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https://twitter.com/vernondavemack/status/1399210502425767937

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Tyler Black, MD

@tylerblack32

31 May

1/ Thread (and it's a big'un!):

Issues with Psychotherapy Research

It is 2021 and virtually none of following major issues have been largely addressed, which severely undermines the practical value of the research.

2/ As a psychiatrist, I am trained in both pharmacotherapy and psychotherapy. I care deeply about evidence in both areas and am a strong proponent of "as many useful tools as I can have to help my patients."

3/ I support, <3, and provide psychotherapy. This is NOT a debunking of it, nor would I dissuade a single soul from taking it or providing it. For children and adolescents, psychotherapy is essential and should be considered first line in most situations.

Read 32 tweets

Tyler Black, MD

@tylerblack32

30 May

https://twitter.com/ElleMandell/status/1398865634256207873

Great paper out of Ontario - showing a number of things.

* Drug overdoses went up significantly during the pandemic period

* Fentanyl overdoses went up very significantly (76% detected in deaths prior to the pandemic, 86% after)

/1

https://twitter.com/ElleMandell/status/1398865634256207873

* the drug overdose increase was much worse for men than women

* it affected rural areas and urban centers alike

* improvements in drug overdose deaths in 2019 disappeared completely

/2

Though I'm really not a fan of the younger age grouping (15-34) because it will be misintrepreted. I am quite certain that the rates of 15-19 year olds are 1-3% of the 20-34 group, and this subset should have been removed/isolated.
/3

Read 5 tweets

Tyler Black, MD

@tylerblack32

28 May

1/ Report analysis:
Adolescent Boys vs Girls during the Pandemic

A new article is out comparing Suicide Attempt frequency (12-18y) in Catalonia during the pandemic.

It's a succinct article that presents data from the population-level registry that was in place prior to COVID.

2/ Unfortunately (I really wish they would not do this), it only compares one pre-pandemic year to 2020-21, but this is also a very interesting study because, famously, Catalonia had a devastating early first wave, significant lockdown, then reopening of schools.

3/ What did they do?

They used the CSRC (a database of suicide attempts estbalished in a suicide prevention effort) to look at # of attempts in the year prior to, and the first year of, the pandemic.

Read 21 tweets

Tyler Black, MD

@tylerblack32

27 May

This brandism in psychotherapy twitter is awful. If you spend time tweeting that "x isn't real therapy" you are the problem.

Therapy is when a form of communication is used by a mental health professional to the betterment and improvement of quality or understanding of life.

There are people who due to neurodiversity, disability, history, or even preference who may prefer therapy via one modality over another.

Get over your effing selves and help your patients.

I've seen "short term isn't real therapy", "texting isn't real therapy", and "CBT isn't real therapy" in the past 3 days and they are coming from the same snooty mindset that gutted certain psychotherapies in the 70s.

Stop believing in your brand and learn multiple modalities.

Read 4 tweets

Tyler Black, MD

@tylerblack32

23 May

A lot of people found out that I block them very easily and quickly?

I block:
1) disrespect
2) anti-science, anti-psychiatry (not criticism, anti. Did a whole article on it.)
3) racism/bigotry/misogyny/transphobia/homophobia/ableism
4) shaming patients
5) my discretion

/1

I will quickly click on someone's timeline and read maybe 10 maybe 20 tweets. It's pretty obvious who they are by that point.

I even discuss the nuances of lived experience, blocking, etc, here: tylerblack.com/twitter

/2

I love debate, I love criticism. I myself criticize psychiatry a lot and beleive that criticism has proven to be necessary to good change in my field, medicine as a whole, and life.

But I'm also a 36-year online veteran. I can tell when you're there to pick fights/troll. /3

Read 4 tweets

Tyler Black, MD

@tylerblack32

23 May

https://twitter.com/NateSilver538/status/1396261412910112769

Here, Nate, with his tremendous reach and followers, makes the common stigmatizing mistake of associating suicides with mental health. Many people with mental health problems don't die by suicide (99% plus!). Many people who die by suicide did not have MH problems (~50%)
/1

https://twitter.com/NateSilver538/status/1396261412910112769

I missed due to an awful type of study called the psychological autopsy has established this untrue "fact" that most suicides are due to Mental Health problems.

As a suicideologist I can confidently say that this is a stigmatizing, narrow, and extremely evidence-free position./2

People in good mental health can die by suicide, and people with poor mental health can lead rich and amazing lives free of suicidality.

Please stop making this mistake, Nate, and anyone else who is reading this.

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Tyler Black, MD

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