TAC's Irrelevant Statistics

A couple of things:

  • I’m going to go the way of Gianna at Bipolar Blast and admit that my stats weren’t as accurate as I would have liked them to be. (Hey, I did say, "I could be wrong.") My math is about average and stats were never my thing so please, feel free to take a page out of John Grohol’s book at PsychCentral.com and do a kick-ass analysis of studies or stats that interest you. I must say, however, I am quite flattered at helping raise awareness about the TAC’s stupidity. All credit goes to Furious Seasons for picking at them piece by piece first. Cairn, a commenter over at CLPsych, did a better job of analyzing the stats I used. It seems pretty spot on to me.
  • My husband – the better mathematician and also my better half – pointed out something I’m not sure anyone picked up on. (My apologies to anyone who did.) Let’s recap:

USPRA: “Violence is no more prevalent among individuals with mental illness than the general public”
Fact: The CATIE violence study found that patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population).

Have you figured out what it is yet? Well, the TAC took the USPRA’s broad statement about violence among people with mental illness and applied data about violence among schizophrenics only. The data the TAC used is irrelevant because it doesn’t even apply. The percentages that the TAC used to combat the USPRA’s statement isn’t even an accurate because, well, the USPRA wasn’t talking about schizophrenics; they were talking about the mentally ill in general. So all my stats in my last post are pretty much moot at this revelation because of TAC’s skewed application of the CATIE violence study statistics.

"There are three kinds of lies: lies, damned lies,
and statistics."
~ Mark Twain

Copies of published studies

All right, I think I asked this before and I know one of my readers sent me a few links to the STAR*D study (which I haven’t had the chance to read). Does anyone know where I can get my hands on CATIE and BOLDER (I and II)? Will this PDF from The New England Journal of Medicine suffice? (I believe it’s phase 1.)

Otherwise, I’ll cross my fingers and hope – oh crap, wait! Maybe I can use the library at my job! Geez, why didn’t I think of this before?

Well, if anyone’s got an electronic copy, that’s preferable. Many thanks in advance.

UPDATE: I just checked the medical library in my building and apparently, I do have access to medical publications that require subscription online. It’s probably unethical to disseminate business material for personal purposes (especially since my other duties require me to work with confidential material), but I can always read the articles and try to pass along bits and pieces that jump out at me here and there.

More during the summer…

A classic case of twisting the words of someone who supposedly shot the messenger

The subject title is long, but – I think – apropos.

The Treatment Advocacy Center’s post, “A classic case of shooting the messenger,” has been bothering me all day. I’ve been wanting to do further research on their claim that “patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public.” Funny thing is, I didn’t have to look far.

The TAC links to a summary of the CATIE violence study and surprisingly, it contradicts the TAC’s post. I couldn’t help but chuckle once I realized I could easily debunk their claims from what they considered supporting evidence.

USPRA: “Violence is no more prevalent among individuals with mental illness than the general public”
Fact: The CATIE violence study found that patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population).

MY TAKE:Overall, the amount of violence committed by people with schizophrenia is small, and only 1 percent of the U.S. population has schizophrenia. Of the 1,140 participants in this analysis, 80.9 percent reported no violence, while 3.6 percent reported engaging in serious violence in the past six months. Serious violence was defined as assault resulting in injury, use of a lethal weapon, or sexual assault. During the same period, 15.5 percent of participants reported engaging in minor violence, such as simple assault without injury or weapon. By comparison, about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period, according to the NIMH-funded Epidemiologic Catchment Area Study.”

This data is a little skewed here. (CLPsych or Philip Dawdy could do a better job at clarifying this for me.) First of all, “about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period.” How many people does this constitute? The sentence doesn’t specify ‘without schizophrenia’; it says “without psychiatric disorder.” That means Americans who do not suffer at any given time from depression, bipolar disorder, psychosis, anxiety, schizophrenia, obsessive-compulsive disorder, postpartum depression, and the list goes on and on. Can anyone compile complete data of Americans who suffer from a psychiatric disorder? (Why do I have the funny feeling that Americans without psychiatric disorders are becoming the minority?)

In the January 1994 issue of the Archives of General Psychiatry, results of the National Comorbidity Study were released. Diagnoses from the DSM-III were applied to the participants ranging from ages 15-54. The study found that 50 percent of participants reported “one lifetime disorder” and 30 percent said they had “at least one 12-month disorder.”

That was January 1994. The American population has grown significantly since then, so I have a hunch that there's an increase in diagnosing people with psychiatric illnesses. But like I said, that’s, uh, just a hunch. (Keep in mind that the study does not include children ranging from ages 4-14 who are likely to receive ADHD and/or bipolar diagnoses.)

