Latest news with #psychiatry
New York Times
17 hours ago
- Health
- New York Times
What Happened in This Doctor's ‘Sleep Room' Might Give You Nightmares
THE SLEEP ROOM: A Sadistic Psychiatrist and the Women Who Survived Him, by Jon Stock Tales of predatory men performing reprehensible acts on unconscious women are as old as human history (see 'Sleeping Beauty,' the 14th-century version) and as recent as yesterday's news (see the Frenchman who invited dozens of strangers to rape his drugged wife). But in the case of the British psychiatrist William Sargant (1907-88), his ministrations to slumbering female patients were for the most part perfectly legal, undertaken in the name of medical science with the aim of curing severe distress. As Jon Stock recounts in 'The Sleep Room,' his disturbing chronicle of Sargant's career, between 1964 and 1972, the psychiatrist, by then an eminence in his field, subjected hundreds of patients — the vast majority of them women — to what he called 'continuous narcosis,' in a twilit, bed-lined garret on the top floor of London's Royal Waterloo Hospital, his 'sleep room.' For up to four months at a time, girls as young as 14 were kept knocked out on cocktails of antipsychotics, sedatives and antidepressants while administered risky experimental therapies — typically one or the other of Sargant's favorites: electroshock (ECT) and insulin coma (in which huge doses of insulin induced a hypoglycemic stupor). 'Under sleep,' he explained in a textbook for fellow practitioners, 'one can now give many kinds of physical treatment, necessary, but often not easily tolerated.' (Conveniently for him, patient consent wasn't British law until 1983, long after he'd retired.) 'Physical' is the key word here. Deploring psychiatry's lack of effective therapies for serious mental illness, Sargant had no patience with the ruling Freudian 'sofa merchants' and 'talkers,' who trafficked in poetic intangibles like the unconscious and sublimation. Instead, he saw the mind, 'conceived merely as the brain,' as no different from any other organ and requiring the same concrete interventions as a burst appendix or broken arm. The theory behind this approach was nearly as crude as the treatments themselves: A dramatic jolt to the system would disrupt negative patterns of thought and behavior and produce what Stock calls 'a factory reset.' Want all of The Times? Subscribe.
Forbes
a day ago
- Health
- Forbes
Is The Mental Health System Broken Or Was It Never Built To Work?
Five years ago, a research team at Stanford achieved what many in psychiatry had long hoped for: A treatment for severe depression that worked rapidly, reliably, and without medication. In their 2020 SAINT trial, 19 out of 21 participants with treatment-resistant depression achieved remission after just five days of transcranial magnetic stimulation (TMS). It was a landmark moment. Yet today, the treatment remains almost entirely inaccessible to the average patient. Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) is still paid for out of pocket, costing roughly $20,000, and insurers have been slow to move. A paradox at the heart of American mental healthcare: as innovation accelerates, access stalls. Over the last five years, more than $13 billion has been invested in the sector, but outcomes haven't improved in kind. Patients still cycle through multiple failed treatments. Clinicians are burnt out, and payers are stuck making decisions with no data. It's tempting to say the system is broken. But perhaps it was never built to do what we're now asking of it. A System Built for Simplicity, Not Reality Modern mental healthcare still relies on a medical model designed for acute illness: assess symptoms, assign a diagnosis, and prescribe a standard treatment. It's a linear approach that works well for infections and injuries. But mental illness is not linear. A messy intersection of biology, trauma, environment, and social context shapes conditions like depression, PTSD, and OCD. There's no single cause, no universal treatment. And yet, the system continues to reduce people to diagnosis codes and protocol templates, often leaving naivety at the door. This reductionist model doesn't reflect the complexity of the human experience, and it leaves patients, clinicians, and payers with more questions than answers. The system doesn't work for anyone. Yet, the misalignment of incentives means that all stakeholders are working against one another. Payers prioritize risk management—and in the absence of meaningful data, default to spending as little as possible. Providers focus on individual outcomes. Pharma chases scalable efficacy. Patients just want relief. But it seems no one is working with the correct information, and the frustration and disappointment are palpable. Data alone doesn't matter, because it's about how you use the data to drive change, according to Brayden Efseroff, psychiatrist and Chief Medical Officer at Allia Health. 