Dave Curtis - archived blogs

http://blogs.bmj.com/bmj/2017/08/25/allen-frances-we-must-not-confuse-trumps-bad-behavior-with-mental-illness The title is somewhat misleading because in general mental health professionals are not suggesting that Trump suffers a mental illness, as it is commonly understood. They are suggesting that he does indeed meet the diagnostic criteria for narcissistic personality disorder and that he may well be developing dementia. This is not to use these diagnoses as terms of abuse - they are relevant because they may feed into the legal process whereby it is determined whether or not Trump should be removed from office. Frances' position is absurd. In one paragraph he says that he supports the Goldwater rule and in the next he flouts it. The fact that he does so in order to defend Trump is irrelevant. He is clearly debating the diagnosis of somebody he has never met and adduces various facts in the public domain to support his own thoughts on the subject. I do not support the Goldwater ...

Aylin and colleagues have written a  public google docs document  to challenge the conclusions of a peer-reviewed study  by Meacock and colleagues. The latter, titled “Higher mortality rates amongst emergency patients admitted to hospital at weekends reflect a lower probability of admission”, seemed to show that the “week-end effect” was an illusion. Although a slightly higher proportion of patients admitted at week-ends die within 30 days, this is not the case if one considers all patients attending A&E. Looking at attendances, the proportion of people who die does not vary between week-end and weekday. The obvious interpretation is that the patients who are admitted at week-ends are the ones who are more likely to die, presumably because they are more unwell to start with. Aylin’s grounds for saying that the conclusions are “deeply flawed” rest on a rather subtle statistical point which is that if one looks at the “risk adjusted relative risk” for direct admissions ...

Transcript of interview between Andrew Marr and Jeremy Hunt, broadcast on the Marr Show, BBC1, 7/2/16. Text approximately captured by Speechlogger and Voicemeeter and then corrected by hand. I think it's fairly accurate. Please use as you think fit. The interview can be viewed on BBC iPlayer (starts at 36 minutes) here:  http://www.bbc.co.uk/iplayer/episode/b070rt5r/the-andrew-marr-show-07022016 AM: And I just happen to have the Health Secretary Jeremy Hunt with me, welcome Mr Hunt. JH: Good morning, Andrew. AM: Now Jamie  just said that he thinks you might be in favour of a tax on sugary drinks. Are you? JH: Well it's a bit terrifying not to answer affirmatively if he's going to get more ninja. AM: He'll get more ninja if you don't say yes. JH: And obviously it's Sunday morning and people are tucking into their bacon and eggs, chocolate croissant or whatever I don't want to be too much of a killjoy but he is right we have got to do something about this. And...

Here is the link to the BBC report about David Ward's comments on Holocaust Memorial Day: Lib Dems condemn MP's criticism of Israel ahead of Holocaust Memorial Day In the article he states that he has only had emails from two detractors. So I thought I would be the third. Another detractor 'david@davidward.org.uk' Dear Mr Ward. I see you told the BBC you had only had emails from two detractors. Please consider this a third. I have never written this kind of email or letter before. Most anti-Israel or anti-Jewish statements I just let go past. Your remarks were offensive. What makes things worse is your defiance in the face of criticism. I am happy to accept that not everything Israel does is perfect and that Palestinians do have some grounds for complaint on some matters. Some actions of the state are of questionable legality and some individuals have probably acted in violent or hateful ways and sometimes may have escaped the sanctions they should have been subjected t...

I had been looking forward to attending the World Congress in Psychiatric Genetics later this year. I had been looking forward to presenting the results of my research investigating genetic factors contributing to mental illness and to explaining the new methodologies I have been developing which could assist others in the study of mental illness, dementia and physical illnesses with a genetic basis. I had been looking forward to hearing at first hand the latest advances in the field, which with recent technological advances is entering a particularly exciting phase. Today, I'm wondering whether I should be going at all. I'm wondering how I can even consider setting foot in a country which has just decided to ban the circumcision of male children for religious reasons. And then to have what we would call the chutzpah to claim that this is not antisemitic. It is absolutely antisemitic to fail to acknowledge the significance of circumcision as having a central place in Jewish id...

'Antipsychotic drugs made me want to kill myself' This is the really unhelpful and misleading title of an online BBC article reporting a Lancet paper on antipsychotic benefits and problems. The article itself is far more balanced. In fact, it gives a good idea of why so many people with psychotic illness do need to take medication and how much they can be helped by it. You can view it here . This sort of headline is absolutely the last way to present this kind of complex issue to the general public. The obvious effect will be to discourage people from taking medication or even seeing a doctor in the first place. I have complained to the BBC about it and it would be helpful if you did too.

