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Old 01-14-2010, 01:33 PM
dmoerman dmoerman is offline
 
Join Date: Dec 2009
Posts: 1
Default Re: Science Saturday: Electroconvulsive Edition (John Horgan & George Johnson)

I sent this to John Horgan yesterday. He suggested I add it here. Took me a while to figure it out.

Dear Mr Horgan

I listened this morning to your bloggingheads discussion of depression. In response, I share with you a paper of mine (with an MD colleague) written some time ago now, but still solid intellectually (rewriting it today I'd use more recent and more compelling examples; but the ones used are more than satisfactory).

Here's a link to the paper:

http://www-personal.umd.umich.edu/~d...n/aim_plac.pdf

In a nutshell, the ambiguity <in Horgan and Johnson's discussion> is the concept of the "placebo effect." While a placebo is a plausible phenomenon (e.g., "an inert tablet"), the problem is that the "placebo effect" can't exist (if a placebo is inert, it can't do anything. That's what "inert" means). But we all know that lots of things can happen after giving someone an inert pill (or other inert procedure). So, if the "effect" isn't due to the "placebo," what is it due to? I argue that it is a response to the "meaning" of the procedure. No space in this nutshell to unpack that here.

But consider that a) response rates in control groups in depression trials have gone up by about 50% in the past 20 years (that is, during the time that "everyone" has come to know that you can effectively treat depression medically. We know this from personal experience, from friends, from celebrities, from books like "LIstening to Prozac," etc etc etc.) Note that b) response to active drug treatment for depression has also risen by about 50% in the same period. Why? because the drugs are better? or because the meanings are more intense, diffuse, widespread? I don't know the answer to that question, but I'd buy the first and short the second.

If you're interested in this, I can send you some more relevant stuff. I have a book from Cambridge UP if you are interested in a more elaborated argument than in the Annals paper. Plus I can send a paper on control groups in depression among others.

All best

dm
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