Mark Hyman, MD, is a “practicing physician and pioneer in functional medicine,” according to his bio on the Huffington Post where he recently penned the nonsensical, “Why Antidepressants Don’t Work for Treating Depression.” I say “nonsensical” because this article is based upon a study that came out 3 years ago, so writing this article to educate the public seems not to be its primary purpose.
Exhibiting sound reasoning and logic also doesn’t seem apparent in this article, since generally a scientist or doctor would not dismiss an entire class of medications — antidepressants — based upon a single study. Or when there are many different types of antidepressants and sub-classes — SSRIs, tricyclics, MAOIs, SRNIs, etc. The study questioned by Dr. Hyman only looked at the more modern and commonly prescribed antidepressants, but it had nothing to say about the older, cheaper antidepressants still prescribed widely in other parts of the world.
The New England Journal of Medicine study in question only looked at studies submitted to the U.S. Food and Drug Administration (FDA) for initial approval of the drug. These studies are important, but hardly provide the final or definitive answer when it comes to proving effectiveness of a particular drug. In fact, after a drug has undergone and received FDA approval, it tends to undergo dozens — and sometimes hundreds — of additional research studies as researchers compare the drug to other treatments, include it in depression research, or conduct large government-sponsored trials such as STAR*D. STAR*D demonstrated that antidepressants are effective, but that it may not be the first antidepressant you try that will work for you.
So why is Mark Hyman, MD writing about antidepressants and a study conducted 3 years ago today?
Well, I think we can gain a clue here:
What can we do? Unfortunately, there is no easy answer. But I do think functional medicine, on which my approach of UltraWellness is based, provides a more intelligent way of understanding the research. Rather than using drugs to suppress symptoms, Functional Medicine helps us find the true causes of problems, including depression.
Ah, UltraWellness. That scientific medical approach to fixing the causes of sickness. Depression being just another medical sickness, apparently.
Wait… You haven’t heard of UltraWellness from the medical research? Well, that’s no surprise, because I couldn’t find a single entry in PubMed referring to “UltraWellness.” And when I perused Dr. Hyman’s website, I also found a not-unsurprising lack of research references to his approach to curing sickness.
But Dr. Hyman does have anecdotes! And he peppers the rest of the article with examples from his actual clinical practice as a family physician showing how he quickly and readily “cured depression” by finding the root cause of it in every case — food allergies, removing high levels of mercury, and vitamin deficiencies.
You see, Dr. Hyman was trained as a medical doctor. So apparently he doesn’t really see mental health problems as mental disorders that more often than not have biopsychosocial causes. It is, in my opinion, an extremely simplistic, naive, un-nuanced view of mental disorders — they are just another medical illness that can be cured with vitamins, omega-3 fish oils, and exercise. Indeed, those things have been shown to work to help some people some of the time — but usually those with mild depression. Research evidence varies for each item, but it’s unlikely that even a combination of all of these things is going to help those with no pre-existing vitamin deficiencies or other medical problems.
Which is an important consideration, because virtually every diagnosis in the DSM-IV (the reference book used to diagnose mental disorders such as depression) has this important criteria — “The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).” So to suggest that depression can be caused by a general medical condition, like hyperthroidism, is to miss one of the exclusionary criteria in the diagnosis of most mental disorders. According to the DSM, if you have the medical condition, you don’t have the mental disorder.
For moderate to severe depression, a more nuanced and complex approach is usually needed to treat it effectively and in a timely manner. So yes, get checked for mercury and hyperthyroidism, and take your vitamins. But let’s not discount the benefits of antidepressants and psychotherapy treatments that also have been proven — both by time and research — to help people with depression.
Read the full article: Mark Hyman, MD: Why Antidepressants Don’t Work for Treating Depression.
25 comments
I have to say… when I see that something was published in the HuffPo, I instantly dismiss the possibility that it’s rational.
Dr. Grohol,
Thank you for this thoughtful response to Dr. Hyman’s article, which I believe to be wholly irresponsible.
