From madhouse to mainstream

It’s not often that historians are described as kicking ass, but the latest issue of the The Lancet has a barnstorming piece by Andrew Scull that gives an uncompromising history of psychiatry from the mad house to Big Pharma.

It must be said that the article is oriented more toward American psychiatry. Although similar influences have been present in European psychiatry, it has been much less subject to, shall we say, the mood swings that have tended to pull the American psychiatric community from one extreme to the other over the last century.

Nonetheless, it is a rollicking read from one of the most respected historians in the field. This is where Scull discusses the rise of neurobiology:

The US National Institute of Mental Health proclaimed the 1990s “the decade of the brain”. A simplistic biological reductionism increasingly ruled the psychiatric roost. Patients and their families learned to attribute mental illness to faulty brain biochemistry, defects of dopamine, or a shortage of seratonin. It was biobabble as deeply misleading and unscientific as the psychobabble it replaced, but as marketing copy it was priceless. Meantime, the psychiatric profession was seduced and bought off with boatloads of research funding. Where once shrinks had been the most marginal of medical men, existing in a twilight zone on the margins of professional respectability, now they were the darlings of medical school deans, the millions upon millions of their grants and indirect cost recoveries helping to finance the expansion of the medical-industrial complex.

One of the best articles on the history of psychiatry I’ve read for a very long time. No stone is left unscorned.

Link to Lancet article ‘A psychiatric revolution’.
Link to PubMed entry for same.

2 thoughts on “From madhouse to mainstream”

  1. Nice tip on the article! It reminded me of an article from the February 2010 American Journal of Psychiatry recounting the history
    of how those Washington University psychiatrists developed the diagnostic criteria that led to the DSM revolution, based on the memories of some of the people who were there when it all happened.
    I have more on my blog linked above, but the gist of it is that the criteria for depression were based on earlier work by Cassidy et al, and when a historian tracked down Dr. Cassidy and asked how he decided on the threshold of six out of 10 criteria, Cassidy replied, “It sounded about right.”
    Psychiatrists from Washington University always emphasize how their department was at the forefront of rational, scientific, medically-based psychiatry. I used to think that their diagnostic criteria was based on something more than conjecture, but now I’m not so sure.

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