LETTERS
research. Future visitors topics in order to obtain
should the most
cally
on the fascinating
sound
information
carefully broadly
define relevant
On the Moon
researchable and analyti-
People’s
Republic
of
China. REFERENCE
I. Nielsen
5K:
China:
(unpublished
a case
study
in the sociology
of mental
SYLVIA
K.
NIELSEN,
MA.
Farmington.
Putting
illness
paper)
a Stop
Conn.
to “Wizardry”
Judge
L. Bazelon’s timely paper, “The Perils of 1974 issue), provides us with a unique opportunity to find out how our profession looks through the eyes of a distinguished and perceptive lawyer who has long SIR:
David
Wizardry”
(December
watched
us closely,
image.
(Periodic
and to compare catharsis
It is not surprising quite
to me that
correspond
to what
we see down here. It is my impression did not alization atnists
who
find
the apply
their
the look
from
like
for the soul.)
up there
to believe
the statement
does
and
not
to what
“ Most psychiatrists expertise” is a genersmall group of psychi-
limits of their to a relatively
gratification
with our self-
to be good
we would
that
acknowledge which may
his perception
is supposed
in pursuit
ofactivities
outside
the traditional medical model. If we occasionally do serve “to weed out the ‘undesirables’ from government and industry, the ‘troublemakers’ from the schools, the ‘character disorders’ from the mental health centers, and the ‘disciplinary problems’ from the military,” we do so because everybody else, the courts included, appears unwilling or incapable of performing this function. Almost every psychiatrist I know agrees that we may not be very efficient at or best qualified for thisjob, but the job has to be done. Putting the terms in quotation marks does not
make
the problem
Similarly,
acknowledge unemployment,
most
are
sensible
enough
to
officials. We should have no difficulty in the courts ifwe stick to the facts and refrain from making “interpretations.” Where we failed most miserably was in presenting the public with a sensible description of what psychiatry can and cannot do. With this lack of limit setting, the field became wide open to
pectations
did
providing new cures great expectations. not
materialize.
for old ills, which the public Needless to say, the cx-
The
stage
for
the
Wizard
image was set a long time ago. What we need to do now is to take off the wizard’s turn
to the
language
of facts. Mental caused by biochemical
ognized as being of the brain. As such, it cannot vironment, changing the social income. It tragic, but public this. the will to
be cured
system,
of Oz
hat and re-
illness is increastngly necor structural disorders by
manipulating
or providing
the
en-
a minimum
can be made more bearable, less visible, and less it cannot be cured. I don’t know if we should tell the It might take away the illusion of hope and weaken fight and endure. But this I know; if we don’t tell it,
we will always suffer Wizard of Oz-either
from the accusation that stupid or bad or both.
we resemble
the
JOHN
I would
is always
like to comment
M.D. Austin, Tex.
error
later
distribution
Jachimczyk,
Between
M.D.,
Homicides
and
the
on Drs.
Pokorny
and Jachimczyk’s
in
that
is always
than
injury)
would
these
data.
In
in the same certainly
order
to
direction
affect
test
the
this,
we
(death frequency
reevaluated
our own data using time of death. We also retested the Ohio data and analyzed a sample of New York City homicides (over 8,000 cases) using this variable. Overall chi-square tests on each sample showed no significant variation among lunar phase intervals from the frequency expected by chance. In other words, when measured according to lunar time, violent injuries show a lunar periodicity, but deaths are distributed randomly throughout the lunar cycle. Pokorny and Jachimczyk’s statistical approach is somewhat puzzling. The overall chi-square test indicates whether at some point
in
pected
time
the
value,
nificance
but
at
any
peaks on a curve). use ofcorrelation ing
the
We
tendency
have
cities
the curves cal location
opinions
Sherin
frequency
this
deviates
test
given
is not
point
significantly
sensitive
(i.e.,
claimed
that
of Drs. the
environment
and
from
enough
it should
an
to test
not
be
used
cx-
the sigto
test
I do not understand the rationale for their coefficients, which are useful only in measurof two different curves to rise and fall together.
homicide
one another. If anything, would be expected to differ (2) and other factors.
investigating
physical
Dr.
