http://www.psychiatrictimes.com/psychopharmacology/quiz-headaches/page/0/2

Dr. King, regarding acupuncture, perhaps you can comment on this article:

Research Casts Doubt on the Value of Acupuncture, Scientific studies show that the procedure is full of holes, Scientific American, August 2016

https://www.scientificamerican.com/article/research-casts-doubt-on-the-value-of-acupuncture/

The article makes these statements below, and it seems to me that because of the subjective nature of endpoints used in any clinical trial of pain or migraine treatment, whether acute or prophylactic treatment, that it seems a bit too early to make definitive conclusions about acupuncture worthy of a “True” or “False” in a quiz because there is no way to filter out bias of hope or expectation and/or researcher/treater bias effects on the subject even with masked raters as they only record the report of the patient:

1. effects of acupuncture are the same whether needles are placed along the meridians or at random locations around the body.

2. acupuncture studies are extremely difficult to double-blind—a methodological approach in which neither the researchers nor patients know who is receiving the treatment under investigation and who is receiving the placebo or sham.

3. researchers know which patients receive or do not receive real acupuncture, likely biasing the results.
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http://www.psychiatrictimes.com/psychopharmacology/top-papers-can-change-your-practice#comment-51647

Article Originally Published in the 'Psychiatric Times' on February 23, 2017

Drs. Saeed and Bloch,

You quoted a paper on IPT as showing IPT to be more effective than placebo or waiting list and comparable to pharmacotherapies.

Did this paper, or any paper, ever study IPT with single-blinding (=subject blind) or double-blinding (and thus with blind placebo) ? I think not as it is impossible to blind a psychotherapy study, using the term “placebo” in a psychotherapy study is misleading as it is not a blind placebo.

In addition, comparing IPT to medications that show efficacy vs blind placebo (thus the rigor in showing efficacy is higher than in unblinded studies) invalidates clinical trial logic because the methods to prove efficacy are very different in blinded medication studies vs psychotherapy studies. MDD is studied with subjective endpoints and an unblinded study can not filter bias from the expectation and hope of knowing the therapy one is given. Blind raters only record the unblinded report of the subjects.

Because MDD psychotherapy trials can not be single- or double-blinded, nor can they have blind placebo, the rigor of these trials for psychotherapy in MDD is low so that it is premature to make claims of efficacy for IPT in MDD. These kinds of papers do not belong in a “Top Ten” list unless you want to include “papers with problems to be aware of” in the list.
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For more information about Douglas Berger Psychiatrist Tokyo visit the following websites:
http://douglasbergerpsychiatristtokyo.com/
http://douglas-berger-psychiatrist-tokyo-reviews.com/
http://about-douglas-berger-psychiatrist-tokyo.com/
http://douglas-berger-psychiatrist-tokyo-info.com/
http://douglas-berger-psychiatrist-tokyo.com/