The Carlat Psychiatry Podcast Controversies in Psychiatry
Apr 8, 2024
Edward Shorter, a historian in psychiatry, discusses the mistakes made in the field over time. Topics include historical evolution of psychiatry, challenges in diagnostics and treatment, evolution of psychiatric medications, role of randomized controlled trials, controversies in psychiatric classification, and the shift from psychopathological entities to neurotransmitter deficiencies in psychiatric illnesses.
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Psychiatry's Divided Nature
- Psychiatry is a divided field with effective clinicians but a shaky scientific base.
- Diagnoses like melancholia and mania are valid, but others lack scientific backing.
Valid vs. Broad Diagnoses
- Some psychiatric diagnoses, like melancholia and catatonia, represent real diseases.
- Others, like major depressive disorder, are too broad and encompass various conditions.
Treatment Efficacy Concerns
- Many current psychiatric treatments are either ineffective or potentially harmful.
- SSRIs may be largely inert, and antipsychotics are overprescribed for children and the elderly.