Comment part 2/

The suicide attempt rate was increased in antidepressant arms relative to placebo (OR = 2.38, 95% CI = 1.63—3.61, p < 0.00001, BF = 180.1 [very strong evidence]).

The absolute risk increase was 0.413% or about 413 suicide attempts per 100,000 antidepressant users.

Although the absolute risk increase in suicide events is small, it must be weighed against the knowledge that the deterioration in quality of life that accompanies the increase in suicide events is significant.

Sorry, my comment was cut-off so it is re-posted here:

The publication bias by the pharmaceutical industry is massive. It can be very hard to unearth given the clever misuse of statistics they engage in. Here's an example from the antidepressant literature I like because they put their finger on different statistical measures used by them vs the US FDA

Newer-Generation Antidepressants and Suicide Risk in RCTs: A Re-Analysis of the US_FDA Database https://www.karger.com/Article/FullText/501215

For suicide events (attempts + death), the absolute risk increase was 0.077% or ~77 suicides per 100,000 antidepressant users, for a Number Needed to Harm of 1,303.

The suicide attempt rate was increased in antidepressant arms relative to placebo (OR = 2.38, 95% CI = 1.63—3.61, p < 0.00001, BF = 180.1 [very strong evidence]).

The absolute risk increase was 0.413% or about 413 suicide attempts per 100,000 antidepressant users.

Although the absolute risk increase in suicide events is small, it must be weighed against the knowledge that the deterioration in quality of life that accompanies the increase in suicide events is significant.

I know, it’s Gí¸tzsche

Are you suggesting that Cognitive Behavioral Therapy, as a form of psychotherapy, is without strong evidence?

Wouldn’t the fittest individuals apply to not just the physical but the mental as well? One of my favorite things about crossfitting is that my body follows what my mind allows. I think it’s great to use the platform they have created to apply critical thinking to not just movement, but life in general. I didn’t take away from the article that was written that they were recommending stopping taking all medication. I also don’t think simply because the author is forward thinking and has opinions regarding health that may not be widely accepted is reason to disregard anything he says. There is plenty of data now, but even common sense could tell you that a mammogram is potentially harmful and carcinogenic... damaging soft tissue and radiate it a bunch. And then repeat. I think throwing words around like cult and conspiracy theory should be done carefully. I think it’s great to challenge a paradigm, how else would improvements happen?

Theo, 

I offer this public endorsement of Gí¸tzsche excerpted from a letter sent by John Ioannidis to Denmark’s Minister of Health 16 November, 2018:

“I am a tenured professor at Stanford University and the current rate of citations of my work in the scientific literature (>3,000 times per month) is the highest among all physicians in the world and among the 10 highest across all scientists in the world. I have unconditional admiration for Peter Gí¸tzsche. Peter is undoubtedly a giant, one of the greatest scientists of our times and one of the most influential, impactful, and useful voices in medicine at large. I cherish enormously his contributions. I believe he is the most recognizable and prominent scientists that Denmark currently has. His dismissal from the Cochrane board two months ago came as a total shock to me. The possibility of compounding this shock with his dismissal also from the Rigshospitalet would deal a severe blow to medicine, democracy, freedom of thought, and justice.” 

I would also like to introduce to you two books published by Peter Gí¸tzsche: 

First, “Mammography Screening - Truth, Lies, and Controversy”, Radcliffe Publishing, 2012. Iona Heath, President of the Royal College of General Practitioners said of this work: “If you care about breast cancer, and we all should, you must read this book.” Fran Visco, President of the National Breast Cancer Coalition, The United States, contributed, “We need to take the time to understand the science of health outcomes for women. We need to take the time to understand the science and the basis for health recommendations we receive, both in the healthy populations and in those diagnosed with breast cancer. This book will help us get there.” 

Second, “Rational Diagnosis and Treatment”, Fourth Edition, Wiley, 2007. This book for 31 years and in four editions endeavored to, in the words of the author of the first edition, “..show that work at the bedside can present just as great an intellectual challenge and yield even more satisfaction than work in the laboratory. Clinical reasoning can be as rigorous and as logical as that in any other academic discipline.” 

I highly recommend both books. “Rational Diagnosis and Treatment” so impressed me that I’ve purchased a sealed mint-condition copy for my library. It would be hard to imagine a more thoughtful gift to anyone seriously committed to clinical practice. 

I offer all of this to encourage you, Theo, to reconsider your hastily drawn conclusions about Dr. Gí¸tzsche and his work. Your assessments are not only sloppy but irresponsible to the aim of honest and useful conversation. 

This began with your exhortation, “I wish CrossFit would stick to WOD’s”. Sir, I’ll never tire of that refrain. And, while I’ll not say, “I wish Dr. A would stick with dermatology”, I will ask you to up your game here on these pages. You don’t have to be a scientist to think clearly nor to do a little research before weighing in. 

Back to WOD’s. 

No, I think CBT is completely legit, behavioral conditioning=parenting etc, but the patient has to be in a place where you can talk to them.  It is not my recommendation for someone in a raging psychosis.  In schizophrenia etc CBT it is a helpful adjunct for comorbid anxieties and personality disorders or some belief modifications.  I am talking about classic Freudian psychoanalysis having foundational origin issues.

But mainly my issue is with Crossfit introducing cult like conspiracy theories from questionable individuals with marginalized ideas and checkered pasts instead of sticking to making the fittest people, which is its stated mission.