Wit and cleverness are wonderful things, but sometimes it’s best to just tell the story as it is.
An Aug. 4 post by Andrea Walker for The Baltimore Sun begins this way:
Are people taking antidepressants when they don’t need the drugs?
Are we becoming a nation who needs drugs to wipe away our sorrows?
A new study by Johns Hopkins researchers suggests we could at least be headed that way.
That’s a clever start. And witty. But misleading. The study that Walker is reporting doesn’t say where we’re heading, whether people who don’t need antidepressants are getting them, or what we need to wipe away our sorrows.
After this creative opening, Walker gets closer to what the study said–and that is where she should have begun. Not everyone who takes psychiatric drugs was diagnosed with a psychiatric ailment, she reports, and many of those prescriptions were written by doctors who were not psychiatrists.
David W. Freeman on CBS.com begins with the rare triple negative: “Not depressed? That doesn’t mean your doctor won’t hand you a prescription for antidepressants.” Stunning in its virtuosity, it requires the reader to stop and parse the verbs before continuing with the story–or clicking out of it. Like Walker, Freeman does better when he gets beyond his clever lede:
More and more doctors are prescribing the drugs for patients who aren’t suffering from depression or any other mental illness, according to a provocative new study.
At The Huffington Post, Catherine Pearson serves us better by playing it straight. Her lede: “Antidepressants are increasingly prescribed for people who have not been diagnosed with an actual psychiatric disorder, according to a new study that raises questions about whether or not the drugs are being prescribed inappropriately or too often.”
To get a better fix on this, let’s take a look at the study. (Oddly, both the Sun and Huff link to the journal where the study appeared–Health Affairs–rather than to the study.) This is not a complicated, statistically tricky story, and the authors of the study write their conclusion in plain language. Antidepressant use has grown over the past two decades, they write, and “Much of this growth has been driven by a substantial increase in antidepressant prescriptions by nonpsychiatrist providers without an accompanying psychiatric diagnosis.”
That’s pretty nicely said. You could cut a few words from that, and it would make a pretty good lede–and an accurate one.
They go on to clarify, and they do a better job of qualifying the findings–again, in plain language–than many of the stories do.
These results do not clearly indicate a rise in inappropriate antidepressant use, but they highlight the need to gain a deeper understanding of the factors driving this national trend and to develop effective policy responses…there may be a need to improve providers’ prescribing practices, revamp drug formularies, or vigorously pursue implementation of broad reforms of the health care system that will increase communication between primary care providers and mental health specialists.
This wasn’t a tough study to cover, but some reporters made it harder than it had to be, and, in the process, were not as accurate as they might have been.
A quick look at a few others:
WebMD: “Antidepressants may be increasingly prescribed by non-psychiatrists to treat medical disorders in the absence of a psychiatric diagnosis.” That lede is weaker than it might have been, speculating about what’s happening now, rather than reporting what the study found. Denise Mann would have done better to drop that sentence and begin with her second, much stronger, graf: “The proportion of non-psychiatrist doctor visits where antidepressants were prescribed without a documented psychiatric diagnosis increased from 59.5% to 72.7% between 1996 and 2007, according to a new study in Health Affairs.” That would have been my favorite lede of the bunch–if it had been the lede.
Wall Street Journal: Shirley S. Wang avoids the cleverness trap, but gets only part of the story in her lede, without much detail: “More people without any documented psychiatric condition are taking antidepressants, according to a study being published Thursday, and some of them are likely receiving little benefit.” Instead of speculating on the benefit, she might have done better to add that the prescriptions are coming from non-psychiatrists.
Kaiser Health News: Jenny Gold gives us two sentences of background before giving us the news: “Antidepressants are the third most common type of medication prescribed in the U.S., with $10 billion a year in sales. Nearly three out of four of those prescriptions are written by non-psychiatric providers (many of them primary care physicians). A study in the journal Health Affairs reports that a growing number of patients receiving antidepressants from a doctor who isn’t a psychiatrist aren’t given an accompanying psychiatric diagnosis.” Better to flip ’em around–news first, background second.
NPR blog: Nancy Shute plays it straight, and gets the two findings (increasing prescriptions and non-psychiatrists) in the first two sentences, along with reasonable speculation: “Antidepressants have become some of the most commonly used drugs in the United States, yet most of them aren’t prescribed by psychiatrists. And what’s more, almost three-quarters of the prescriptions are written without a specific diagnosis, according to a new study, raising the question of whether antidepressants are being prescribed too often.” Nicely done.
– Paul Raeburn
Leave a Reply