would have to be “a lot”. And it simply isn’t.
Testosterone levels are a standard test, lead poisoning has thankfully become so rare it isn’t usually tested. But those are object level distractions from the point that mental health has advanced enormously, and a big part of that is the diagnostic side.
Freudian psychoanalysis doesn’t (usually) help, of course. That’s why I didn’t include it in the lists of things that can.
I thought we were arguing about actual clinical practice. Testosterone tests do exist but from what I read they are seldomly done in actual clinical practice.
Freudian psychoanalysis is still a large part of actual clinical practice.
Obviously. What’s your point?
I’m not that certain that St John’s Wort really has much worse side effects than many of the regular drugs. It might have more drug-drug interactions than various drugs because it has more active components.
There’s much money invested into proving that existing drugs do better than something like St John’s Wort and we know that this money skrews study results.
Testosterone tests are common in the group that tends to need them (men over 40).
Freudian psychoanalysis continues to be paid for by health insurers in Germany for historical reasons and there’s an aging cohort of psychoanalysts making their living with it in private practice, but clinics overwhelmingly do CBT instead, even in Germany.
What would convince you that St John’s Wort is inferior to modern antidepressants?
For moral reasons I would also want a clinic who reserves it’s right to take people’s freedom away to predict outcomes of it’s decisions.
There might be other reasons to see changes in the system as success. If suicide rates go down, that might be a sign that depression get’s treated better.
US numbers suggest 15–24 years olds are more likely to commit suicide while people over 55 are less likely to commit suicide.
That doesn’t suggest a much better system.
If you can point to other things besides suicide that caused by depression and the prevalence went down a lot, that might be a sign that our system is more effective.
I might also be convinced by an inside view account but it would have to be quite conclusive to overrule the biases inside the system for finding that patented drugs are more effective.
It doesn’t have to be “a lot” to be better than the 1.80 points for SSRI’s.
Do you have an estimate for the detection rates? How many people who have depression due to testosterone deficiency do you think do get accurately identified by our system?
Let alone people who have depression due to lead poisoning. I would estimate most of those not being identified by our present system.
Last week I spoke to a person who went to a Freudian psychologists for four years. Partly multiple times per week. They thought it didn’t bring them much forward.
Depression drugs also have their side effects.
For a single individual, no. But to beat 1.8 points on average across multiple studies with hundreds of subjects, yes that would have to be “a lot”. And it simply isn’t.
Testosterone levels are a standard test, lead poisoning has thankfully become so rare it isn’t usually tested. But those are object level distractions from the point that mental health has advanced enormously, and a big part of that is the diagnostic side.
Freudian psychoanalysis doesn’t (usually) help, of course. That’s why I didn’t include it in the lists of things that can.
Obviously. What’s your point?
I thought we were arguing about actual clinical practice. Testosterone tests do exist but from what I read they are seldomly done in actual clinical practice.
Freudian psychoanalysis is still a large part of actual clinical practice.
I’m not that certain that St John’s Wort really has much worse side effects than many of the regular drugs. It might have more drug-drug interactions than various drugs because it has more active components.
There’s much money invested into proving that existing drugs do better than something like St John’s Wort and we know that this money skrews study results.
Testosterone tests are common in the group that tends to need them (men over 40).
Freudian psychoanalysis continues to be paid for by health insurers in Germany for historical reasons and there’s an aging cohort of psychoanalysts making their living with it in private practice, but clinics overwhelmingly do CBT instead, even in Germany.
What would convince you that St John’s Wort is inferior to modern antidepressants?
I wrote http://lesswrong.com/r/discussion/lw/oe0/predictionbased_medicine_pbm/ for specifying a formal way of how I want to be convinced that something is clinically more effective and better than an alternative.
For moral reasons I would also want a clinic who reserves it’s right to take people’s freedom away to predict outcomes of it’s decisions.
There might be other reasons to see changes in the system as success. If suicide rates go down, that might be a sign that depression get’s treated better.
US numbers suggest 15–24 years olds are more likely to commit suicide while people over 55 are less likely to commit suicide. That doesn’t suggest a much better system.
If you can point to other things besides suicide that caused by depression and the prevalence went down a lot, that might be a sign that our system is more effective.
I might also be convinced by an inside view account but it would have to be quite conclusive to overrule the biases inside the system for finding that patented drugs are more effective.