**UPDATE – Not long after one of Dr. Bremner’s blogs was posted, the site started “malfunctioning” disabling both the archive and the comments. The site was later back up and running and this is a functioning link to the entry: http://www.beforeyoutakethatpill.com/index.php/2009/07/15/test-2/
Because something with the BYTTP blog is not functioning and I can’t click on the link to share, I decided to repost this so that in the future when it gets moved further down into the BYTTP archives, you won’t get lost if you go to Dr. Bremner’s blog… which is the only link I can share right now: http://www.beforeyoutakethatpill.com/
Aaah, I love the smell of a good debunking in the morning. And I find it amazing that someone with a Psy.D. would publish a misleading lit review summary. Does Dr. Grohol lack ethics, or thoroughness? I don’t know which one…
Dr. Bremner writes:
After I wrote this post yesterday called “Motherhood is Not a Medical Disorder” about the Mother’s Act, which advocates for widespread screening of moms for post-partum depression (PPD), something I don’t think is a good idea because it medicalizes a normal stage of life, increases the chances that people will be but on antidepressant medications that they may not need and that may have side effects, and represents yet another intrusion into privacy, I got this response from John Grohol at psychcentral.
First he grumbles about my pointing out that the psychiatrist quoted in the Time article, Katherine Wisner, MD (you can follow the link to the Time article in yesterday’s post), was on the speakers bureau for Pfizer and Lilly (something not noted in the article but which I found on my own), makers of Zoloft and Prozac, respectively, which as a commenter pointed out are promoted as the two safest antidepressants for pregnant and lactating women. Being on a speaker’s bureau these days means giving “promotional talks”, which translates into working for the drug company to advertise to other doctors, and is relevant. In addition, the psychcentral website has paid ads, most of them for treatment (which includes medications), while this site has no ads. And don’t say I am trying to profit off my book, which now goes for a nickel on amazon.
Grohol further takes issue with my statement that women without a prior history of anxiety or depression are not at risk for PPD and therefore would not benefit from widespread screening. However in support of that he cites Ross et al 2009, claiming that history of abuse and alcohol or substance abuse are risk factors for PPD as well. However a perusal of Ross et al shows that a history of childhood abuse is not in fact a factor, rather only abuse during pregnancy. In addition, it is alcohol and substance abuse during pregnancy that is a risk factor, on the order of a pregnant woman drinking a six pack a day or actively abusing cocaine. That kind of substance abuse is a risk to the fetus, and needs to be stopped.
If you have a man beating his pregnant wife, or a woman snorting cocaine while pregnant, that it is a situation much more serious than PPD, and should be stopped. These extreme circumstances hardly justify mass screening for PPD.
I still say NO to the MOTHER’S ACT.
[note: comments are down now, working on fixing that]