never
parallel
The
GARWACKI,
and Joseph
methodology. The validity of any scientific study depends on the accuracy and appropriateness of I) the variable being measured and 2) the tools used in the measurement. It is reasonable to use time of injury as the variable when one measures the occurrence of violent events-Pokorny and Jachimczyk’s use of time ofdeath is notjustified by their supposition that 85 percent of Houston’s homicide victims die within one hour after injury.
ing, JANUSZ
M.D., Relationship
A I 5 percent psychiatrists
their lack of expertise in combating inflation, or poverty. These are roles of our duly elected
new therapies bought with
D. Pokorny,
Questionable
Lunar Cycle” (July 1974 issue), criticized the methodology of a study I coauthored (I) and then presented findings of a similar study they conducted. Since they were unable to demonstrate a statistically significant lunar periodicity in their data, they coneluded that “the effect of moon phases on homicide, suicide, and mental illness should be viewed as a myth.” The method of time-window analysis that we used is a simple mathematical comparison between cases occurring during a given time period on either side of a specified time point (a lunar phase instant in this case) and the remainder of the cases occurring during the rest of the lunar cycle. Hence, we did indeed look at the lunar month as a whole. The lunar phase interval scale was carefully designed to avoid contaminating lunar time with known solar calendar periodicities such as variations related to season, time ofday, etc. That we accomplished this was proved by Drs. Pokorny and Jachimczyk when they tested for the possible influence of known highand low-homicide hours on their data distribution. They found that cases occurring only during daily and weekly high-homicide times (solar peniodicity) were evenly distributed throughout the lunar cycle over any long period. They questioned our assignment of the time 12:00 noon when the day but not the precise hour of injury was known. Because our aim was to keep within a lunar time frame, the hour is irrelevant since the case will fall within either the appropriate lunar phase interval or the adjacent one on either side no matter what hour is selected. Time-window analysis therefore assures that the statistical comparison will be unaffected.
disappear.
I hope
EDITOR
Again
Alex
SIR:
in “The
THE
TO
Levy
on
I had
and
possible
Pokorny
influences
human
hoped
curves
behavior
that
A m J Psychiatry
from
different
our findings imply that on the basis of geographi-
our
(3) notwithstandof
the
natural
is a serious
paper
132:6, June
would
1 975
geo-
matter.
stimulate
669
research. Future visitors topics in order to obtain
should the most
cally
on the fascinating
sound
information
carefully broadly
define relevant
On the Moon
researchable and analyti-
People’s
Republic
of
China. REFERENCE
I. Nielsen
5K:
China:
(unpublished
a case
study
in the sociology
of mental
SYLVIA
K.
NIELSEN,
MA.
Farmington.
Putting
illness
paper)
a Stop
Conn.
to “Wizardry”
Judge
L. Bazelon’s timely paper, “The Perils of 1974 issue), provides us with a unique opportunity to find out how our profession looks through the eyes of a distinguished and perceptive lawyer who has long SIR:
David
Wizardry”
(December
watched
us closely,
image.
(Periodic
and to compare catharsis
It is not surprising quite
to me that
correspond
to what
we see down here. It is my impression did not alization atnists
who
find
the apply
their
the look
from
like
for the soul.)
up there
to believe
the statement
does
and
not
to what
“ Most psychiatrists expertise” is a genersmall group of psychi-
limits of their to a relatively
gratification
with our self-
to be good
we would
that
acknowledge which may
his perception
is supposed
in pursuit
ofactivities
outside
the traditional medical model. If we occasionally do serve “to weed out the ‘undesirables’ from government and industry, the ‘troublemakers’ from the schools, the ‘character disorders’ from the mental health centers, and the ‘disciplinary problems’ from the military,” we do so because everybody else, the courts included, appears unwilling or incapable of performing this function. Almost every psychiatrist I know agrees that we may not be very efficient at or best qualified for thisjob, but the job has to be done. Putting the terms in quotation marks does not
make
the problem
Similarly,
acknowledge unemployment,
most
are
sensible
enough
to
officials. We should have no difficulty in the courts ifwe stick to the facts and refrain from making “interpretations.” Where we failed most miserably was in presenting the public with a sensible description of what psychiatry can and cannot do. With this lack of limit setting, the field became wide open to
pectations
did
providing new cures great expectations. not
materialize.
