A Behavioral Approach to Mental Disorders

Sandra Steingard, MD, is a practicing psychiatrist who from time to time posts articles on Robert Whitaker’s Mad in America website. Dr. Steingard apparently prescribes psychotropic drugs in her practice, but she is by no means a pill-for-every-problem practitioner, and her articles are always interesting and thought-provoking. Dr. Steingard posted A Paradox Revealed – Again on Mad in America on July 7, 2013. In this article she mentions the recent study by Lex Wunderink et al, which found that people being treated for first episode psychosis were doing a great deal better functionally after seven years if their neuroleptic drugs had been discontinued or reduced relatively early in the process, as compared to individuals who were retained on the drugs for two years. ...

BACKGROUND The CAFE Study, conducted by Jeffrey Lieberman, MD, et al between 2002 and 2005, has been the subject of much comment. Carl Elliott, in particular, has written extensively on the matter, including his article The Deadly Corruption of Clinical Trials in Mother Jones. In order to address the issues involved in the CAFE study, we must first take a brief look at the CATIE study. This was also conducted by Dr. Lieberman et al (not the same et al as CAFE, but with some overlap). CATIE was conducted between 2001 and 2004. ...

On Twitter yesterday, Robert Stamatakis commented: "I have to ask, I don't understand. Do you work in the UK? Your descriptions of psychiatry are nothing I recognize. These descriptions of psychiatry are nothing like the practice I see on a daily basis." I am certainly a very outspoken critic of psychiatry, and in that regard Robert's question/challenge is a fair one, to which I will try to respond. My primary criticism of modern psychiatry – and indeed the criticism that underpins all the others – is that its fundamental concepts are spurious. ...

I’ve recently read a noteworthy article on PLOS One. It’s by Joanne M. Dickson and Nicholas J. Moberly, and it’s called Reduced Specificity of Personal Goals and Explanations for Goal Attainment in Major Depression. It’s a very interesting and detailed paper. The authors, who work at the University of Liverpool and the University of Exeter respectively, asked a group of depressed people and another group of people who were not depressed to list their goals. ...

There’s a very important article on Mad in America. It’s called Does NIMH Follow the Rules of Science? A Startling Study, by Niall McLaren, MD, dated July 9, 2013. Dr. McLaren is an Australian psychiatrist who has relentlessly combed the literature for proof of the fundamental psychiatric claim – “…that a full understanding of the brain will give a full understanding of mental disorder, with no questions unanswered.” He found nothing in the way of proof! ...

Recently on Twitter, Disparity asked for my opinion on the term mid-life crisis, which “…is often treated as a mental health condition.” The term mid-life crisis has no formal meaning in mental health, though as Disparity says, the concept does emerge from time to time. The original meaning of the word crisis was a turning point in an illness. In the past forty of fifty years, the connotation has extended to embrace almost any kind of challenging situation or adverse event. ...

I guess everybody knows by now that Robert Whitaker spoke at the NAMI conference in San Antonio last Saturday (June 29). You can view an outline of his speech, The Case for Selective Use of Antipsychotics here. He spoke about the fact that for people who have been assigned a “diagnosis” of “schizophrenia,” long-term outcomes are better among those who took relatively little of neuroleptic drugs, and worse among those who took relatively more. ...

It is a central theme of this website that psychiatry has done, and continues to do, a great deal of damage to people it claims to help. In my opinion, the damage done by neuroleptic drugs is among the most severe. The increasing use of these products ought to be a huge cause for concern. This is particularly true in that these very toxic drugs are being administered with increasing frequency to children – even to children as young as two years old! ...

BACKGROUND Mad in America ran an article (Reduction/Discontinuation of Antipsychotics Produces Higher Long-Term Recovery) on July 3, describing a piece of research on this topic which had been done in Holland. The original article, by Lex Wunderink, MD PhD et al, was published in the Journal of the American Medical Association Psychiatry (JAMA-P). You can see an abstract of the article here, but the full text is behind a pay wall. ...

BACKGROUND I’ve recently read Crazy Like Us: The Globalization of the American Psyche, by Ethan Watters (Free Press, 2010). It’s a great book, the theme of which is that western countries, especially America, are exporting the medicalization of human problems to less developed regions of the world. The new “illnesses” are being avidly promoted as if they had the same kind of reality as pneumonia or cancer, and are being foisted on vulnerable populations, with little regard for their impact on the cultures, ideas, sensitivities, and health of the recipients. ...