Humor me: Let’s take the NC study’s findings and apply it to the current estimated U.S. population (assuming that the percentage of those with a lifetime disorder has remained the same). Out of nearly 300 million Americans (July ’06 estimate), that means about 150 million Americans have at least some form of a psychiatric disorder. If 1 percent of the general population suffers from schizophrenia, that comes out to 3 million people. If we apply CATIE’s violence percentages, TAC’s right; 19.1 percent of schizophrenic patients engage in violent behavior of any kind. However, the CATIE study also says that two percent of the general population without psychiatric disorder engages in violent behavior. That means out of the remaining 150 million, 2 percent of that would be —*drumroll please* — 3 million Americans! Maybe it’s just me, but doesn’t seem 10 times likely. I could always be wrong.

Continue reading “A classic case of twisting the words of someone who supposedly shot the messenger”

Loose Screws Mental Health News

I haven’t done this for a while so hopefully I can pick this up again a little more regularly. (crosses fingers)


Read a heart-wrenching story in the UK Daily Mail about a mother whose postpartum depression led her to begin slitting her wrists.

Tom ChaplinTom Chaplin, singer for the band Keane, has admitted to contemplating suicide.

Tom – who was taking up to two grams of cocaine a day – revealed to Britain’s Q Magazine: “I was at the end of my tether in Japan. I was tired of my life and feeling pretty suicidal. I got off the plane and called my dad. I’d told him that I’d left the band and that I was falling apart. I checked myself into The Priory.”

Chaplin’s interesting view:

Despite his own drugs hell, Tom says it’s a personal decision to experiment with substances. He claims troubled rock star Pete Doherty should be left to take all the drugs he wants.

Tom said: “No-one’s got any right to stop him killing himself.”

An article in the Chicago Tribune on how VNS is beginning to show benefits for some patients. Which reminds me, browse on over to VNSdepression.com to learn more.

Nicholas Vakkur must have read the Treatment Advocacy Center’s post on how the CATIE study shows an increase in violent offenses by mentally ill patients (namely those with psychosis and schizophrenia). He refutes this idea on dissidentvoice.org:

Individuals with a mental illness are far more likely to be the victims, rather than the perpetrators of violence, while the vast majority of people who commit acts of violence against others are not in fact mentally ill.

This rush to stereotype individuals suffering from psychiatric illness as likely murderers is reckless and lacks credulity. Mental illness has no role in the majority of violent crimes committed in our society. Alcohol and substance abuse far outweigh mental illness as factors contributing to violence, while the strongest predictor of violent and/or criminal behavior is a past history of violence and criminality, not a major mental illness.

Lots of studying to do

I don’t know much about the CATIE study (haven’t researched it yet) but feel free to go to the FREE CATIE breakfast symposium near you.

From the site:

Objectives:
At the end of these educational activities, participants should be able to:

  • Differentiate the clinical outcomes among patients prescribed the various treatment modalities in the CATIE study.
  • Choose an efficacious medication that improves symptoms in patients with schizophrenia who have failed on previous treatments.
  • Choose a tolerable medication to improve compliance in patients with schizophrenia who have discontinued previous treatments.
  • Individualize treatment for patients with schizophrenia based on history of symptoms, ability to tolerate adverse effects, and comorbid illnesses.
  • Discuss the effectiveness of antipsychotic medications for schizophrenia in terms of efficacy, tolerability, and cost.

I’ve heard about the CATIE study from sites like Furious Seasons and Clinical Psychology and Psychiatry, but now that I know it deals with schizophrenia, I’m interested in learning more about it.

CashIn other news, I attended a Bipolar and Depression Support Group tonight and received a presentation from UPenn on a genetics study they are doing to study bipolar disorder. They need 4,000 volunteers with bipolar disorder to help and they currently only have 2,000. If a person qualifies for the study, he or she will receive a $100 compensation. The study closes in December 2007. The following is some more information:

  • Individuals 16 and older with Bipolar I Disorder or Schizo-affective Diorder, Bipolar Type, are eligible to join this study.
  • Participation involves the following:
  1. Completion of questions
  2. A 1-2 hour interview (in person or over the phone)
  3. Small blood sample (drawn at UPenn’s expense)
  4. $100 compensation
  • The study does not change your treatment.
  • No travel required.

I can’t stress enough that people will bipolar disorder should participate in the study. Again, people do NOT need to live in the Philadelphia or Pennsylvania area to participate. People with bipolar disorder who live ANYWHERE in the United States can participate in the study. Please, let’s help make this study a success to improve treatment – not only for ourselves but also for future generations.