Psychiatric "Spin"

On April 15, Ronald Pies, MD, an eminent and widely published psychiatrist, wrote an article for Medscape.com. The piece is titled Nuances, Narratives, and the ‘Chemical Imbalance’ Debate in Psychiatry. The main thrust of the article is that: "…the 'chemical imbalance theory' was never a real theory, nor was it widely propounded by responsible practitioners in the field of psychiatry." This is not the first time that Dr. Pies has made this claim, On July 11, 2011, he wrote an article for Psychiatric Times titled Psychiatry’s New Brain-Mind and the Legend of the “Chemical Imbalance.” In that article he wrote: "In truth, the ‘chemical imbalance’ notion was always a kind of urban legend- – never a theory seriously propounded by well-informed psychiatrists." ...

On April 19, 2014, The Lancet published an article titled Do we underestimate the benefits of antidepressants? by German psychiatrists Mazda Adli and Ulrich Hegerl. The Lancet, founded in 1823, is a weekly, general medical journal which since 1991 has been owned by Elsevier, a private, Amsterdam-based, publishing house with offices in the UK, USA, and other countries. The gist of the article can be gathered from the opening paragraph: ...

As my readers know, I am a great fan of Jeffrey Lieberman, MD, President of the APA. In his capacity as president, Dr. Lieberman writes a regular bulletin in Psychiatric News. These literary and intellectual gems have been a wonderful source of inspiration to me in my efforts to draw attention to psychiatry’s flaws, and I don’t think it would be an exaggeration to say that in many respects, Dr. Lieberman has been one of our greatest allies. ...

Alex Langford is a British trainee psychiatrist. He blogs at The Psychiatric SHO, and on April 21, he posted an article titled Antidepressants are not ‘happy pills.’ Thanks to Jean Davison for the link. The article is an impassioned attack on psychiatry’s critics. Here are some quotes, with my responses: "I am sick and tired of the way the press portrays depression as unhappiness and antidepressants as ‘happy pills’." This is interesting, though my general impression is that the mainstream media lean a good deal more towards psychiatry than towards our side of the debate. In addition, the words "depression" and unhappiness are pretty much synonymous. So it's difficult to see why that, or the characterization of antidepressants as "happy pills," should be so upsetting to Dr. Langford. We all, of course, have our linguistic likes and dislikes. I personally don't care much for the growing trend to pronounce the indefinite article as "ay," or for psychiatry's insistence on calling neuroleptic drugs "anti-psychotics." But what can you do? I just Googled the phrase "antidepressants are happy pills" and got 204,000 hits! So the notion has some traction and is probably here to stay. One can't legislate for the way people use words. Or perhaps psychiatrists imagine that they can. "For problems in other areas of health we’d only trust the experts to comment, but when it comes to mental health it seems like anyone can cast judgement." ...

About six months ago, I wrote a post called Health Care Reform and Psychiatry. In that article, I gave a brief account of the APA’s Council on Communications, and I expressed the belief that the council seemed more concerned with PR (in the most tawdry sense of the term) than with any serious examination or reform of psychiatric practices. Lately, I was browsing the APA blog Healthy Minds, Healthy Lives, and it seemed that a good deal of what I was reading seemed to have a fairly heavy PR component. So I opened the Council on Communications tab and found that their lead page is pretty much as it was six months ago. ...

On March 19, a new article was posted on Aeon Magazine. It’s titled A Mad World, and was written by Joseph Pierre, MD, who works in Log Angeles as a psychiatric practitioner and professor. Dr. Pierre has authored more than fifty papers, and has received several awards. He has lectured nationally and internationally, and would, I think, be considered an eminent psychiatrist. I am grateful to several readers for the link to the article. ...

On February 28, Awais Aftab, MD, a psychiatrist working in Qatar, published an interesting article on Psychiatric Times. The article, which is titled Mental Illness vs Brain Disorders: From Szasz to DSM-5, is an attempt to validate the concept of “mental illness” and, in particular, claims to refute the position of the late Thomas Szasz, MD, that mental illness is a spurious concept. The validity or otherwise of the concept of mental illness is fundamental to psychiatry’s claim to legitimacy, and for this reason, Dr. Aftab’s article deserves close scrutiny. ...

On February 28, our good friend, the eminent Jeffrey Lieberman, MD, President of the APA, published Politics of Psychiatry and Mental Health Care on Psychiatric News, the APA’s online bulletin. His co-author on this occasion is Patrick Kennedy, former Congressman from Rhode Island and co-sponsor of the Mental Health Parity and Addiction Equity Act. The piece is fluff and cheerleading, which have become Dr. Lieberman’s areas of specialty. ...

There’s a truly delightful little piece in February’s Current Psychiatry. It’s written by Henry Nasrallah, MD, and is titled Psychiatry’s future shock. Dr. Nasrallah is Editor-in-Chief of Current Psychiatry. The gist of the article is that “transformative” changes are occurring in the psychiatric field, and psychiatrists had better get on board, or they will be left behind. Here are some quotes: "The 'neuroscientification' of psychiatry, ongoing for more than 3 decades, is now approaching a tipping point: The specialty is on the verge of an unprecedented denouement of the old tenets and assumptions." ...

On January 29, the APA’s online bulletin Psychiatric News, published Psychiatry Embraces Patient-Centered Care, by Jeffrey Lieberman, MD, and Lisa Dixon, MD. Dr. Lieberman is President of the APA, and chair of psychiatry at Columbia University. Dr. Dixon is a professor of psychiatry at Columbia. Here’s the opening statement: "Psychiatry has long been considered the medical specialty most attuned to listening to the patient." This is a little difficult to reconcile with the fifteen minute med-check that has been pretty much the standard of care in most psychiatric offices for the past 25 years. It is also difficult to reconcile with reports from psychiatric survivors. The authors are willing to concede, however, that “…the nature of the doctor-patient relationship was traditionally one-sided.” What they mean by this is: ...