I have been dismayed by this odd phenomenon among some physicians who feel compelled to offer mental health advice. In offering him a great benefit of doubt, I’m sure that Dr. Hyman is qualified in many areas of traditional, non-traditional, and non-Western medicine. But this does not in any way mean he is qualified to practice, or advise in the area of mental health treatment and I believe that his doing so is deeply troubling and irresponsible. It reminds me of the last time I went in for a general gynecological check-up and made the mistake of mentioning to my OB/GYN that I suffered from depression (for which I was getting treatment). “You need to take deep breaths, and get some exercise and go to the drugstore and get something called 5-htp.” I was stunned that this doctor, who was clearly very good at her practice, had the gall to advise me on my treatment for a completely separate issue. And I thought, would she ever tell me what chemotherapy treatment was best for my cancer? (If heaven forbid this was my issue instead)? Why do so many doctors see psychology as their pet-project? I would dare remind them that the brain is perhaps the most complicated of the organs and if these doctors would like to offer advice on the subject they might first return to school for another 5-10 years education.
I was banned from HP for vociferously objecting to Dr. Hyman’s article, false conclusions and faulty statistics.
From the letter I sent HP:
>Dr Hyman’s conclusion that “Antidepressants don’t work for treating Depression” is journalistic puffery, at best. 30,000 prescribing clinicians would disagree with him, INCLUDING several MD’s who chimed in in the comments section.
Along with dozens of Huffcommenters who shared personal accounts stating that “medication saved their lives” in the 20+ pages of comments. Pretty poignant reading in many cases.
Stated in a public forum, “Antidepressants don’t work for treating Depression” could quite easily cause a mentally ill person to forgo taking their medication, or not seek help to begin with, resulting in an eventual suicide.
It is the most irresponsible of journalism, IMHO, to allow Dr. Hyman a public forum in which to state such a conclusion.
Nor do I believe I posted anything else that could be construed as a “direct personal attack” while PASSIONATELY disagreeing with the headline, and conclusions reached by “the good doctor.” 😉
What infuriated me the most were two comment deletions in particular:
1) Offering HP members who disagreed with Hyman’s conclusions the address of the American Medical Association. Why would Hyman or HP be scared of the AMA if he is in fact, offering sound medical advice?
2) Deletion of ANY posting I made which discussed, openly and honestly, the fact that one or more suicides might result as a result of Hyman spreading his personal belief that “Antidepressants simply don’t work.” It might be 5 years from now, but someone will recall reading that an MD stated, in a headline, that “Antidepressants dont’ work” and having not even read the article, much less the comments, believe him.
Neither of these comments can even remotely be construed as constituting a personal attack.
Other Huffcommenters repeatedly “shot down” Dr. Hymans statistics, which imply that because both placebos AND anti-depressants have a placebo effect, they are therefore “not useful” for treating depression.
Would HP be willing to change the headline of this article to “Why Antidepressants SOMETIMES Don’t work to treat Depression?”
Believe me xxx, I appreciate the incredibly hard job you have as Lead Moderator, and I appreciate your effort to resolve this.
Wade H. Nelson
Durango, Colorado
Your response makes more sense than Doctor Hyman’s spiel (faint praise, I know), but psychotherapy for severe depression is usually a waste of time and money — I don’t know a single person who credits such an approach with alleviating that extremely debilitating condition, and I know of no convincing evidence that puts it in the category of “proven” treatments alongside anti-depressants. Perhaps once the more acute symptoms are alleviated, psychotherapy might be a useful (albeit time-consuming and pricey) adjunct, but as a sole therapy it’s very close to useless imo.
I am sorry that the good doctor, who is not a psychiatrist or psychologist was featured in HuffPost. HP has continually shown disregard for fact checking and I believe that this is one of their better examples for not verifying a writer’s statements.
I agree with Wade who spoke about the possibility of someone either quitting their meds or committing suicide because “that doctor said that my meds aren’t helping me”..People with mental health issues are already bombarded with several med commercials on television and most probably disregard the info on the screen because they know that the company is trying to make money……not trying to help those of us who are depressed. But add a doctor to the scenario and some people are going to believe what the doctor says about meds and depression.
I would suggest that anyone who reads the doctor’s article on HuffPo. take it with a huge shaker of salt and talk to either a psychiatrist or psychologist before making a drastic change (or choice) to their meds.
I am absolutely opposed to anyone but a psychiatrist prescribing an anti-depression med for me.
Good article, Doc John.
While a scientist or doctor should not dismiss an entire class of medications, in this case antidepressants, based on a single study, nor should a scientist or doctor endorse an entire class of medications without considering the acceptations to the rule – antidepressants do not help all people and in fact may cause more harm than good for many.
