Astonishing Rise Of Mental Illness Research Articles

The Research Basis for Robert Whitaker's “Anatomy of An Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America

Whitaker has been writing about the treatment of the mentally ill for over 12 years. In Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America, he examines what appears to be a trend toward poorer long-term outcomes for persons with major mental disorders, as compared to the era before modern psychopharmaceuticals. He posits that the timing is not coincidental, but that modern medications may be a contributing factor to these outcomes. Specifically, the medications are not very effective (i.e., that group outcomes for persons on modern psychotropic medications are minimally or not significantly better than placebo). More disturbingly, he reports that these medications are more than just ineffective, but may result in deleterious outcomes (i.e., that over time, many current pharmaceuticals may be altering the symptoms, course, and duration of several Axis I major mental illnesses). The author explicates the connections of medication to the changes in the prevalence and course of illness for persons with schizophrenia, unipolar and bipolar affective disorders, as well as anxiety disorders and disorders arising in childhood. He supports his propositions with references to research studies. Those cited include naturalistic studies as well as placebo-controlled medication trials of the present era. In this column I attempt to provide an informed analysis of several of the major research papers that underpin the theses, and some implications of the book and these studies for today’s psychiatric nurse professionals. This column is delimited to a review of cited research for only one diagnostic category: unipolar depression. In addition to the studies cited by Whitaker, I will report the findings on several newer studies in this same area. (Please see the book review

Anatomy of an Epidemic – Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America20121Robert Whitaker. Anatomy of an Epidemic – Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. Broadway 2011. £9.99, ISBN: – 9780307452429

Anatomy of an Epidemic – Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America20121Robert Whitaker. <i>Anatomy of an Epidemic – Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America</i>. Broadway 2011. £9.99, ISBN: – 9780307452429

Book Reviews: Unhinged: The Trouble with Psychiatry A Doctor's Revelations about a Profession in Crisis, The Emperor's New Drugs: Exploding the Antidepressant Myth, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Book Reviews: Unhinged: The Trouble with Psychiatry A Doctor's Revelations about a Profession in Crisis, The Emperor's New Drugs: Exploding the Antidepressant Myth, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Book Review:Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Building upon his previous work, Mad in America, the investigative journalist Robert Whitaker examines the widespread use/abuse of psychotropic medications in his breakthrough publication Anatomy o...

Robert Whitaker, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Robert Whitaker, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Prominent M.D.'s Book Reviews Give Negative View of Psychiatry

