Neurocritic Asks, Where Are Psychiatry’s Clinical Tests?

In an age of laboratory medicine, psychiatry’s reliance on interviews, confession, and often funky diagnoses remain the disciplines great bugbear. The move over the last two or three decades to ‘biological psychiatry,’ which got hijacked by the drug industry, has hovered  between disappointment and disaster. Neurocritic looks at the dilemma from a neuroscientist’s point of view:

The lack of laboratory diagnostic tests for mental disorders, along with the shady marketing practices of the pharmaceutical industry, are often viewed as the most fatal flaws in the medical practice of psychiatry.… Widespread perceptions that the field is relatively low in scientific precision, and that the patients have a poor prognosis, are among the possible reasons for this.…

This lack of respect from other medical professionals, not to mention from consumer/survivor advocates, puts neuroscientists in an awkward position. We believe in neurobiological explanations for the full gamut of human behavior, yet we’re left to defend a specialty that relies on clinical interviews and a disputed classification system. There is in fact a large and growing literature on structural and functional differences between the brains of those with and without psychiatric disorders, but these discoveries have not yet translated into reliable diagnostic tests.

Why has it taken so long for biological psychiatry to develop clinical tests?

What follows — NC’s attempt to answer this question — is essential reading for anyone trying to understand psychiatry as it struggles desperately to revise its Diagnostic Statistical Manual.

The Neurocritic: Where Are the Clinical Tests for Psychiatric Disorders?

Image: Surgeon’s exam room, via otisarchives1, h/t @Neurocritic. Some rights reserved

4 responses

  1. Psychiatry is intentionally kept vague for political reasons. It’s
    necessary to have a few undefinable disorders handy for when you need to
    have political opponents silenced, and drugged into irreversible

    To add a little veracity to this statement, just look at how quickly
    politicians point to psychological “disorders” to label all dissidents
    today. Everyone who disagrees with whatever lies the TV is foisting upon
    the public this week is quickly labelled “crazy, paranoid, or given
    some such other label that people generally associate with mental

    The entire “science” should be completely discredited until some of
    those quacks who call themselves doctors can start proving what they’re
    saying, because if politicians regularly resort to these accusations,
    that provides at least some evidence of how these labels are being used
    in a very unscientific way.

    • ST, thanks for writing in, but I’ll gently differ here, as I think that while motivations and mileage vary among psychiatrists, many and quite likely most are TRYING to do things well and to help people, and the best do help. The discipline is in disarray and struggling, but not, methinks, through mal intent.

  2. Or just count up all the political dissidents already incarcerated in “mental health” wards. Everyone who disagrees with the government is already considered insane. Stalin never had it so good, and if the psychiatrists of today don’t change that trend, it’s their own field of study whose credibility is being destroyed, and none of them are of any more use to society than the doctors of the Nazi concentration camps. The entire profession needs to police itself, before they’re all labelled as crazy themselves, and I”m inclined to think that many are nearing that point right now.

  3. MSSW’s do the lions share of helping patients with mental problems… they use DSM-4 as the diagnostic tool to define behaviors, similar to what a Dr of Psychiatry would do as part of the service the doctor provides in mental patient care…
    So methinks the clinical tests that Neurocritics are asking for is comparing actual patient behavior with DSM-4 definations of what is / is not mentally defective behavior…
    Do not see any conspiracy here, only an attempt to help folks…

Leave a Reply

Your email address will not be published. Required fields are marked *