First and foremost, the “root cause†of depression must be found, and as stated this should follow the guidelines of the DSM by excluding cases where there is an underlying medical condition, substance abuse, side effects of other drugs (including psychotropics) and one issue that is not considered – circumstances/environment/lifestyle.
As per my husband who has worked in pharmaceutical research and development for 25 years, “scientific studies of psychotropics, though we try our best to make them objective and reliable, are not perfect. There is a lot of subjective data due to placebo effects and other factors that require careful statistical analysis in order to determine the true efficacy of a drug. Studies of alternative medicine/remedies for depression are also prone to subjectivity and are not always reliable. The problem is when it comes to depression, it is a very “soft” science and there are a lot of variables that contribute to an individual’s condition. If a person is isolated, not getting sunlight or exercise, is unemployed, suffering malnutrition or adversity/loss/trauma, an antidepressant may only have a band aid effect. By ignoring circumstantial stressors, the patient may be on psychotropic treatment indefinitely without resolving the underlying cause.
I was treated by three doctors, all medical school professors. The first, while not disclosing the diagnosis of BPD w/accompanying depression due to stigma in the 1980’s, was able to stabilize me and bring me into full remission after 1 ½ years with 100 mg. of Trazodone per day – minimal and effective at the height of the disorder, without hospitalization (in spite of suicidal ideation and overdosing attempts on near 100 occasions). Therapy included methods that would in the 1990’s be established as DBT.
Years later, when suffering from the effects of menopause, advancing Multiple Sclerosis, low thyroid levels, current traumas that were affecting our family a Professor of Psychiatry from Yale who specialized (as per his claims) in Bipolar disorder determined I was Bipolar 1 (while lacking mania other then insomnia). He claimed the same for my children and dead mother. When I asked about the effects of medical conditions he firmly held his ground stating “Those are not my specialty. I cannot comment.†So much for looking into root causes. Having not requested my former records, a mistake I paid a high price for, this doctor misled me down a dangerous road for 11 years adding one medication after another up to 25 pills a day, as per the Guidelines for Treatment of the American Psychiatric Association. In spite of numerous serious side, all which he treated by adding medications rather than withdrawing them, I reached a point of toxic overdosing (thanks to off label practices and exceeding recommended dosages). After going 7 days w/o sleep he ordered me to go to the psych ER and by phone, dismissed me as a patient, not referring me over to another doctor. Under yet another Yale Med professor, I endured ECT to remove me safely from the numerous, unnecessary medications.
As far as circumstantial events go, he and the new doctor claimed, “A patient with Bipolar is incapable of “normal” emotions. Any happiness or sadness is symptomatic of the disease.” So much again for root causes. This same doctor noted in her reports that a series of focal seizures experienced after my fifth treatment with ECT resulting in total speech arrest was a delusional attempt to avoid treatment. My abnormal EEG by a neurologist negated that. Again these are professors teaching a whole new generation of doctors – ignorance and stigma.
Upon moving to MA, I consulted with J. Gunderson and a colleague who both agreed I had been subjected to grievous malpractice. They also felt I had previously had BPD but was recovered; suffering only from MS induced fatigue and apathy which is handled nicely with Amantidine. I did contact that first doctor and asked what my actual diagnosis was and he admitted it was BPD.
While I agree anti-depressants work for many, you must be open to the cases where over use of SSRI’s leads to hypomania induced symptoms, suicide, depression, seizures and so on. In those people, a low as the numbers may be, they are 100% damaging. I also feel that many psychiatrists would benefit from a review of basic medicine and held accountable if they do not direct a patient to the proper doctor if psychotherapy, a GP, a neurologist, or other specialist would be helpful in getting to the root of the problem. Intentional misdiagnosis and disregard for outside factors for the sake of maintaining a paying customer is misconduct.
As a note – studies conducted with bipolar patients (not having access to the journals I cannot reference which they were but was told this by doctors that participated in them) -Patients that were put in exercise programs while in depressive cycles and meditation during manic cycles had an equal effectiveness as psychotropic intervention. In another study, patients who were put on a 12/12 program of darkness and light also showed the same improvement in bipolar as those on meds. Meds are not the only answer.
