Challenging myths about psychiatry

Nada Stotland was the 2008-9 President of the American Psychiatric Association. She writes on Huffpost Health challenging "myths about psychiatry". The trouble is she has promoted just such a myth. She writes, "Using brain scans ... we now can distinguish between the brain of a person with depression and a person who is not depressed". Evidence please. And perhaps she could explain what the "many, many other such observations" are.

Political nature of psychiatry

Interesting seminar last week, which I attended, organised by Tony Stadlen, invited Vladimir Bukovsky, the anti-communist, to talk about his experiences of being detained in psychiatric hospital in the Soviet Union. Luckily for him, he was never given psychiatric medication and there was a dispute amongst psychiatrists about his diagnosis.

His case nonetheless highlights, which Bukovsky himself did, the political nature of psychiatric diagnosis and its potential for misuse. In Soviet psychiatry, the particular problem was the development of diagnoses such as sluggish or creeping schizophrenia and paranoid development of the personality, and the Soviets withdrew from the World Psychiatric Association for a while because of criticisms of their political abuse of psychiatry. People who do not fit into society are at risk of being regarded as mentally ill and such a mechanism can be exploited by the state.

Many factors affect the number of antidepressant prescriptions dispensed in particular areas

The Guardian has published a map of GP antidepressant prescribing. Its article based on the data makes a lot of the finding that it tends to be Northern parts of England with higher numbers of prescriptions.

However, as the care services minister commented, "There are many factors that affect the number of antidepressant prescriptions dispensed in one particular area". For a start the Guardian data is not age standardised. There are significant differences between GP practices in the same area, which can be greater than the average differences between areas. The article doesn't mention the high rates in Norfolk and Waveney where I work.

Deprivation is likely to be a factor in prescribing as mental health need is correlated with deprivation. Pharmaceutical company marketing influences cannot be ignored.