Reflections From A Chair

The NY Times has a thought-provoking article on lying and getting at the truth.

The below are some of the highlights from article, Judging Honesty by Words, Not Fidgets:

• “Liars do not avert their eyes in an interview on average any more than people telling the truth do, researchers report; they do not fidget, sweat or slump in a chair any more often.”
• “No brain-imaging machine can reliably distinguish a doctored story from the truthful one, for instance; ditto for polygraphs…”
• “One broad, straightforward principle has changed police work in Britain: seek information, not a confession.”
• Dr. Bull (heck of a name for somebody who studies lying) says “It’s a lot like the old ‘Columbo’ show, you know, where he pretends to be an idiot but he’s gathered a lot of evidence.”



• “Kevin Colwell…says that people concocting a story prepare a script that is tight and lacking in detail.”
• “People telling the truth tend to add 20 to 30 percent more external detail than do those who are lying.”
• “…challenging people with pieces of previously gathered evidence, gradually introduced throughout an investigative interview, increases the strain on liars.”
• “And it all can be done without threats or abuse, which is easier on officers and suspects. Detective Columbo, it turns out, was not just made for TV.”

Maybe I’ll buy myself a wrinkled raincoat and some cigars…

A new study takes a look at the effectiveness of various treatments for teenage depression. Unfortunately, I cannot give you a link to the article as it is on a subscription service. But here’s the citation for the article:
Treatment of adolescent depression: what we have come to know
Benedetto Vitiello, M.D
Depression and Anxiety
Volume 26, Issue 5, 2009.
Pages: 393-395

Three months after starting treatment, fluoxetine (Prozac) brought about a higher response rate than cognitive behavioral therapy (CBT). A response rate is a reduction in some but not all of the symptoms. Whereas the elimination of all symptoms of the depression is called a remission. 61% of the patients studied showed improvement from fluoxetine alone versus 43% of the patients who had CBT by itself. So fluoxetine is clearly better at bringing more adolescents into the response range than CBT or placebo. And fluoxetine is more cost-effective (cheaper than) psychotherapy at the three month point.

But a combination of fluoxetine and CBT was most effective at achieving remission of symptoms at three months (37%). Furthermore, “the combination (of medication and psychotherapy) was also superior to (medication alone or CBT alone) at improving functioning, overall health, and quality of life at the 3-month assessment.”

“(A)t the 9-month assessment, fluoxetine, CBT, and their combination did not differ in response rate (81, 81, and 86%, respectively) or remission rate (55, 64, and 60%, respectively). Thus, it appears that the value of antidepressant medication consists in speeding up the process of improvement and recovery, whereas psychotherapy gradually catches up and, given enough time, it does not seem to make too much difference which treatment modality was used.”

There was “a greater incidence of suicidal events (a category including suicide attempts and suicidal ideation) was found in the fluoxetine condition (14.7%) than on CBT (6.3%).” But there appears to be “a protective role of CBT when used in conjunction with medication” because “the suicidality rate in the combination group” dropped down significantly to 8.4%. And this level of suicidality was not statistically higher than when patients were treated with CBT alone.

In conclusion, the study found that “Although fluoxetine was clearly the most cost-effective treatment modality during the first 3 months…, combined treatment was more cost effective than fluoxetine when the entire 9-month outcomes were taken into account, primarily due to the higher number of suicidality-related hospitalizations in the fluoxetine group.”

In a thought provoking article, Sleep study at Pitt is a researcher’s dream job, in the Pittsburgh Post-Gazette, the role of sleep in mental health is explored.

Some of the many interesting points from the interview of Dr. Anne Germain are:

• “…there is growing evidence that sleep problems are actually the cause of many psychological and physical illnesses, rather than a side effect of them.”
• “‘Whether we’re dealing with depression, anxiety or post-traumatic stress disorder, when we target sleep problems, we can have a significant improvement in people’s daytime functioning,’ she said.”
• There are ” two effective therapies available to reduce or eliminate nightmares….
  One is an older high blood pressure medication called prazosin.
  [The other is] imagery rehearsal therapy, it provides ways for people to rewrite their nightmares into less threatening dreams, and it is effective in more than 90 percent of people who have tried it…”
• And, of course, “the vast majority of people need between 6 1/2 and 8 hours of sleep a night to function well.”