Psychiatry is a mess. Patients who urgently need help go untreated, while perfectly healthy people are over-diagnosed with serious mental disorders and receive unnecessary medical treatment. The roots of the problem are the vast pharmaceutical industry profits and a diagnostic system-the Diagnostic and Statistical Manual of Mental Disorders (DSM)-vulnerable to exploitation. Drug companies have fostered the development of this system, pushing psychiatry to over-extend its domain so that more people can be diagnosed with mental disorders and treated with drugs. This book describes the steady expansion of the DSM-both the manual itself and its application-and the resulting over-medication of society. The author discusses revisions and additions to the DSM (now in its fifth edition) that have only deepened the epidemics of major depression, premenstrual dysphoric disorder, social anxiety disorder, attention deficit disorder and bipolar disorder. Table of Contents Acknowledgments ix Introduction: The Fundamental Question 1 One • Snake Oil Psychiatry 5 Are Psychiatrists Quacks? 5 Peddling Mental Disorder 8 Disease Mongering 13 The Creation of Spurious Epidemics 16 Two • The Influence of Big Pharma 20 The Selling of Psychiatry 20 The Corruption of Data and the Suicide Scandal 42 Turning Psychiatrists into Quacks 50 Three • The Nature of Mental Disorder 58 Diseases Are Explanations 58 When Is a Mental Disorder Not a Disorder? 60 Four • The Creation of DSM-III 71 Unreliable Diagnoses 71 Abuse of Psychiatric Diagnosis 77 The Antipsychiatry Movement 79 Psychoanalysis Is Unscientific 81 The DSM-III Solution 84 Five • The Dangers of DSM-III 86 Medicalization and the Expandability of DSM 86 The Myth of Political Neutrality 90 The Sacrifice of Understanding 95 The Death of Clinical Judgment 98 Playing into the Hands of the Pharmaceutical Industry 103 Six • Ordinary Sadness versus Major Depression 108 A Short History of Melancholic Depression 108 The DSM-III Definition 109 Overdiagnosing Depression 112 The End of Sadness 116 Creating a Drug Dependent Society 119 The Creation of Subclinical Depressive Disorder 127 DSM-5 and the End of Grief 129 Seven • Shyness versus Social Anxiety Disorder 132 The Demise of Anxiety Neurosis 132 Branding a Condition 133 The Invention of Social Phobia 135 The Epidemic of Social Anxiety Disorder 139 DSM-5 Fans the Epidemic 141 The Marketing of Paxil 143 Eight • Boisterous Boys versus Attention Deficit Hyperactivity Disorder 146 A Terrible Synergy 146 From MBD to ADHD 148 The Manufacture of an Epidemic 150 DSM-5 Fuels the Epidemic 154 Pushing Drugs Onto Children 155 Adults Join the Market 160 An Alternative Picture 164 Nine • Female Woes versus Premenstrual Dysphoric Disorder 172 New Bottles for Old Wine 172 The Invention of Premenstrual Dysphoric Disorder 173 Direct to Consumer Advertising 180 PMDD Comes of Age in DSM-5 182 Ten • Mood Swings versus Bipolar Disorder 185 A Very Brief History of Manic-Depression 185 DSM-III and the Bipolar Epidemic 186 Borderline Personality Disorder as Bipolar Disorder 190 Bipolar Disorder in Children 193 Big Pharma in the Ivory Tower 199 The DSM-5 Compromise 203 Forgetting the Context 205 Conclusion: The Future of Psychiatry 207 In a Nutshell 207 Recommendations 209 How to Climb Off the Tiger 216 Chapter Notes 219 Bibliography 240 Index 255 About the Author: Lawrie Reznek is an associate professor of psychiatry at the University of Toronto and has written a number of books on the philosophical foundations of psychiatry.
|