This work seems to assume that "randomized, controlled trials" necessarily produce correct and meaningful results, that such a trial is necessarily meaningfully possible at all, and that, where either of these is false, the treatment is valueless.
But a randomized, controlled trial can produce meaningful results only where just one malady is being treated. The DSM is full of diagnoses that lump together a whole family of pathologies with (sometimes only superficially) similar symptoms, but entirely different causes. This is especially notable in psychiatry, but far from unique; for an extreme example, cancers.
The reason such trials produce bad results is that there is no way to know which patients have the particular pathology whose cause is addressed by the treatment under test, without actually administering it to see.
Actually performing such a trial, with an effective treatment agent, tends to produce strong results for a few patients, and null or actually harmful results in the rest. Nothing is wrong with the treatment, when applied to the patients who should get it, but the trial fails to produce a positive result.
Confusing a bad trial with a bad treatment should be an error made only by ignorant observers, but it is all too commonly seen in apparently respectable media.
> Actually performing such a trial, with an effective treatment agent, tends to produce strong results for a few patients, and null or actually harmful results in the rest. Nothing is wrong with the treatment, when applied to the patients who should get it, but the trial fails to produce a positive result.
Do you have any actual data to support this assertion, or is it just a weak sophism, same as used to support ineffective "integrative medicine" practices?
What sort of data do you imagine would convince you? Or is this just a reflexive rejection of change?
Insisting on data that demonstrates invalid RCTs while assuming that DSM diagnoses precisely distinguish causes, on the basis of no data at all, puts the cart before the horse.
But a randomized, controlled trial can produce meaningful results only where just one malady is being treated. The DSM is full of diagnoses that lump together a whole family of pathologies with (sometimes only superficially) similar symptoms, but entirely different causes. This is especially notable in psychiatry, but far from unique; for an extreme example, cancers.
The reason such trials produce bad results is that there is no way to know which patients have the particular pathology whose cause is addressed by the treatment under test, without actually administering it to see.
Actually performing such a trial, with an effective treatment agent, tends to produce strong results for a few patients, and null or actually harmful results in the rest. Nothing is wrong with the treatment, when applied to the patients who should get it, but the trial fails to produce a positive result.
Confusing a bad trial with a bad treatment should be an error made only by ignorant observers, but it is all too commonly seen in apparently respectable media.