My email to the readers' editor at the Observer re this article on raising the money to send a girl with cancer to the Burzynski clinic in USA. http://www.guardian.co.uk/theobserver/2011/nov/20/a-family-gripped-by-cancer The worst year of my life: cancer has my family in its grip Hi. I think you should take a really serious look at what has gone on around the publication of this article. Of course it’s a moving account of knowing a child with cancer. But the whole emphasis is on people clubbing together to allow her to receive some treatment which is unavailable on the NHS. The overall impression is horribly misleading, which is that there is some expensive and sophisticated treatment which is for some reason inaccessible through the NHS. Actually, the obvious reason it’s not provided by the NHS is that it plain doesn’t work. Unlike a number of treatments which are available on the NHS (e.g. herceptin), the chemicals used by this clinic are fairly simple and easy to manufacture and...

My paper on cost to patient of medical interventions got published. So I suppose I may as well mention it here. Patient experience – the ingredient missing from cost-effectiveness calculations

Arizona is proposing fining obese Medicaid recipients who do not comply with a diet. People are complaining that this represents a "nanny-state" mentality but if the state is providing your healthcare and you are behaving in a way which makes this more expensive, why shouldn't the state try to recoup some of that extra expense? Fining non-dieters sounds impracticable but it would be fairly straightforward to allocate a specific cost to a wide range of activities which would tend to make people less healthy and hence to require more expensive healthcare. One could assign such a cost not only to each cigarette or each unit of alcohol but also each calory of food consumed. Thus there could not only be components of tobacco and alcohol duty which were badged as related to healthcare costs but also a health tax on food and drink related to calorific and salt content. As an example this would either make diet drinks cheaper than their sugar-containing equivalents or else the ma...

Seriously ill people will clutch at straws. Homeopaths are in the business of selling those straws.

Here is the response you get from the ASA if you complain about a homeopathy website. Seems fair enough to me. Dear Sir/Madam ADVERTISING CLAIMS ON HOMEOPATHY WEBSITES Thank you for your recent complaint. As you may know, the Advertising Standards Authority (ASA) has received over a hundred and fifty complaints about over a hundred different websites for homeopathy. Complaints cover a range of issues from specific claims made by individual advertisers to general concerns about the sector as a whole. Because of the volume of complaints, we are sending this letter to everyone who contacted us on these issues to let you know what action we intend to take. The ASA has an established position on claims that can be made, and those claims that are not likely to be acceptable for homeopathy, based on the requirements set out in the CAP Code and previous ASA adjudications. Although we have not historically received many complaints about advertising for homeopathy, the Code has general requi...

There was an invitation to respond to this consultation. Here's the email I sent: Hi. This whole project is lunacy. Why are you wasting tax-payers money on it? Why don’t you waste your time licensing sunlight and lettuce? Even thinking about thinking about licenses for homeopathy is an insult to every hard-working NHS professional trying to alleviate people’s suffering using evidence-based practice. Anybody involved in such an endeavour should go take a long hard look at themselves in the bathroom mirror and then flush themselves down the toilet. There, that’s what I think. Regards -         Dave Curtis -- Professor David Curtis Consultant and Honorary Professor in Psychiatry Dept Adult Psychiatry 3rd Floor Outpatient Building Royal London Hospital

Here's an email I sent my MP, for all the good it will do. She's a LibDem minister so she'll most likely just toe the party line. From: Curtis David (East London NHS Foundation Trust) Sent: 27 December 2010 17:28 To: 'Lynne Featherstone - Liberal Democrat MP for Hornsey & Wood Green' Subject: Government plans for the NHS Dear Ms Featherstone. I am writing to express my extreme concern at the government's plans for the NHS. The major reorganization proposed has not been properly thought through. The very process of reorganization will certainly strain the NHS in the short term and is being carried out at a time when the NHS is under extreme pressure for other reasons. It breaks the pledge which the Conservatives made not to subject the NHS to new reorganizations. The eventual outcome of the reorganization is quite likely to be deleterious for the NHS. There is no reason why GPs are likely to do a better job of commissioning than professional commissioners. It...

A study in the Lancet seemed to imply that large chromosomal deletions could cause ADHD - children with ADHD were found more often to have such deletions than control subjects. However there is a flaw in the argument because according to the paper the children with ADHD also had lower IQ than controls. It is already known that large chromosomal deletions are associated with intellectual impairment. So a plausible explanation is that by selecting children with ADHD one obtains a sample with low IQ and such subjects can be expected to have more large deletions by virtue of their lower intelligence rather because of any specific relationship between deletions and ADHD. Of course, at one level it is true that ADHD is associated with large deletions. But if the effect is mediated by IQ then this is somewhat different from the notion that "deletions cause ADHD". To test this, one would need to study a sample of subjects with ADHD compared with controls who had been matched for IQ....

Maybe I could use a space to put things up which will be searchable and linkable and which people can comment on. I'll try posting things here and see how it all goes.