cassowary37

ELIZA wasn't the only chatbot in the late 1960s... this JAMA+AI podcast explores how their creators took very different paths in beliefs about AI in medicine

Not to take anything away from the meta-analysis and the important points in the blog post, but there's a glaring error in the abstract: "the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively."

The authors mean increased /odds/, not likelihood (probability). WHy does it matter? Well, when your whole paper is a statistical exercise, misusing basic statistical language in the abstract is not a great sign.

sorry, intended to elaborate: When I query my health system's deidentified research patient data registry, there are multiple individuals with both a diagnosis of schizophrenia and a diagnosis of congenital (cortical) blindness. One can of course quibble that claims codes are unreliable (ie, these people really have different diagnoses), but my real point is that the entire article is based on a very limited analysis that could readily be refuted with any of the claims/health registry data sets.... also amusing to see this downvoted, people on HN don't like to see their pet theories questioned.

Just queried my health system database and this statement as it pertains to congenital cortical blindness is factually incorrect.

>"I feel like perpetuating this mindset is the ultimate sin of modern psychiatry and the entire industry of psychiatric pharmaceuticals"

Hmm. Modern psychiatry is usually accused of the opposite. Also interesting that leading comment on an article about how many (non-CNS) meds have CNS effects becomes yet another opportunity to criticize antidepressants. HN community's hostility to treating brain diseases (while emphatically supporting people with brain diseases) is perplexing.

Ironic that folks who work in CNS drug discovery spend much of their time worrying about how to get our molecules /into/ the brain... and less energy thinking about keeping non-CNS meds out. For what it's worth, though, these 'off-target' CNS effects have also prompted a lot of enthusiasm for repurposing existing FDA-approved drugs for new indications, since their safety is already established.

the studies (which admittedly are short-term) reflect remission - i.e., resolution of symptoms. This is a critical point: the goal is resolution of symptoms, not partial improvement.

The closest thing to a cure (for some people) can be cognitive-behavioral therapy, or long-term antidepressant treatment when indicated.

actually that statement is itself rather presumptuous. How would you know that those of us who repeat it don't know? I can state with authority that may of us do.

A colleague of mine calls suicide 'a permanent solution to a temporary problem' - not to diminish it, but to recognize that for most people the desire to die is a temporary state.

Whenever depression comes up on HN (as it does with surprising frequency), I'm both touched by people's willingness to share their own stories, and frustrated by otherwise very rational and logical people's speed to dismiss data. Initial treatment (meds or evidence-based therapies) work for about 1/3 of people; subsequent treatments work for another 1/3; and there are up to 1/3 where multiple treatment trials fail them. (This comes from STAR*D, plus Cipriani Lancet meta-analysis, plus vast CBT literature). But, there are a number of next-step treatments showing promise (rTMS, esketamine, variants of CBT, and so forth).