Psychiatrists are way up there when it comes to ignoring input from their clients. An example, as reported in a EurekaAlert article, Are doctors missing depression medication side effects?, is the extent to which they can overlook the number of negative drug effects reported to them by their patients.
A study from Rhode Island Hospital shows that patients report side effects from medication for the treatment of depression 20 times more than psychiatrists have recorded in the charts. The researchers recommend the use of a self-administered patient questionnaire in clinical practice to improve the recognition of side effects for patients in treatment. The study is published in the Journal of Clinical Psychiatry, Volume 71, No. 4, now available online ahead of print.
This is to say that a patient has to mention a negative effect 20 times for it to register once with a psychiatrist. I feel certain that if the same kind of study were conducted on patients being treated for other mental illness labels besides depression, the results would be much the same, if not worse.
[Dr. Mark] Zimmerman and his colleagues asked 300 patients in ongoing treatment for depression to complete a self-administered version of the Toronto Side Effects Scale (TSES). The patients rated the frequency of the 31 side effects and the degree of trouble they experienced. Those patients’ charts were then examined to extract side effects information recorded by the treating psychiatrist.
The findings indicate that the mean number of side effects reported by the patients on the TSES was 20 times higher than the number recorded by the psychiatrist. When the self-reported side effects were limited to “frequently occurring” or “very bothersome” the rate was still found to be two to three times higher than recorded in their charts.
You’d think “frequently occurring” or “very bothersome” would strike a nerve, and maybe they do, but apparently not enough of a nerve. Psychiatrists, it would seem, are not very good listeners. The patient still has to bring up these more disturbing effects twice or thrice before it registers once with a psychiatrist. I have to be wondering sometimes if we don’t have the wrong people on the couch.
I have to take issue with calling any unpleasant effect produced by a psychiatric drug a side effect, too. The presumption is that these chemical compounds alleviate mental disorder, and that any unpleasant effect arising from these pills must be an effect for which they weren’t intended. The reality is that there is no magic anti-mental illness pill, and that what are referred to as the side effects of these drugs are actually direct effects.