Hostile? No. I’ve made my peace. An Advocate for patients and watchdog against arrogance & ignorance – yes. My mistakes of blind trust in the misdoings of others have taught me well.
As someone who had depression for 4 years, half of whose family suffer or have suffered from depression, who was cured from depression with a combination of good therapists and antidepressants, I was really angry after reading that article on HP.
The writer completely ignored the fact that a lot of people (including friends of mine) get given antidepressants by busy GPs who don’t bother sending them to psychologists or psychiatrists to be properly diagnosed with depression. And of course antidepressants don’t help them.
He also ignored the fact that “depression” is a loose term in the common parlance. Clinical depression based on a chemical imbalance in the brain is something very specific, and it DOES respond to medication. I’d like to know how many of the people (in that study he kept quoting) who responded well to antidepressants had chemical imbalances versus people who didn’t. I would expect a medical professional to analyze research studies more carefully.
And no, antidepressants don’t cure depression 100%. In my experience, they diminished my symptoms to the point that I could work through them with my therapist.
Hopefully, people won’t take that article too seriously. But I definitely am not reading HP’s medical articles anymore.
The field of psychology is not an exact science. I work with those who have mental health challenges Medicine prescribers sell their souls to the pharmaceutical companies and people are prescribed medication which often times come with so many side effects it makes them worse, physically and emotionally. this debate is about mind set and western medicine approach to health both mental and physical. Taking omega 3 oil can be taken fordepression , 5htp can also be taken from depression. This I lezrned form my medical doctors. when i asked my PCP what would happen if I became a vegetarian she said than the diabetes and high cholesterol would be addressed.Functional medicine is a way of looking a the real causes of an ailment and using other ways of resolving the medical concerns without reverting to medication at all the time. the medical profession wants to keep people alive as long as possible for the profits it brings. the sicker they are the more money is to be made.Same for the mental health profession.American are finally being educated about how to stay healthier by simply using food as their medicine and this makes the mindset of those who practice disfunctional medicine into a defensive attack. Patients have been brainwashed into thinking medication is the answer for bad healthy style choices they have made functional medicine is helping those health again.fox example you have gas and you go to the pharmacy to find relief and there are numerous pills you can take when water with apple cider vinegar will do the same immediately. Welcome DR Hyman and functional medicine forever grateful for waking me up.
Anyone with an ounce of knowledge on this topic will see through Dr. Hyman’s idiotic claims. As you mentioned there are several classes of anti-depressants, and he throws out a blanket statement like this based on one study? Rational minds will recognize this. Unfortunately there are many people who believe anything published by a doctor. Sad, he may be doing more harm than good.
Gee, people with agendas when they make overgeneralizations or rigid assessments. Now that is a surprise. Another example of the oversimplification and narrowminded approach to a field that is multifactorial in etiology and intervention.
But, unfortunately, what is coming as the eventual aftermath of Obamacare. PCPs, Family Docs, Nurse Practitioners, who only have 5-8 minutes with patients will fit this niche perfectly for the governmental takeover that is to be. So, why would they sell a message of taking more time with the patient? It is just surprising he dismisses medications as an intervention when he concurrently sells biological-only factors to illness.
It is a shame he presents himself as clueless to the rest of providers who know better. And what does HuffingtonPost sell politically: the Democratic sponsors of things to come.
Transparency. Think that word will be in the dictionary in another 5 years?
That article really pissed me off because antidepressants DO help people. People with mild depression very well may not need them and may be better off by making lifestyle changes. But for people like me who have clinical depression stacked with situational depression and very serious issues, I might be dead without antidepressants.
Also, as to the commenter who references Obamacare, why not try using less inflammatory language if you actually want someone to take you seriously? Just a thought.
This kind of quackery will be popular as long as what passes for mental health care in North America continues down the road it is on: 10 minute appointments with a psychiatrist who doesn’t remember your name when you walk into his or her office, much less know anything about your life doesn’t cut it and people who are looking for a quick fix to complicated problems for which medication alone may very well not be the only answer.
