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Relative to some other medical specialties, psychiatry is a new and still scientifically underdeveloped field - as a result practitioners can be influenced by attractive but unproven ideas. Since mental illness is still a mystery and answers to the most important questions about mental illness will require another century of research, it is important to criticise contemporary practice - especially as fads in psychiatry have occurred not only on the fringe, but in the very mainstream of theory and practice. Some of the trendiest theoretical paradigms may turn out to be unsupported by data. In diagnosis, the many faddish approaches to classification are unlikely to last. In treatment, both psychopharmacology and psychotherapy sometimes embrace interventions with a weak base in evidence that run the risk of doing harm to patients. This book examines the fads and fallacies that have and continue to plague psychiatry, in both diagnosis and in treatment. These include over-diagnosis (especially of depression, bipolar disorder, ADHD, PTSD and autism), over- treatment with pharmaceuticals and the assumption that neuroscience has all the answers for psychiatry. The reasons why psychotherapy has long been prone to faddishness are explored; as are the reasons for more recent faddishness in psychopharmacology, which can lead to irrational methods of over-treatment, and a failure to consider alternatives. There is discussion of the problematic areas of diagnostic systems (ICD and DSM) and an over-reliance on drugs. Many examples from the author's own personal clinical experience are included. The author's strong opinions and critical tone may seem to conflict with the dispassionate approach of evidence-based medicine, however, the book presents balanced arguments and includes positive suggestions and recommendations for change. Until we really understand the nature of serious mental illness, psychiatrists need to resist fads in diagnosis and treat
"This book, now revised in a section edition, examines the problem of over-diagnosis in psychiatry, focusing on problems with current diagnostic systems. It will show that diagnosis is not always a good guide to treatment selection, and that diagnoses have bee expanded in scope to justify currently popular methods of pharmacotherapy or psychotherapy. The most important categories that are over-diagnosed are bipolar disorders, major depression, attention-deficit hyperactivity disorder, and post-traumatic stress disorder. The boundary of pathology and normality remains unclear. This edition will also discuss dimensional systems that are transdiagnostic, and show how over-diagnosis is linked to the practice of aggressive psychopharmacology"--
Aspects of mental illness are still a mystery. Answers to the most important questions in psychiatry may require decades of further research, so it is important to critique contemporary practice - especially as fads in psychiatry have occurred not only on the fringe, but in the very mainstream of theory and practice. Some of the trendiest theoretical paradigms may turn out to be unsupported by data. In diagnosis, some faddish approaches to classification are unlikely to last. In treatment, both psychopharmacology and psychotherapy sometimes embrace interventions with a weak base in evidence that run the risk of doing harm to patients. This book examines fads and fallacies, both past and present, that plague psychiatry, both in diagnosis and in treatment. These include over diagnosis (especially of depression, bipolar disorder, ADHD, PTSD and autism), overtreatment with pharmaceuticals and the assumption that neuroscience has all the answers. Until we really understand the nature of serious mental illness, psychiatrists need to resist fads in diagnosis and treatment. The best antidote lies in cautious conservatism and the principles of evidence-based practice. Readership: All mental health professionals, with a wider audience of those interested in mental health.