'When patients cycle through multiple failed treatments before finding relief, it's not just frustrating - it's a sign of systemic dysfunction. Decisions are being made without context.' Ariel Ganz, PhD, a precision mental health researcher at Stanford, agrees, 'The same data clinicians need to design effective treatment plans is also critical for payers to manage risk, researchers to improve understanding, and patients to advocate for themselves on their health journey. 'Without more high-quality data, none of these parties can effectively improve patient outcomes.' Precision Mental Health Company is addressing this issue at its core. Their AI-native electronic health record (EHR) isn't designed to replace therapists or psychiatrists, but to support them by capturing, organizing, and translating real-world data into usable, structured insights. This innovative solution holds the promise of a brighter future for mental healthcare. Instead of extracting revenue from clinicians through software subscriptions or taking a percentage of their reimbursement, payers partner directly with Allia on value-based contracts. They're paid only when patients achieve measurable improvements, a stark contrast to the fee-for-service model that rewards volume over outcomes. Amie Leighton, CEO of Allia Health, discovered the need for better data firsthand during years of cycling through hospitals and treatment before finally receiving adequate care. The turning point came when her clinicians had access to complete information about her and were able to communicate with each other - something that had been missing throughout her previous treatments. This personal experience, and the empathy it engenders, shaped the company's mission: to build the infrastructure that allows for context-rich, coordinated, and personalised care. The Bigger Picture How do you fix a system that was never designed to work in the first place? We still have a long way to go, but for the millions of Americans struggling with mental health challenges, finally, an infrastructure-first approach offers something that's been missing: a system designed to actually help people recover. In an industry where patients commonly endure multiple failed treatments before finding relief, this represents a significant shift toward care that prioritizes outcomes.
ABC News
4 days ago
- Health
- ABC News
DEEP DIVE: Coming off antidepressants and is "chemical imbalance" a myth?
Brain zaps, increased anxiety, confusion: these are just some of the symptoms people report when they're getting off antidepressants. So why is coming off antidepressants such a taboo topic? And why are researchers arguing about what actually happens during withdrawal? In this extended episode, we unpack the withdrawal symptoms you're experiencing, look into the massive debate about a recent study, and get some advice for what to do if you decide to stop taking antidepressants. Guest: Professor Jon Jureidini, psychiatrist, University of Adelaide Get the whole story from Hack:
CNA
6 days ago
- Health
- CNA
Acute psychiatry services to be expanded to all healthcare clusters in Singapore
Acute psychiatry services will expand to all healthcare clusters to meet increasing demand and provide greater access for patients. According to the Health Ministry, mental health disorders are among the top leading causes of disease burden in Singapore. Meanwhile, a new practice guide for mental health practitioners was also launched at the Singapore Mental Health Conference. It aims to standardise assessments and referrals based on a patient's symptoms and care needed. The guide will focus on managing depression, anxiety and suicidal tendencies. Chloe Teo reports.