Well I just read Talking Back To Prozac(to which Listening to Prozac is a prerequisite if you want the full whiplash effect) and it kept me awake as it was so shocking. You do have to be very responsible when advocating for
holistic cures for depression. And you must never go off your anti-depressants cold turkey, if at all. However I do believe that depression is
often overmedicated when sometimes it is the body telling us we need to
change some part of our MO in order to go on at our full capacity– and by over-medicating we could tune out important messages. I was lucky to be able to tough out all my depressions with talk therapy and no meds as anti-dep’s are mostly contraindicated for bipolar. However the ironic thing is during my last depression, my talk therapist found me boring, so I sure wanted to get out of that one quick, as her not liking me depressed was making me even more so-LOL! [That malaise had been brought on by Risperdal and the simultaneous loss of a beloved job due to an illness(they would’ve taken me as a BIPOLAR but the TREATMENT disqualified me from a job where speed and high manual dexterity were expected.] So yes, mea culpa, I am in that rut of entertaining my therapist.
Generally I disagree with a lot of what’s said on this blog, and view it as rather simplistic and light on emphasizing basic science that doesn’t already support the mental health status quo, but I have to wholeheartedly agree with this take-down.
Although, I’d like to offer a more pointed criticism.
I love the HuffPo, and sure, the Living section is chock full of specious, guru-derived theories, most of it harmless. But every Saturday when they publish an article by Dr. Hyman, I cringe. This week I cringed more than I had ever upon finishing the article.
Antidepressants don’t work as well as we thought. There’s no denying that. Maybe they don’t work at all beyond the placebo effect. I dont know, we’ll see. But this was obviously taking it too far.
Antidepressants don’t work? Oh, ok. So are you going to offer up some empirically validated psychotherapy as an alternative? Sound advice about relationships, behavior, and mood? … No.
Fish oil, magnesium, blah blah blah. More than the fact that none of the treatments he recommends will have any noticeable effect on depression beyond their own placebo effect, I am troubled, and in fact nauseated, by the fact that he makes no mention of anything having to do with psychotherapy, relationship-based interventions, or the proximate social causes (which are really biological in that they effect a living system) of depression.
This is the kind of thing that causes depressed people to ignore what may be causing their depression, ignore their feelings — essentially writing them off as due to uncontrollable aberration in their brain chemistry.
Just do yoga and eat bread because it bread has serotonin it. and chase it with an acai berry smoothie. chelate the toxins out of your system and the candida overgrowth in your stomach. wtf
It’s like the unscientific, false, neurochemical explanations of the 90’s and 00’s — only just take your fish oil instead of your paxil.
Failing at your job? Might be the mercury. Just realized you have few meaningful relationships in your life? Probably the candida overgrowth. Still feeling that major loss everyone says you should have gotten over a long time ago? Magnesium deficiency.
Naive is putting it lightly. This guy is DUH- UHMB!
As one who who is tapering off of psych meds and has been quite critical of psychiatry, let me preface what I am about to say by stating that I am not a big fan of Dr. Hyman. Oh, I agree with some things he says but he sounds just like the wacky alternative professionals I have dealt with who didn’t solve my med withdrawal problems.
But as far as him claiming antidepressant don’t work, a crazy Scientologist named Dr. Danny Carlat (yes, I am being facetious) stated in an article in NY Times that 3/4 of the antidepressant response is due to the placebo effect. Therefore, please explain why Dr. Hyman is base with what he said.
Again, if antidepressants are so effective, where is the five year study that shows this? I keep asking where it is and I get no response. I think that says it all.
By the way, I don’t doubt they work for some people. But to act like they work for a majority of folks seems pretty inaccurate based on the studies.
AA
Dr. Carlat’s 3/4 response is a statistic that’s based upon his opinion and reading of the research literature. Certainly he’s entitled to his opinion, but it doesn’t make it a hard fact.
The hard fact is that for any given person, we honestly don’t know whether antidepressant X is going to work a little, a lot, or not at all. It’s all trial and error. But eventually docs find an antidepressant that seems to work for their patients (or else docs like Dr. Carlat would be out of business).
The STAR*D is a pretty decent, objective study, but it didn’t do a 5-year followup. Such long studies are very expensive to run, hence the reason I don’t think you see them very often (nor will you in the future, unless the government started requiring them).
John, thanks for responding.
Sorry I wasn’t clear about Dr. Carlat. Everyone seemed to be treated Dr. Hyman as this radical crazy alternative med zealot who is manipulating statistics to claim that antidepressants don’t work. I was trying to point out that Dr. Carlat, as mainstream as they come, seemed to be agreeing with him. As a result, maybe Dr, Hyman isn’t as off base as you might think he is.
