Are we over-diagnosing mental illness?
http://www.cnn.com/2013/03/16/health/mental-illness-overdiagnosis/index.html?hpt=hp_bn13
‘Normal’ is continually redefined by society. However, society’s mental illness is now being defined by for-profit organizations who stand to make billions of dollars by having ‘normal’ defined in such a way that the vast majority of people now ‘must’ take prescription (and generally on-patent) drugs just to ‘be normal’. This article is nice in that it gives a bit of an overview. There are certainly conditions that have increasing evidence that indicate they are likely to benefit by being in the DSM manual, but there are also quite a few conditions that have a whole lot of evidence that show they are nothing but fads. I won’t bore you with the details, however, psychiatrists, as a group, have a lot of difficulty doing any sort of double blind studies since for the vast majority of the cases there is a huge amount of subjectivity involved in diagnosis. As a consequence publication stringency has to be dropped in comparison with the more hard medicine and science. I think it is easy to argue that that stringency has dropped too much. As I have talked about here before (but am too lazy to look for examples), it is not that challenging at all for ‘real’ scientists to completely fuck up their experimental design and wind up with nothing but wish fulfillment. Given the ease for this happening in hard science, I think it is safe to assume that it happens a whole lot more in psychiatry. Indeed, assuming there is a bit of positive feedback (meaning first the industry attracts people who aren’t that stringent minded who then mentor people who then wind up being reviewers, etc.) it is plausible to assume the majority, if not nearly all, the results published could be questionable. I have no doubt that psychiatrists would object to my characterization, but I doubt any will read my blog so figure I can be free with my opinion.
So, to me the take-home from this article is that one should likely greet any psychiatric diagnosis and concomitant prescription with a grain of salt, a huge block if it is coming from your GP.
