{"id":25183,"date":"2013-03-14T11:51:28","date_gmt":"2013-03-14T10:51:28","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=25183"},"modified":"2013-03-14T11:51:28","modified_gmt":"2013-03-14T10:51:28","slug":"elizabeth-loder-inventing-disease-and-pushing-pills","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/03\/14\/elizabeth-loder-inventing-disease-and-pushing-pills\/","title":{"rendered":"Elizabeth Loder: Inventing disease and pushing pills"},"content":{"rendered":"

\"ElizabethThe recent 2013 Selling Sickness<\/a> conference in Washington, DC was chock full of fascinating speakers. In an earlier blog I discussed my participation in a panel discussion at the conference, and Rachel Hendrick <\/a>has also blogged about the meeting. It was difficult to choose from the topics on offer during the two day gathering, and many of the most enticing talks seemed to be scheduled concurrently with others that were equally intriguing. Since there were so many speakers and topics at the meeting who deserve attention, here are some selected highlights from my notes with links to more information about their work: <\/p>\n

Jeremy Gruber of the Council for Responsible Genetics <\/a>spoke about the large amount of money being poured into research on genetics: \u201cWhat the world of genomics doesn\u2019t want you to know is that the vast majority of morbidity and premature mortality come from smoking, overeating, and lack of exercise. For research in behavioral and social sciences, where even a small improvement in our ability to alter behaviour could yield significant benefits, funding is low.\u201d<\/p>\n

Rachel Liebert took a provocative look<\/a> at what she terms \u201cpsychic policing,\u201d surveillance, and disease mongering in public education. She noted that in the wake of the recent Connecticut school shootings the popular Dr Oz called<\/a> for \u201ca homeland security approach to mental illness,\u201d voicing the popular but unproved assumption that most school shootings are carried out by the mentally ill and that \u201cthe proper response is medical.\u201d According to Ms Liebert, the classroom is \u201cat risk of becoming a psychiatric assessment unit\u201d where teachers and others are on constant high alert for any unusual behavior that might indicate a budding psychiatric problem. Ms Liebert provided examples of commercial companies that have developed costly programmes to mitigate perceived risks and improve school safety. She suggested this might be considered disease mongering since it fosters discussion about psychiatric illness rather than access to guns. She refers to this as the \u201cintersection of medicalisation and securitisation.\u201d<\/p>\n

Making fun of the concept of \u201cpre-disease\u201d and its contribution to medicalisation, a psychiatrist in the audience stood up and said \u201cMy diagnosis is pre-psychosis, but I\u2019ve warded it off by wealth, education, an intact family, and living in safe neighborhoods. I have connections in my church. The treatment has worked marvelously and I\u2019ve avoided hospitalisation. I want to thank the genome project for adding thousands of papers that show it\u2019s nurture not nature that determines we will be healthy\u2026we automatically assume [a drug] is the treatment\u2026 but really it\u2019s the matrix in which the gene exists. It\u2019s the environment.\u201d<\/p>\n

Rhetorician Judy Segal<\/a> of the University of British Columbia compared old advertisements for patent medicines with the pharmaceutical advertisements of today. Depressingly little has changed. \u201cDrug marketing is one way consumers learn what their symptoms might add up to,\u201d said Dr Segal. \u201cPatent medicine ads hailed an audience that was tired, nervous, constipated, and broadly disappointed. Drug ads today are much the same\u2026We are broadly vulnerable and at least a little sick. We are at our computers with better resources, but with many of the same concerns. Lydia Pinkham\u2019s vegetable compound helped to constitute the female subject now considering Yaz for moodiness, Premarin for a menopausal vagina, Gardasil for her daughter, and Zoloft for depression.\u201d<\/p>\n

Finally, for pure fun I advise you to watch the following list of videos. These are just some of those shown at the \u201cSelling Sickness Popcorn Showcase\u201d on the first evening of the conference. The first on the list is my favorite. Enjoy!<\/p>\n