From Our Readers

A Black Mark

I found the American Psychiatric Association’s response (“Setting the Record Straight”) to the commentary by Allen Frances, MD, (“A Warning Sign on the Road to DSM-V”) outlining concerns about the DSM-V to be an embarrassing black mark against the association.* As president of an organization supposedly devoted to scientific objectivity, Dr Alan Schatzberg’s (lead author of the response) ad hominem attack and use of unprovable innuendos to discredit Dr Frances reflects an approach I want nothing to do with.

If Dr Schatzberg and his coauthors need an example of a professional, objective, and scientific response to Dr Frances, they should refer to the commentary by William T. Carpenter, MD, “Criticism vs Fact” (http://www.psychiatrictimes.com/display/article/10168/1426507), or to the essay by Renato D. Alarcn’s, MD, MPH, “Inside the DSM-V Process: Issues, Debates, and Reflections,” which appeared on the cover of the July 2009 issue.” Both authors counter Dr Frances’ arguments without attacking him personally.

I can only assume that as president of the APA, Dr Schatzberg represents the mind-set of our organization. If that is the case, the APA is an organization with which I take no pride in my affiliation.

Stephen Rosenblum, MD
George Washington University School of Medicine
Life Fellow, American Psychiatric Association

A Dying Art

Kudos to Psychiatric Times for putting Dr Jan Goddard-Finegold’s article on the cover of your June issue. And thanks for publishing the essay by Jerry M. Lewis, MD, “Moving In and Out,” (in the same issue, page 17) in which he describes the complex skills of the psychotherapist. This skill is all but dying out, as well as this kind of concern for the patient. Recently, a patient called me in extreme distress in an acute distress reaction related to his job. He had called 5 psychiatrists-4 had not returned his call. One said he could see him in a month! Seeing him the next day, we averted the development of an extreme case of PTSD.

I have been in practice 58 years and, at 88, am still reaping the rewards of providing psychotherapy. And I am vicariously enjoying watching the fine work being done by several men whom I trained as residents many years ago. I do believe the public is gradually understanding that as efficacious as medication is, for many people psychotherapy is essential.

Barbara Young, MD
Baltimore, Maryland

An Approved Treatment

I read the article by W. Clay Jackson, MD, DipTh, “Treatment-Resistant Depression: Primary Care Experience and Nonpharmacological Treatment Strategies” in a May 2009 supplement to Psychiatric Times (page 8), and want to point out an inaccuracy. The statement is made that repetitive transcranial magnetic stimulation (rTMS) “should be considered an investigational therapy and has not yet received FDA approval as a treatment for depression.” In fact, the FDA approved this form of treatment in October 2008. Since January of this year at our center, we have successfully treated 4 out of 4 patients with treatment-resistant depression to the point of full remission using the NeuroStar TMS device approved by the FDA.

Irwin I. Rosenfeld, MD
Laguna Hills, California