Criticism of psychiatric treatment

Abstract

Criticisms of psychiatric treatment often involve comparison to idealized depictions of general medical treatment. Psychiatric treatments are described as not reversing diseases but many treatments in general medicine also do not reverse disease and some have unknown mechanisms. It is stated that psychiatrists prescribe medication to reverse hypothesized mechanisms, but a survey found they usually prescribed a medication in a clinical situation because research had shown it to be effective, even though the mechanism of action was unclear. Antidepressants are said to be ineffective because of a small overall effect averaged over groups of participants but this ignores evidence that some people will derive a significant clinical benefit. Antipsychotics are effective in preventing relapse of psychosis in research studies; for a variety of reasons, withdrawal-induced psychosis is unlikely to explain enough of this advantage to prove the claim that antipsychotics are ineffective. Although lithium research trials are imperfect, including reporting high rates of lithium withdrawal-induced mania, there is still some evidence of benefit in acute mania and of modest benefit in preventing relapse of bipolar disorder in those who can continue lithium for two years or more. Questions comparing psychiatric and general medical treatments were generated.