Richard Bentall in the Washington Post

I love that he’s getting so much coverage! From today’s Washington Post:

Recent decades have seen dramatic improvements in the survival rates of patients suffering from heart diseases and cancer. But the same cannot be said of psychiatric disorders.

So far as we can tell, outcomes for patients suffering from the most severe forms of psychiatric disorders — the psychoses — have hardly changed since the Victorian period. Poor countries without well-resourced psychiatric services seem to do about as well or even better than the developed world. There is therefore little evidence that modern psychiatric services have had a global, positive impact on mental health, but the perception is often different.

The medical historian Edward Shorter has remarked that, “If there is one central intellectual reality at the end of the twentieth century, it is that the biological approach to psychiatry — treating mental illness as a genetically influenced disorder of the brain chemistry — has been a smashing success.”

In fact, the contrary seems to be the case. Attempts to find a genetic basis for schizophrenia or bipolar disorder have led to the identification of a number of candidate genes, for example COMT, NRG1 and DTNBP1, each announced with enormous fanfare. Similarly, huge attention has been given to the discovery of an allele (variant) of one gene, 5-HTTLPR, which appears to make people liable to depression if they are exposed to negative life events.

But, without exception, later studies have failed to replicate these findings. In one of the largest psychiatric genetic studies ever published, which appeared in the American Journal of Psychiatry last year, no association was found between any candidate gene and schizophrenia. A recent analysis of the evidence on 5-HTTLPR found no evidence that the gene directly causes depression, or that it makes people liable to become depressed if something unpleasant happens. However, the study observed a direct relationship between depression and adversity. As our mothers could have told us, bad experiences make us miserable. (read the rest here)

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