Weaving together lyrical history and personal memoir, Virdi powerfully examines society’s—and her own—perception of life as a deaf person in America. At the age of four, Jaipreet Virdi’s world went silent. A severe case of meningitis left her alive but deaf, suddenly treated differently by everyone. Her deafness downplayed by society and doctors, she struggled to “pass” as hearing for most of her life. Countless cures, treatments, and technologies led to dead ends. Never quite deaf enough for the Deaf community or quite hearing enough for the “normal” majority, Virdi was stuck in aural limbo for years. It wasn’t until her thirties, exasperated by problems with new digital hearing aids, that she began to actively assert her deafness and reexamine society’s—and her own—perception of life as a deaf person in America. Through lyrical history and personal memoir, Hearing Happiness raises pivotal questions about deafness in American society and the endless quest for a cure. Taking us from the 1860s up to the present, Virdi combs archives and museums to understand the long history of curious cures: ear trumpets, violet ray apparatuses, vibrating massagers, electrotherapy machines, airplane diving, bloodletting, skull hammering, and many more. Hundreds of procedures and products have promised grand miracles but always failed to deliver a universal cure—a harmful legacy that is still present in contemporary biomedicine. Blending Virdi’s own experiences together with her exploration into the fascinating history of deafness cures, Hearing Happiness is a powerful story that America needs to hear. Praise for Hearing Happiness “In part a critical memoir of her own life, this archival tour de force centers on d/Deafness, and, specifically, the obsessive search for a “cure”. . . . This survey of cure and its politics, framed by disability studies, allows readers—either for the first time or as a stunning example in the field—to think about how notions of remediation are leveraged against the most vulnerable.” —Public Books “Engaging. . . . A sweeping chronology of human deafness fortified with the author’s personal struggles and triumphs.” —Kirkus Reviews “Part memoir, part historical monograph, Virdi’s Hearing Happiness breaks the mold for academic press publications.” —Publishers Weekly “In her insightful book, Virdi probes how society perceives deafness and challenges the idea that a disability is a deficit. . . . [She] powerfully demonstrates how cures for deafness pressure individuals to change, to “be better.” —Washington Post
This text examines the fads and fallacies, both past and present, that have plagued psychiatric diagnosis, treatments and research. It argues that such practices have led to an over-diagnosis of conditions such as depression, bipolar disorder, ADHD, PTSD and autism. It examines the over-treatment of psychiatric disorders with pharmaceuticals, and asks if neuroscience will actually hold the answers to the biggest questions in the field. Thoroughly updated in light of new research, this new edition addresses some of the more recent developments in psychiatry, including behavioural genetics, genome-wide association studies, and brain imaging. It looks at new advances in psychotherapies and argues for a broad biopsychosocial model. The book will inform psychiatrists, clinical psychologists, other mental health professionals, and medical students of the limits of mental health practice and the importance of adopting cautious conservatism and the principles of evidence-based practice.
A clear and concise guide to help recognise the signs and symptoms of psychiatric illness in clinical care.
A clear and concise guide to help recognise the signs and symptoms of psychiatric illness in clinical care.
At a time of huge pressures on mental health services, this highly topical, broad-ranging and thought-provoking analysis of the mental health crisis examines the current challenges in mental health service delivery and access using a range of perspectives (political, economic, and cultural, organisational issues). It then puts forward a number of alternatives, reviewing both current and alternative initiatives, and exploring what is needed for a mentally healthy society.
"Trauma is a term that describes damage to the mind caused by a distressing life event. Traumatic events, in and of themselves, are most certainly not a myth. Some events, such as shootings or rapes, are particularly likely to provoke post-traumatic symptoms. We need not lose sight of the fact that highly adverse life events can trigger serious psychopathology"--
Synthesizing the latest research and treatment developments, Stepped Care for Borderline Personality Disorder: Making Treatment Brief, Effective, and Accessible aims to make treatment for borderling personality disorder (BPD) more accessible by providing clinicians with innovative brief and targeted intervention methods. Focusing on integrative treatment models, it offers clinicians a vital guide to the management of patients who are difficult to treat. Acknowleding the early developmental roots of BPD, the book includes sections on BPD in adolescence, childhood precursors of the disorder, and a broad range of etiological factors. It looks at the pitfalls clinicians face when trying to treat BPD, and offers a roadmap to avoiding them. - Brief and targeted methods of integrative treatment for BPD patients - Makes treatment more accessible to a wider range of patients - Provides clinicians and researchers with a review of the current BPD literature - Offers solutions to the problem of treatment access for BPD patients - Addresses questions regarding the complex developmental trajectories of BPD - Presents a model of stepped care treatment of BPD and describes research on its effectiveness