Well, he is in many areas as I previously pointed out but in my opinion, not regarding his claims that ADs don’t work.
Causation doesn’t equal correlation. Antidepressants may not be working very well but people may think they have spent out all this time trying them out and feel if they give up, all those years will have been wasted.
And they may think they are working when they really aren’t.
They also don’t see alternative solutions to meds even when they aren’t working.
And by the way, I am not putting down anyone who feels meds are working for them just so people are clear on my position.
Anyway, I don’t know that for a fact but my theories are just as valid as yours without any real studies that prove they work in the long term.
The STAR*D study has many problems according to what I have read. Even mainstream researchers were expressing disappointment in the results.
I would think with all the money drug companies have that they would be dying to do a five year study to prove their meds worked.
AA – I would point to the research literature which actually has quite a few 1-year studies on antidepressants. Remember, drug companies never said an antidepressant needs to be prescribed for X number of years — that’s between a patient and their doctor. Most people don’t take them for that long (5 years). Most people also don’t take them for just 12 to 16 weeks either.
Nobody’s disputing what the study Dr. Hyman noted says. What we’re disputing is why he’s saying it now, 3 years later, and how he implicates *all* antidepressants based upon this single study. Sloppy reasoning, at best.
STAR*D is a gold standard study, and while many may have been disappointed by its results, its methodology and data are some of the best you’ll find in this area.
John, sorry I am late in responding. It looks like the results of the Star D study were greatly misinterpreted according to this article by Robert Whitaker.
The success rate of 67% was reported as the success rate based on these facts. Thirty-seven percent recovered on the first drug, another nineteen percent recovered on the second drug, six percent after the third, and five percent after the fourth which tallied to 67%.
But this also counted the people who dropped out between the trial phases on the assumption they would have had the same success rates. Not counting them led to a 50.5 success rate.
Only 20% of those folks reported to the investigators during the 12 month period at some point that they were still doing well.
Mr. Whitaker then discovered in a document that unfortunately you have to pay for that after a year, that only 3% of people had a sustained remission.
If I criticize mainstream psychiatry for publicizing studies that don’t allow open access, I have to be consistent with this criticism. Therefore, I am not ready to claim the 3% is accurate without seeing where it came from.
But even if you go by 20%, that is a whole lot different than 67%.
Anyway, if that is the gold standard study, I would hate to see what a poor one is.
http://www.psychologytoday.com/blog/…e-stard-report
As far as people taking ADs long term, I am shocked by your statement as more and more people have been on them for several years. I admit I can’t find statistics to back me up but many psychiatrists recommend long term treatment after 1 to 2 relapses.
Of course, I feel that is due to drug withdrawal symptoms from the drug but that is another post for another day.
Susan’s commment is the only one that make sense in all of these submitted. It is apparant to me having worked in medicine for over 32years that the push is using antidepessants on everything and anything. Medicine has become disease management and symptom treatment not wellness care. Physicians are under the control of Pharmaceutical Co. and are brainwashed to keep Americans in the illness cycle. Susan spells it out so clearly and I am so sorry that she was tortured by the very establishment that took an oath to heal. I never could understand how torture is healing.
If you question his research you should look further, he is the most well researched physician I have come across in my 10 years of studies in my dual degrees. He’s not just saying it now, you just came across it. He’s been busy transforming medicine at IFM. Here’s another study in JAMA that looked at all the research. This one study is a study on all the studies not just the ones the drug companies wanted you to see. If you like your meds, that’s fine but your argument against Hyman is completely unfounded in fact or reason.
http://jama.ama-assn.org/content/303/1/47.short
Tons of misinformation from everyone. I took the time to read Dr. Hymans book on this subject matter and he absolutely doesn’t dismiss medications completely, he does however, make mention that medications MAY NOT work if your body’s “ecosystem” isn’t up to par. This generation is absolutely a pill popping one and in order to stop that we must find other ways to adjust. I think all of you should youtube xanax and see how bad it really is. Also, I highly doubt the article in HuffPo were less from the doctor than the editor.
I have to say that this article misrepresents Dr. Hyman’s article. He is not basing his opinion on one study, but rather a meta analysis of sorts, that looks at close to a hundred studies.
Perhaps deciphering scientific literature is not a psychoanalysts strong point.
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