Back to table of contents Previous article Next article Professional NewsFull AccessProminent M.D.'s Book Reviews Give Negative View of PsychiatryMark MoranMark MoranSearch for more papers by this authorPublished Online:5 Aug 2011https://doi.org/10.1176/pn.46.15.psychnews_46_15_8_1AbstractA two-part book review in the New York Review of Books on June 23 and July 14 by Marcia Angell, M.D., senior lecturer in social medicine at Harvard Medical School and former editor in chief of the New England Journal of Medicine, has garnered the attention—and the ire—of APA leaders and other psychiatrists. In her review of three recent books about psychiatry, mental illness, and the rise of psychopharmacology, Angell's comments are broadly critical of the field of psychiatry, while underscoring her own vigorous criticisms of the pharmaceutical industry generally. The three books are The Emperor's New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch; Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker; and Unhinged: The Trouble With Psychiatry—A Doctor's Revelations About a Profession in Crisis, by Daniel Carlat, M.D. "The books ... are powerful indictments of the way psychiatry is now practiced," Angell wrote. "They document the 'frenzy' of diagnosis, the overuse of drugs with sometimes devastating side effects, and widespread conflicts of interest.... If we knew that the benefits of psychoactive drugs outweighed their harms, that would be a strong argument, since there is no doubt that many people suffer grievously from mental illness. But as Kirsch, Whitaker, and Carlat argue convincingly, that expectation may be wrong." APA leaders, in turn, find Angell's critique to be simplistic at best and deeply misinformed at worst. Much of her criticism was aimed at DSM and revisions planned for the new edition—DSM-5. APA has submitted a response to the New York Review of Books in the form of a letter by Darrel Regier, M.D., M.P.H., executive director of the American Psychiatric Institute for Research and Education and director of APA's Division of Research (see Book Review Misses Evolution of Psychiatry). "They read not as critical reviews but, rather, as if they are news reports basically endorsing the content of the books," APA President John Oldham, M.D., said of Angell's reviews. "Her text states that 'most psychiatrists treat only with drugs,' that 'mental illness is caused primarily by chemical imbalances in the brain,' and that 'these disorders are biologically determined and not a result of environmental influences.'" Oldham said he was puzzled by Angell's comments, "given the overwhelming evidence of the profound impact of early-life stress, trauma, or neglect and the well-recognized importance of bidirectional gene-environment interaction and the stress/vulnerability model of illness applicable across all of medicine." At one point in one of her reviews, Angell also makes the curious statement that schizophrenia was "once mainly self-limited or episodic," to which Oldham responded, "Who were all of those patients in our state hospitals?" He added that the tactics of industry Angell complains about apply across the rest of medicine. "There's a lot of very bad distortion in here for someone with her stature to be promoting," Oldham said. Angell's reviews are posted at <www.nybooks.com/shared/225cc2615373ab821643c72ace3a18b7> and <www.nybooks.com/shared/227dd89163be78c35c21581f1e911822>. ISSUES NewArchived

Two views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Two views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Two views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Back to table of contents Previous article Next article Book ReviewsFull AccessTwo views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in AmericaRory P. Houghtalen, M.D.Rory P. HoughtalenSearch for more papers by this author, M.D.Published Online:1 Apr 2011https://doi.org/10.1176/ps.62.4.pss6204_0438aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in AmericaWhitakerRobert; New York, Crown Publishing, 2010, 416 pages, $26Will reading Robert Whitaker's Anatomy of an Epidemic interest you or make you angry? My guess: this book will do both. Whitaker is an investigative journalist best known for his writing on the treatment of the mentally ill population in America and the growing influence of the pharmaceutical industry in the practice of medicine and psychiatry. His latest book combines these topics. These intertwined issues deserve our attention and are generally good for provoking loud debates, if not genuine placard-carrying protests.I am unable to fully bridle my enthusiasm to point out the flaws in Whitaker's theories. His primary premise is that the reason so many more people are now on disability rolls for mental illness than was the case in the halcyon days of the 1950s is because they were exposed to psychotropic medication. There are a host of logical errors in his analysis that I painfully learned earning a B in Logic 101 as a college sophomore, most notably post hoc reasoning and the appealing slippery slope.Like a skillful prosecutor presenting a circumstantial case, Whitaker “connects the dots” to “expose” the pharmaceutical industry-American Psychiatric Association-National Institute of Mental Health-National Alliance on Mental Illness conspiracy (yes, even NAMI is a co-conspirator) to put every man, woman, and child on the planet on one psychotropic drug or another. The inclusion of heartbreaking stories of people mired in debilitating situations at the end of each chapter is a rather obvious ploy to appeal to emotion, increasing the likelihood of a conviction in the court of public opinion. Sadly, witnesses to the often life-improving, if not life-saving, benefits of properly applied medical treatments for mental illness barely find a voice in the transcript of this trial.This said, I cannot disagree with Prosecutor Whitaker that behaviors of the pharmaceutical industry and its speakers' bureaus, the practitioners of footloose diagnosis and fancy-free polypharmacy (especially for the young), the too cozy relationships between big pharma and big academia, and dare I say certain decisions the APA has made all provide enough evidence for an adverse verdict, especially by a lay reader. The author makes important points about overvalued theories, misplaced treatments, and bad behaviors of some engaged in the often messy, uncertain practice of medicine and psychiatry. Unfortunately, this book is more indictment than honest critique—an example of confirmation bias pretentiously devoid of any balance in the attack.This book provokes thought, discussion, and strong emotions. It will force you to reflect on the strength of the evidence for psychiatry's convictions about the nature and proper treatment of mental illness, to evaluate your personal professional practices, and to renew the oath that you as a physician once took to “first do no harm.” These are all good things. You should read this book; patients and their families will, and you should be ready with some answers to their questions. My copy is full of margin notes to prepare responses that I hope will not sound too defensive when delivered.Dr. Houghtalen is medical director of ambulatory mental health services and education, Department of Behavioral Health, Unity Health System, Rochester, New York.The reviewers report no competing interests. FiguresReferencesCited byDetailsCited byNone Volume 62Issue 4 April 2011Pages 438-439 Metrics PDF download History Published online 1 April 2011 Published in print 1 April 2011