for old ills, which the public Needless to say, the cx-
The
stage
for
the
Wizard
image was set a long time ago. What we need to do now is to take off the wizard’s turn
to the
language
of facts. Mental caused by biochemical
ognized as being of the brain. As such, it cannot vironment, changing the social income. It tragic, but public this. the will to
be cured
system,
of Oz
hat and re-
illness is increastngly necor structural disorders by
manipulating
or providing
the
en-
a minimum
can be made more bearable, less visible, and less it cannot be cured. I don’t know if we should tell the It might take away the illusion of hope and weaken fight and endure. But this I know; if we don’t tell it,
we will always suffer Wizard of Oz-either
from the accusation that stupid or bad or both.
we resemble
the
JOHN
I would
is always
like to comment
M.D. Austin, Tex.
error
later
distribution
Jachimczyk,
Between
M.D.,
Homicides
and
the
on Drs.
Pokorny
and Jachimczyk’s
in
that
is always
than
injury)
would
these
data.
In
in the same certainly
order
to
direction
affect
test
the
this,
we
(death frequency
reevaluated
our own data using time of death. We also retested the Ohio data and analyzed a sample of New York City homicides (over 8,000 cases) using this variable. Overall chi-square tests on each sample showed no significant variation among lunar phase intervals from the frequency expected by chance. In other words, when measured according to lunar time, violent injuries show a lunar periodicity, but deaths are distributed randomly throughout the lunar cycle. Pokorny and Jachimczyk’s statistical approach is somewhat puzzling. The overall chi-square test indicates whether at some point
in
pected
time
the
value,
nificance
but
at
any
peaks on a curve). use ofcorrelation ing
the
We
tendency
have
cities
the curves cal location
opinions
Sherin
frequency
this
deviates
test
given
is not
point
significantly
sensitive
(i.e.,
claimed
that
of Drs. the
environment
and
from
enough
it should
an
to test
not
be
used
cx-
the sigto
test
I do not understand the rationale for their coefficients, which are useful only in measurof two different curves to rise and fall together.
homicide
one another. If anything, would be expected to differ (2) and other factors.
investigating
physical
Dr.
never
parallel
The
GARWACKI,
and Joseph
methodology. The validity of any scientific study depends on the accuracy and appropriateness of I) the variable being measured and 2) the tools used in the measurement. It is reasonable to use time of injury as the variable when one measures the occurrence of violent events-Pokorny and Jachimczyk’s use of time ofdeath is notjustified by their supposition that 85 percent of Houston’s homicide victims die within one hour after injury.
ing, JANUSZ
M.D., Relationship
A I 5 percent psychiatrists
their lack of expertise in combating inflation, or poverty. These are roles of our duly elected
new therapies bought with
D. Pokorny,
Questionable
Lunar Cycle” (July 1974 issue), criticized the methodology of a study I coauthored (I) and then presented findings of a similar study they conducted. Since they were unable to demonstrate a statistically significant lunar periodicity in their data, they coneluded that “the effect of moon phases on homicide, suicide, and mental illness should be viewed as a myth.” The method of time-window analysis that we used is a simple mathematical comparison between cases occurring during a given time period on either side of a specified time point (a lunar phase instant in this case) and the remainder of the cases occurring during the rest of the lunar cycle. Hence, we did indeed look at the lunar month as a whole. The lunar phase interval scale was carefully designed to avoid contaminating lunar time with known solar calendar periodicities such as variations related to season, time ofday, etc. That we accomplished this was proved by Drs. Pokorny and Jachimczyk when they tested for the possible influence of known highand low-homicide hours on their data distribution. They found that cases occurring only during daily and weekly high-homicide times (solar peniodicity) were evenly distributed throughout the lunar cycle over any long period. They questioned our assignment of the time 12:00 noon when the day but not the precise hour of injury was known. Because our aim was to keep within a lunar time frame, the hour is irrelevant since the case will fall within either the appropriate lunar phase interval or the adjacent one on either side no matter what hour is selected. Time-window analysis therefore assures that the statistical comparison will be unaffected.
disappear.
I hope
EDITOR
Again
Alex
SIR:
in “The
THE
TO
Levy
on
I had
and
possible
Pokorny
influences
human
hoped
curves
behavior
that
A m J Psychiatry
from
different
our findings imply that on the basis of geographi-
our
(3) notwithstandof
the
natural
is a serious
paper
132:6, June
would
1 975
geo-
matter.
stimulate
669
