New Scientist: Psychiatry divided as mental health ‘bible’ denounced
The world’s biggest mental health research institute is abandoning the new version of psychiatry’s “bible”…
The world’s biggest mental health research institute is abandoning the new version of psychiatry’s “bible”…
When Mark Twain’s hero Huckleberry Finn was forced to study spelling for an hour every day, he said, “I couldn’t stand it much longer. It was deadly dull, and I was fidgety.” His teacher, Miss Watson, threatened him with eternal damnation if he didn’t pay attention. Huck admits it didn’t seem like such a bad alternative. “But I didn’t mean no harm. All I wanted was to go somewheres; all I wanted was a change, I warn’t particular.”
If that had happened today, Huck would have been diagnosed as ADHD, put on Adderall, and forced to attend school, while the book about his adventures would never have been written.
The American Psychiatric Association invented the term “ADHD” in 1980 to give kids with hyperactivity, impulsivity, short attention span and easy distractibility a diagnosis.
Who would have thought that 28 years later, the National Center for Health Statistics would report that over 5 million American kids (8 percent) between the ages of 3-17 would receive this diagnosis? That’s 1 out of 12, with about half of those on medication.
For any mental illness or passing mood swing that may trouble a person, the Diagnostic and Statistical Manual of Mental Disorders — better known as the DSM — has a label and a code. Recurring bad dreams? That may be a Nightmare Disorder, or 307.47. Narcolepsy uses the same digits in a different order: 347.00. Fancy feather ticklers? That sounds like Fetishism, or 302.81. Then there’s the ultimate catch-all for vague sadness or uneasiness, General Anxiety Disorder, or 300.02. That’s a label almost everyone can lay claim to.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. Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), almost all of whom would be described as KOLs, ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.
The term “mental illness” is heavily charged, politicized, and ambiguous. I prefer to talk about “anomalous experiences,” “extreme emotions,” and “emotional distress.” The main reason I don’t use medical language is that people who are suffering often don’t find it very helpful. No one experiences “schizophrenia” — that’s just a technical name for a lot of complicated feelings.
People who have been taught that “mental illnesses are brain diseases” see psychiatric patients as dangerous and unlikely to recover. And those in crisis are often understandably reluctant to consult mental-health professionals, because the stigma of mental illness is so severe: it’s possible to lose your job, your home, and your family as a consequence of being diagnosed with a mental illness. In cultures that take a social view of emotional distress, by contrast, people more readily seek help because they aren’t as likely to be ostracized and are assumed to be capable of full recovery.
A complaint filed with the federal Office of Research Integrity alleged that a group of psychiatrists, including an associate professor at the Harvard Medical School, signed their names to an academic paper written by a communications firm hired by a major pharmaceutical company.
Gary S. Sachs, a researcher affiliated with Massachusetts General Hospital, is one of five doctors identified in the formal accusation filed July 8 by University of Pennsylvania professor Jay D. Amsterdam.
The psychiatrists allowed the medical communications company Scientific Therapeutics Information, hired by SmithKline Beecham, to draft a paper using their names, according to the complaint. The paper, according to Amsterdam, suggested that the antidepressant Paxil can help treat some cases of bipolar disorder.