Following the current epidemic of obesity, the worldwide prevalence of nonalcoholic fatty liver disease(NAFLD)has increased with potential serious health implications. While it is established that in adults NAFLD can ...Following the current epidemic of obesity, the worldwide prevalence of nonalcoholic fatty liver disease(NAFLD)has increased with potential serious health implications. While it is established that in adults NAFLD can progress to end-stage liver disease in many cases, the risk of progression during childhood is less well defined. Since most obese children are not adherent to lifestyle modifications and hypocaloric diets, there is a growing number of studies on pharmacological interventions with the risk of disease mongering, the practice of widening the boundaries of illness in order to expand the markets for treatment. Here, we propose a critical appraisal of the best available evidence about long-term course of pediatric NAFLD and efficacy of treatments other than hypocaloric diet and physical exercise. As a result, the number of NAFLD children with a poor outcome is small in spite of the alarming tones used in some papers; large-scale longitudinal studies with longterm follow-up of pediatric NAFLD patients are lacking; the studies on ancillary pharmacological interventions have been performed in few patients with inconclusive and conflicting results.展开更多
The growing number of people suffering from depression has become a social problem in Japan. The problems associated with depression in Japan have been influenced by the pharmaceuticalization of mental health. Since s...The growing number of people suffering from depression has become a social problem in Japan. The problems associated with depression in Japan have been influenced by the pharmaceuticalization of mental health. Since selective serotonin reuptake inhibitors were introduced to Japan＇s pharmaceutical market in 1999, demand for anti-depressant medications has rapidly expanded. It seems likely then that the efforts of pharmaceutical companies, as part of their marketing strategies, to increase people＇s awareness of mental illness have led people who are not actually depressed to have medical consultations and drug treatments for it. This phenomenon is known as ＂disease mongering＂ and has been reported on. Problems exist from the medical perspective also and include the following： expansion of the diagnostic criteria for depression as formulated in the American Psychiatric Association＇s Diagnostic and Statistical Manual of Mental Disorders; treatments that rely heavily on drugs; and biomedicalization. Another reason for the increase in medical consultations is the declining function of communal bodies. This has resulted in individuals struggling psychologically, for example, with anxiety, worry, and depression. In summary, this sociological research analyzed the problems of depression in ｜apan and revealed how the pharmaceuticalization of mental health accelerates the individualization of social problem.展开更多
文摘Following the current epidemic of obesity, the worldwide prevalence of nonalcoholic fatty liver disease(NAFLD)has increased with potential serious health implications. While it is established that in adults NAFLD can progress to end-stage liver disease in many cases, the risk of progression during childhood is less well defined. Since most obese children are not adherent to lifestyle modifications and hypocaloric diets, there is a growing number of studies on pharmacological interventions with the risk of disease mongering, the practice of widening the boundaries of illness in order to expand the markets for treatment. Here, we propose a critical appraisal of the best available evidence about long-term course of pediatric NAFLD and efficacy of treatments other than hypocaloric diet and physical exercise. As a result, the number of NAFLD children with a poor outcome is small in spite of the alarming tones used in some papers; large-scale longitudinal studies with longterm follow-up of pediatric NAFLD patients are lacking; the studies on ancillary pharmacological interventions have been performed in few patients with inconclusive and conflicting results.
文摘The growing number of people suffering from depression has become a social problem in Japan. The problems associated with depression in Japan have been influenced by the pharmaceuticalization of mental health. Since selective serotonin reuptake inhibitors were introduced to Japan＇s pharmaceutical market in 1999, demand for anti-depressant medications has rapidly expanded. It seems likely then that the efforts of pharmaceutical companies, as part of their marketing strategies, to increase people＇s awareness of mental illness have led people who are not actually depressed to have medical consultations and drug treatments for it. This phenomenon is known as ＂disease mongering＂ and has been reported on. Problems exist from the medical perspective also and include the following： expansion of the diagnostic criteria for depression as formulated in the American Psychiatric Association＇s Diagnostic and Statistical Manual of Mental Disorders; treatments that rely heavily on drugs; and biomedicalization. Another reason for the increase in medical consultations is the declining function of communal bodies. This has resulted in individuals struggling psychologically, for example, with anxiety, worry, and depression. In summary, this sociological research analyzed the problems of depression in ｜apan and revealed how the pharmaceuticalization of mental health accelerates the individualization of social problem.