Two views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Two views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Two views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Two views: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. Robert Whitaker. New York: Crown Publishers, 2010, 404 pp., $26.00 (hardcover). Although we have the same last name, the author of Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America and the present reviewer are not related. If I have bias, it can be attributed to my having read some of his previous works including Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (2002), one of his books and articles that have won national awards. At present, building on his previous research and further rigorous inquiry into virtually every aspect of the accelerating, particularly, American phenomenon of promoting psychiatric diagnoses and drugs, Robert Whitaker has documented the devastating but persistently denied long-term consequences of psychiatric drugs. Anatomy of an Epidemic is so well researched and written and its findings so evidently truthful that any reasonably intelligent reader might assume it would quickly be adopted in all health policy and practice. However, another kind of reality keeps getting in the way. Briefly stated, the other reality comprises moneyed interests synergistically compounded with our universal desire for quick fixes alleged to make us more comfortable in the short run. Thus influenced, even the most intelligent of our species may persistently deny this book's validity. The author, keenly aware of the business aspects of clinical drug testing and the lure of denial, chose to eschew assumptions about psychiatric drugs and to take the reader through his step-by-step investigatory process. In 1994, Robert Whitaker began his intellectual journey as a believer in the conventional wisdom . . . that psychiatric researchers were discovering the biological causes of illnesses (leading) to a new generation of psychiatric drugs that helped 'balance' brain chemistry . . . like 'insulin for diabetes.' (p. xi). There was much history to investigate because the so-called modern era of psychiatry dates back to 1954 with the introduction of antipsychotic drugs such as Thorazine and the promise of preventing patients from becoming chronically ill. More than a half century later, the U.S. General Accounting Office concluded that 1 in every 16 young adults was seriously mentally ill, and we had outstripped all other nations with our plague of illness in newly minted adults. Whitaker's latest book takes the reader with him on his rigorous scientific discovery process, integrated with patient accounts illustrating particularly how they suffer the consequences of having believed in the pseudoscience of psychiatric drugs. It is a story told by a master science journalist integrating a wealth of carefully researched facts into a major discovery. Instead of producing medical miracles, fulfilling fervent promises to prevent, cure, or at least ameliorate mental diseases, psychiatric drugs, their supposed increasingly strong scientific foundation disproven with each claim investigated, have done the opposite; in actual effect, the drugs have caused real disease, disablement, and death. Thorazine and other neuroleptic drug treatments are now clearly shown to produce chronicity, not prevention or cure or even limitation of disablement. Their theoretical basis, arguing that schizophrenia was caused by excess dopamine supply and transmission in the brain, led to systematically depleting many millions of patients of a neurotransmitter essential for vital neurological and cognitive function and for enjoyment of life. In the 1970s, studies showed that schizophrenic patients not treated with neuroleptic drugs did better than those drug-treated. Nondrugged patients not only had fewer short-term disturbing symptoms; over the long term, they were more able to cope with subsequent life stresses; neither were they brain-damaged and made prone to earlier deaths caused by the drugs. …