Thursday, February 24, 2011

When Prescribing Less May Improve Outcomes - ABC News

When 'Medicine' Makes Things Worse

When 'Medicine' Makes Things Worse

In the past, psychiatric physicians have diagnosed homosexuality, paraphrenia, paranoia, narcissism, neuroses, combat fatigue and other entities, treating those "disorders" with a variety of therapies, including pills.
More recently, psychiatrists diagnose bipolar disorder not otherwise specified (NOS), adult attention deficit disorder and pre-psychotic conditions, for which they may prescribe pills. The problem is that some of those earlier diagnoses like (homosexuality, neuroses, combat fatigue, paranoia and paraphrenia) no longer exist as entities recognized by the DSM-IV-TR -- the most current compendium of mental conditions and disorders.
Virtually anyone at any given time can meet the criteria for bipolar disorder NOS or ADD. Anyone. And the problem is everyone diagnosed with even one of these illnesses triggers the pill dispenser. It's also OK to offer the patient a metaphorical motivational kick and advise them to just do something to help themselves. That may do more to improve outcomes and reduce adverse events and unnecessary prescribing than an injudiciously prescribed pill or procedure.
Dr. Stefan Kruszewski is an Addiction Psychiatrist and CEO of Kruszewski & Associates, a Harrisburg, Pennsylvania based firm specializing in illuminating healthcare and financial fraud.

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