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… Marcia Angell highlights the corruption of academic psychiatry:

Drug companies are particularly eager to win over faculty psychiatrists at prestigious academic medical centers. Called “key opinion leaders” (KOLs) by the industry, these are the people who through their writing and teaching influence how mental illness will be diagnosed and treated. They also publish much of the clinical research on drugs and, most importantly, largely determine the content of the DSM. In a sense, they are the best sales force the industry could have, and are worth every cent spent on them…

[T]here are no objective signs or tests for mental illness — no lab data or MRI findings -and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that…

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Related.

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Also related. If you can read this article without wanting to vomit, you’re a better man than I am.

Once the medical establishment started buying into the idea of bipolar kids in the 1990s, the diagnosis gained unusual force. In 2000 the National Institute of Mental Health convened a roundtable of researchers in pediatric bipolar disorder and financially supported several controversial propositions, including the practice of asking bipolar adults to date the origins of their own disease. The creation of a new source of funding generated frenetic activity among university psychiatrists, and in a twinkling it created stakeholders in the diagnosis.

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3 Responses to “In the second part of her important New York Review of Books series on psychiatry…”

  1. Margo Says:

    I’m not a psychiatrist, I’m a patient. Anti-depressant drugs have been a life-saver for me. They enabled me to get through high school and graduate from college.

    It’s fashionable to bash on mental illness but I’d like to point out that everything that Dr. Angell says about mental illness can be said of Parkinsons Disease, too. Yet, because neurologists treat PD, it’s somehow treated with more respect.

  2. Bernard Carroll Says:

    I take your point, Margo, and it is helpful for patients like you who have genuinely been helped by psychiatric medications to say so. Such individuals are indeed out there, and we critics of the current scene need to be careful not to dismiss those successes.

    At the same time, Marcia Angell’s case documenting the over promotion and overselling of these medications is persuasive. Much of current psychiatric drug use is futile, and it carries real risks of physical and neurological harm.

    Here is a fuller discussion over on Health Care Renewal:
    In Defense of Psychiatric Diagnoses and Treatments 04-02-2009
    http://hcrenewal.blogspot.com/2009/04/in-defense-of-psychiatric-diagnoses-and.html

  3. dmf Says:

    I had to stop working with kids and their families b/c of these nightmare diagnoses/tx. Everything becomes an extension of a ‘disease’ that has a medication. The worse slippery slope is the childhood social disorders of attention and mood that when unchecked bloom into “personality” disorders which are now also being rewritten as “bipolar”. There are widespread “public health” screenings in schools in states like NY that will require psychiatic evaluations to get reimbursed for services and when one has a diagnosis medication tx isn’t far behind. Not only are we severely mistreating these children but we are creating a whole underclass of people whose status as citizens, which depends on their mental capacities, has been put in doubt.

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