Saturday, October 24, 2020

Comments by dr_jb

Showing 2 of 2 comments.

  • Fiachra

    Thank you. As much as I’d like to find solid support for the notion that SSRI’s does not decrease suicide rates, this study fails to provide it. I am a critical psychiatrist (MD, PhD), and I have no interest in trying to promote antidepressant drugs, but this paper is seriously flawed for a number of reasons:

    1. Among men and women in different age categories (15-24, 25-44, 45-64, and 65+) in Sweden, women in the youngest age group is the only group in which this association can be seen in the given time period. This might indicate cherry picking (with the exception of the youngest males, analysis of any of the other 6 groups would probably find an inverse and statistically significant association). This is not discussed in the paper.

    2. The period prior to 1999 was excluded from the analysis. It is possible to obtain data on antidepressant prescription prior to 1999, and including this period would obviously lead to a very different conclusion. This is not discussed in the paper, and no rationale for selecting the time period in question is given.

    3. The coverage of forensic investigations of suicide is, on average, 93%. This rate could change over time and influence the results (eg. if this rate increases with time, the number of suicides will appear to have increased) There is excellent data on the total number of confirmed and suspected suicides that could be used. This is not discussed as a limitation.

    4. Correlation does not imply causation. There might be alternative explanations to the correlation (if it’s really there) that still leaves room for the possibility that antidepressants are effective in reducing suicides. For instance, if something in the Swedish society has changed that makes it more difficult to be young (such as decreased economic equality, which we have seen during that time period, or increased use of social media) more young women might be (wrongly) treated with antidepressants while the number of young women who commits suicide increases somewhat due to the aforementioned societal changes. This is just a speculation of course, but I just want to point out that there might be alternative explanations.

    5. There is no limitations section. I don’t think I have ever seen an original study in quantitative sciences that lack a limitations section.

    Finally, when looking at the the author name, he has the same name as the most well-known critic of psychiatry in Sweden, and who has clear ties to the Scientology movement, and he has no scientific education or institutional ties as far as I know. I’m not absolutely sure it’s the same person, but it seems extremely likely in my view. My conclusion is that, while the results might have had some interest were the paper of higher quality, this is a deeply flawed paper produced to promote an anti-psychiatric agenda. As such, it hardly contributes anything to the issue at hand and using it as an argument in this debate seems ignorant, at best.