Scott Alexander examines whether psychiatrists should test for lead more often, concluding that while it could be relevant in some cases, there's not enough evidence to justify universal testing. Longer summary

Scott Alexander discusses the question of whether psychiatrists should test for lead more often in patients with mental health issues. He presents a case where lead poisoning was found to be a factor in a patient's psychiatric symptoms, and explores the broader implications of this. Scott then examines the complexities of deciding which potential factors to test for in psychiatric practice, given the numerous possible causes of depression and other mental health issues. He argues that while lead could be a factor in some cases, there's insufficient evidence to justify universal testing. He also discusses the challenges of interpreting and acting on test results, especially when they fall within normal ranges. Scott concludes by reflecting on different approaches to medical practice and the difficulties of balancing evidence-based guidelines with emerging theories and individual clinical judgment. Shorter summary

Scott Alexander explores two contrasting attitudes in psychiatry, discussing their merits and pitfalls, while reflecting on his own tendency to favor a more straightforward approach. Longer summary

Scott Alexander discusses two contrasting attitudes in psychiatry: Attitude 1, which takes patients' requests at face value, and Attitude 2, which seeks to unravel underlying complexities. He provides examples where Attitude 2 is clearly beneficial, but also highlights its potential for misuse. The author admits to leaning towards Attitude 1, partly due to personal preferences and social pressures. He expresses uncertainty about whether this approach is always correct and worries about potentially missing important underlying issues. The post reflects on the challenges of balancing these approaches in psychiatric practice. Shorter summary

Scott Alexander argues for the use of probabilities in decision-making even without well-defined models, using examples to show why this approach is necessary and beneficial in real-world situations. Longer summary

Scott Alexander argues against the idea that probabilities should not be used without well-defined models. He presents scenarios where probability judgments are necessary even in novel situations, such as alien contact or evaluating research proposals. The post discusses the importance of making probability estimates in real-world decisions, even when precise models are unavailable. Scott acknowledges some valid criticisms but ultimately argues that using probabilities allows for better decision-making, accuracy checking, and challenging overconfidence. He suggests that alternatives to probabilistic thinking fall short when faced with real-world choices. Shorter summary

Scott examines how rare but severe drug side effects often lead to underprescription compared to drugs with common but less severe side effects, potentially resulting in suboptimal patient care. Longer summary

This post discusses the issue of rare but severe side effects in psychiatric medications versus common but less severe side effects. Scott uses two main examples: nefazodone vs SSRIs for depression, and modafinil vs Adderall for stimulants. He argues that drugs with rare but spectacular side effects (like nefazodone and modafinil) are often underprescribed compared to drugs with more common but less severe side effects (like SSRIs and Adderall). The post explores the reasons for this, including doctors' risk aversion, lawsuit concerns, and media coverage of rare side effects. Scott suggests that this pattern may lead to suboptimal treatment choices for patients. Shorter summary