ABC News
12-07-2025
- Health
- ABC News
What is kleptomania? Understanding the compulsive urge to steal
Lynn* can remember the very first time she stole something. A kid's toy from a friend when she was seven years old. It was nothing out of the ordinary — young kids often steal and tend to grow out of it. But as she got older, Lynn found herself stealing more often. She'd take hair ties from her teacher's desk, umbrellas from her university, a small doll from the shops. And at 22, the urge to steal has taken over Lynn's life. "Almost everywhere I go right now I have to steal something, which is really disabling for me," she says. Two years ago, Lynn was officially diagnosed with kleptomania — a mental health condition characterised by a compulsive urge to steal. Kleptomania is considered an "impulse control disorder" under the Diagnostic and Statistical Manual of Mental Disorders (DSM), a clinician's key handbook for mental health conditions. Impulse control disorders are a relatively rare cluster of conditions that also includes pyromania (an intense fascination with fire and the repeated, deliberate setting of fires) and oppositional defiant disorder (a pattern of disobedient or hostile behaviour towards authority figures in childhood). People with kleptomania repeatedly steal items, but they do it impulsively and they find it very difficult to stop," says Sam Chamberlain, a professor of psychiatry at the University of Southampton. "Importantly, when they steal these items, it's not because they need them and it's not for personal or financial gain," he says. According to Dr Chamberlain, the typical pattern of behaviour for someone with kleptomania is a sense of tension that builds up before the theft, followed by a feeling of gratification or release after they've done it. Lynn says the urges feel like she is being pulled towards a particular object — that "it feels like there's no way of not taking it." She says it feels reflexive and difficult to suppress, like a sneeze or a yawn. And once she's taken the object, there's a rush of euphoria, quickly followed by guilt. "After a minute already I feel so very guilty about it. And I feel like a terrible human being," she says. Despite being mentioned in medical manuscripts for hundreds of years, kleptomania is still not well understood. "It's really stigmatised and hidden," Dr Chamberlain says. "And this means, sadly, that the person with a condition will suffer more. "It also makes this condition hard to study because people might be reluctant to come forward for research and admit that they've got this condition," he adds. The evidence we do have suggests about three to six in every 1,000 people have kleptomania. That makes it much rarer than conditions like anxiety and depression, which affect sizeable proportions of the population. It typically emerges during someone's teenage years and is thought to be more common in women than men — though again, that finding is based on the limited number of people diagnosed with the disorder. And while the numbers of people affected are small, kleptomania can be debilitating. Lynn often avoids going to the shops or visiting friends because she's scared of stealing and being caught. "And my parents will know and I will be arrested and convicted and the anxiety starts going up from there," she says. Concealing the condition — and the associated anxiety that comes with it — is typical of people with kleptomania, Dr Chamberlain says. "We often see that people, develop, anxiety and depressive disorders and other addictions such as alcohol use disorder. Sometimes these can be a direct consequence of the kleptomania and other times they can be happening in parallel." Research into kleptomania is limited, and work that examines the drivers of the condition is less common still. While no clear cause has been identified, we do know people with severe symptoms of kleptomania are more likely to also be diagnosed with other conditions such as obsessive-compulsive disorder or an eating disorder. They also tend to have higher levels of impulsivity. "This means that in terms of their personality, they have a tendency towards doing things on the spur of the moment. Maybe in response to reward, perhaps not planning things through to the extent that a less impulsive person would," Dr Chamberlain says. When researchers look at the brains of people diagnosed with kleptomania against those who don't have the condition, there appear to be subtle differences in the white matter tracts (bundles of nerve fibres) that connect key parts of the brain together. "We also see changes in the white matter tracts … in people with other conditions such as attention deficit hyperactivity disorder or obsessive-compulsive disorder," Dr Chamberlain says. "So probably there's some kind of common brain processes contributing to these different conditions." After receiving her diagnosis two years ago, Lynn trialled a number of different strategies to curb her impulses. These included talking therapies, recordings of her friends' words of encouragement she plays through headphones while at the shops, and a card she carries listing the potential consequences of stealing. She's also been prescribed the drug naltrexone, which is most often used to treat alcohol use disorder — and which has the best evidence of any medication for treating kleptomania, Dr Chamberlain says. A small but high-quality study done in 2009 found the drug was better than a placebo pill in reducing both urges and actual stealing among people with kleptomania. "So naltrexone is often a useful choice, but obviously as with any medication there are side effects for some people … it's not the easiest medication to prescribe," he says. For Lynn, none of these treatments have been effective in reducing her stealing. She wants more work done in researching ways to address the urges. In the meantime, she manages as best she can. "I have never been caught, and I hope to let it stay that way. But I'm not sure how long I will be able to," she says. *Lynn's name has been changed to protect her identity. Listen to the full episode of All In The Mind about kleptomania and its impact , and follow the podcast for more.
