We’ve never seen such a mass amount of media coverage about the weakness of bio-psychiatry before. It’s quite amazing and one wonders where it will lead. Today the Wall Street Journal continues the dialogue:
To flip through the latest draft of the American Psychiatric Association’s Diagnostic and Statistical Manual, in the works for seven years now, is to see the discipline’s floundering writ large. Psychiatry seems to have lost its way in a forest of poorly verified diagnoses and ineffectual medications. Patients who seek psychiatric help today for mood disorders stand a good chance of being diagnosed with a disease that doesn’t exist and treated with a medication little more effective than a placebo.
Psychopharmacology, or the treatment of the mind and brain with drugs, has come to dominate the field. The positive side is that many illnesses respond readily to medication. The negative side is that the pharmaceutical industry seeks the largest possible market for a given drug, and advertises huge diseases, such as major depression and schizophrenia, the scientific status of which makes insiders uneasy.
In the 1950s and ’60s, when psychiatry was still under the influence of the European scientific tradition, reasonably accurate diagnoses still sat at center stage. If you felt blue, uneasy and generally jumpy, “nerves” was a common diagnosis. For the psychotherapeutically oriented psychiatrists of the day, “psychoneurosis” was the equivalent of nerves. There was no point in breaking these terms down: clinicians and patients alike understood “a case of nerves,” or a “nervous breakdown.”
Our psychopathological lingo today offers little improvement on these sturdy terms. A patient with the same symptoms today might be told he has “social anxiety disorder” or “seasonal affective disorder.” The increased specificity is spurious. There is little risk of misdiagnosis, because the new disorders all respond to the same drugs, so in terms of treatment, the differentiation is meaningless and of benefit mainly to pharmaceutical companies that market drugs for these niches. read the rest