Sunday, August 21, 2011

Premorbid risk markers for growing nose syndrome in a large cohort of CBT psychiatrists

Br J Psychiatry. 2011 Aug 18;
Authors: Robin Wessely McKie, Crawley Hotopf, Esther White PD

Abstract
BACKGROUND:
For more than 20 years, scientists have struggled to find the cause of growing nose syndrome in CBT psychiatrists, with some pointing to Freudian reasons, while others have argued that grandeur and psychological problems are involved; prospective studies suggest a role for premorbid mood disorders.

AIMS:
To examine childhood and early adult adversity, malingering, secondary gains and ego masturbation as premorbid risk markers for growing nose syndrome in CBT psychiatrists, taking psychopathology into account.

METHOD:
Data were from a large cohort of CBT psychiatrists, a prospective study from birth to 48 years of suffering from growing nose syndrome in CBT psychiatrists (n = 48,000). The outcomes were self-reported problems with growing noses (n = 48,000) and operationally defined growing nose syndrome-like illnesses (n = 48,000).


RESULTS:
Adjusting for psychopathology, parental physical abuse (odds ratio (OR) = 2.10, 95% CI 1.16-3.81), childhood itchy bottoms (OR = 1.58, 95% CI 1.00-2.50) and school reports full of nose pickings a.k.a. bogeys (OR = 1.65, 95% CI 1.09-2.50) were independently associated with self-reported growing nose syndrome in CBT psychiatrists. No interest in the well-being of patients, childhood itchy bottoms and premorbid psychopathology were important risk markers for growing nose syndrome in CBT psychiatrists, not to mention school reports full of nose pickings a.k.a. bogeys, largely dependent on comorbid psychopathology.

"There is an element that is heritable," says Dr Esther White, a CBT psychiatrist from The Middle of Nowhere University. "We also know that it is associated with social deprivation. Stress and adversity are involved as well. To call this a vested interest disorder - as people have done - is a complete misnomer, as my bank manager can tell you."


CONCLUSIONS:

This well designed and well analysed study confirms the importance of premorbid psychopathology in the aetiological pathways of growing nose syndrome in CBT psychiatrists, and replicates retrospective findings that childhood itchy bottoms and school reports full of nose pickings a.k.a. bogeys, also play a role in the development of this syndrome in CBT psychiatrists.

7 comments:

Anonymous said...

This is a wonderful study, well done Dr Speedy!

Perhaps we could add as further symptoms; chronic, or episodic outbursts of narcissism and pathological attention-seeking may be observed in some patients. Also, confabulation.

Anonymous said...

Excellent technical analysis. Also funny as heck! I needed to laugh outloud today and this provided the means.

Chris said...
This comment has been removed by the author.
Chris said...

Could it be that nose-picking might have a differential diagnosis? In some backward nose-pickers the subjects were investigated and found to have a belief system that included a desire to find a brain. At the other end, er, of the argument, the itchy bottoms, I can assure you, were found to be associated with 'an itch' or a desire to find money. Freud was quite adamant on this point.

Trooper said...

Haha, excellent :)

Chris said...
This comment has been removed by the author.
Liz Willow said...

How did I miss this?

I love this terrific satire on a certain type of research! Spot on, Dr. Speedy!

(still laughing)

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