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Big gaps in reporting plus misleading statements mar Newsweek’s fluffy look at magnets for depression

Rating

2 Star

Categories

MOOD-BOOSTING MAGNETS MIGHT HELP TREAT DEPRESSION

Our Review Summary

depression and anti-inflammatory drugsTranscranial magnetic stimulation (TMS) has been around for more than a decade, but this story encourages the reader to see the procedure as new by offering virtually no historical context. Additionally, it offers little in the way of systematic evidence for the technique’s efficacy, and includes several factual errors.

Clearly, many physicians embrace TMS, but a 2007 overview article in Nature offers what remains a salient cautionary note: “Although there is good evidence that this technique can modify cortical activity, the rationale for its use in many of the conditions investigated so far is not clear.”

 

Why This Matters

Some 15 million adults wrestle with significant depression, and many migrate from one type of treatment to another in an ongoing search for relief.  Quick, relatively painless applications of electromagnetic pulses to regions of the brain will be hard to resist, despite the uncertainties in outcome. News stories should not oversell the treatment or overlook the medical evidence for and against its use.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

Cost is mentioned in the photo caption. And, the reader will find a cautionary comment lower in the story warning that “TMS is not widely covered by health insurance,” although other TMS stories indicate that insurance companies are slowly coming to the table.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story only notes that studies employing TMS sessions to treat Parkinson’s and autism “have seen some success,” but the reader will find no specific information about what that means. Also missing: What percentage of patients with depression respond to treatment, and if the effects are short-term or long-term.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

Side effects are a feature of this story.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The reader will find virtually no information about systematic studies of the efficacy of this technique. A 2012 study, not mentioned in this story, did find that the use of TMS in 42 clinics around the country to treat depression and anxiety yielded improvement in more than 50% of the 307 patients examined. But for many people, depressive symptoms return, leading some physicians to recommend “maintenance” TMS sessions every month or so, a process with as yet little systematic evidence to support it.

Those studying TMS acknowledge that much remains to be understood, from the most effective way to administer the technique to its long-term impacts.

Does the story commit disease-mongering?

Not Satisfactory

Serious depression is a killer, and treatments are not consistently effective for many people. But the story misleads with its description of depression.

First, the story relates the old neurotransmitter deficit idea–specifically that of serotonin–which has largely been debunked.

We also take issue with the first line of the article: “One of the leading causes of disability in the United States isn’t physical—it’s mental.”

Mental illness is indeed physical, as the article even mentions when it discusses the “physical” brain changes later in the story.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The one scientist quoted in this story holds patents on several brain stimulation methods and apparatuses, a potential conflict of interest that receives no attention in the story.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story briefly mentions other treatments, such as drugs and talk therapy.

It would have been a stronger effort if it had made an effort to compare success rates.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The story states “its use is federally restricted with exemptions only for those with severe depression.”

This is incorrect and a misinterpretation/misunderstanding of the FDA approved indication for depression. The FDA (the “federal” we assume here) approved TMS for the treatment of depression after a patient fails to respond to one antidepressant, whatever his or her’s degree of depression severity (moderate, severe…). A physician makes the judgement of whether TMS is indicated and can do so even before trying a drug if there is some reason a person cannot tolerate drugs. The FDA does not regulate the practice of medicine.

Does the story establish the true novelty of the approach?

Not Satisfactory

TMS has indeed been around for decades now, 1985 according to the NIMH web site.

Does the story appear to rely solely or largely on a news release?

Satisfactory

While a news release does not seem to be at the base of this story, the text seems to have stemmed in part from another journalistic effort: an NPR story in 2016.  That suggests only modest enterprise work here.

Total Score: 4 of 10 Satisfactory

Comments (4)

Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.

Rob Wipond

April 10, 2017 at 10:24 am

You write: “Mental illness is indeed physical, as the article even mentions when it discusses the “physical” brain changes later in the story.” When I experience anxiety, one may be able to detect common physical changes such as increased heart rate, adrenaline release, and activation of certain areas of the brain. Depressed feelings are often associated with other types of physical shifts. This is not proof, however, of physical brain changes being caused by an “illness” of “anxiety disorder” or “depression”. Besides the debunked serotonin notions, the article you refer to includes a lot more description of highly questionable, unproven notions about the alleged physical aspects of the “illness” of “depression” as if they are established fact. Which ones is HNR suggesting are unquestionably evidence that “depression” is a “physical illness”? By conflating what are essentially some loose, general correlations with strong evidence of causation, it seems you are falling into disease-mongering, too.

Reply

Susan Molchan

April 10, 2017 at 12:02 pm

Thanks for writing Mr. Wipond, and you’re right in saying that just because we can observe physical changes that go along or correlate with our anxiety or depression, whether it’s increased heart rate or increased transcription of a gene, does not mean that these are the cause of our anxiety or depression. Our review here is of one specific article that we hope to clarify, and thereby hopefully improve future articles and discourse on depression and its treatment. I’m not sure where in our review you’re suggesting we are suggesting evidence of causation. For those interested, I found a somewhat old, but still a good review of the multifactorial aspects of depression and ideas about what may happen in the brain to effect symptoms : http://www.health.harvard.edu/mind-and-mood/what-causes-depression

Reply

    Rob Wipond

    April 16, 2017 at 9:50 pm

    Ms Molchan: I am aghast and nearly speechless about this article you have posted a link to in response to my comment. The article uses primarily a handful of highly dubious studies to make reams of unverified scientific claims being parroted as if they are indisputable fact, without any critique or independent analysis whatsoever. Doesn’t it? The article is called “What causes depression?” and at least half of it is pumping claims that depressed feelings are caused by things like “genes that make individuals more vulnerable to low moods” and “sluggish production of new neurons in the hippocampus” while “antidepressants do spur the growth and enhanced branching of nerve cells”.Let’s run that article through the HNR review process, please, and see what kind of grade it gets! I’m a health journalist, and I don’t know how HNR can hope to improve news coverage of psychiatric science if these are the kinds of articles that you point to as a “good review” of pertinent scientific issues.

    Reply

      Kevin Lomangino

      April 17, 2017 at 7:35 am

      Rob,

      Your response to Dr. Molchan’s comment seems a bit over the top itself. “Aghast and nearly speechless”? “Reams of unverified scientific claims being parroted as if they are indisputable fact”? I read the piece and wouldn’t have characterized it that way at all. Although I’m happy to share your viewpoint with readers, I think this thread of discussion is becoming repetitive.

      Kevin Lomangino
      Managing Editor