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New version of Mindsite is up now - check it out and leave us feedback please.  Related note, great article and image in the NY Times today.

We've been on a blogging hiatus, working on a new version of Mindsite that will ship shortly - sorry for the blogging interruption and stay tuned for our new release. In the mean time, it was tough to pass up writing a quick note on a fascinating article that just came out by Benedict Carey at the NY Times on a new theory about the mind as it relates to our genes.

Their idea is, in broad outline, straightforward. Dr. Crespi and Dr. Badcock propose that an evolutionary tug of war between genes from the father’s sperm and the mother’s egg can, in effect, tip brain development in one of two ways. A strong bias toward the father pushes a developing brain along the autistic spectrum, toward a fascination with objects, patterns, mechanical systems, at the expense of social development. A bias toward the mother moves the growing brain along what the researchers call the psychotic spectrum, toward hypersensitivity to mood, their own and others’. This, according to the theory, increases a child’s risk of developing schizophrenia later on, as well as mood problems like bipolar disorder and depression.

In short: autism and schizophrenia represent opposite ends of a spectrum that includes most, if not all, psychiatric and developmental brain disorders. The theory has no use for psychiatry’s many separate categories for disorders, and it would give genetic findings an entirely new dimension.

While these theories will undoubtedly remain highly controversial for some time, they are a fascinating new lens to view the topology of mental health disorders currently detailed in the DSM-IV. You can read the full DSM-IV text at Mindsite on Autism as well as Schizophrenia. The implication that all human mental health can be characterized as a continuum of predisposition between these two conditions is definitely very 'out of the box' thinking; only time will tell if there is an evidence base to support these assertions.

Guy Kawasaki recently worked with us to ink a humorous spoof "How to Tell If Your Boss is Crazy" and just posted it on his blog with the full text on the American Express Open Forum. We used the DSM-IV criteria for Narcissistic Personality Disorder, Paranoid Personality Disorder, Obsessive-Compulsive Personality Disorder, and Anti-Social Personality Disorder to play off popular sterotypes of problematic managers. We originally pitched an idea to Guy on psychoanalyzing Steve Jobs, but his comment was on that plan was merely "not interested."

Guy has a bunch of really cool materials out there including a whole bunch of books, a new blog network called Alltop, and of lots of inspirational speaking about early stage technology companies including my all-time favorite from TIECon 2006, below.

For people who encounter mental health issues, a perennial question must be answered, namely 'should I think about meds or psychotherapy.' Often, that question is answered for them based on which type of health care provider they see such as a psychologist or therapist vs. a psychiatrist or internist. At Mindsite, we hope to provide tools and features going forward that better educate people about what is best for them when making this critical decision.

Recently, a new study published in the Archives of General Psychiatry found that for people who seek help from a psychiatrist, the emphasis on medication is increasing. Denise Gellene from the LA Times reports that this trend may be driven by insurance reimbursement:

Psychiatrists who said they provided psychotherapy to all of their patients declined to 10.8% in 2004-2005 from 19.1% in 1996-1997, according to the report. Consistent with previous studies, researchers found that patients who paid out-of-pocket, generally the wealthiest patient group, were more likely to receive psychotherapy.

Financial incentives were weighted against psychotherapy, the report said. Reimbursement for a 45- to 50-minute outpatient psychotherapy session was 40.9% lower than reimbursement for three 15-minute medication management visits, the report said, citing a 2003 study. Anticipated changes in Medicare reimbursement are expected to bring payments into closer balance, experts said.

Another interesting section from the article noted:

The report found evidence of a cultural preference for psychotherapy in the Northeast, which Olfson said might be attributable to the influence of Yale University School of Medicine and the University of Pennsylvania School of Medicine, whose faculties are strong proponents of psychotherapy.

Has anyone seen The Dark Knight? We were thinking of checking it out this week. Looks like a solid review on Rotten Tomatoes. Interesting excerpt including DSM-IV references from another review on TimeOut Chicago:

Nolan’s sequel to 2005’s Batman Begins internalizes the schism between serious aims and summer-movie duties. The problem isn’t the admittedly jaw-dropping Sturm und Drang—this is Batman, not Bergman—but how the pummeling action rarely informs the psychological angst. Still wrestling with a DSM-IV’s worth of disorders, the Caped Crusader (Bale) now has to contend with Harvey Dent (Eckhart), a district attorney with a transformative face-lift coming his way, and the Joker (Ledger). Thankfully, an origin story isn’t offered for the grinning archnemesis; he simply appears like the Ebola virus, armed with an appetite for destruction and John Wayne Gacy’s makeup manual. What the late actor accomplishes with little more than a nurse uniform and a Groucho Marx waddle makes the various set pieces—never mind Bale’s raspy, remote characterization—pale in comparison.