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 treatment and the author concludes that the best antidote to fads lies in cautious conservatism and the principles of evidence-based practice.
RCPsych Publications is the publishing arm of the Royal College of Psychiatrists (based in London, United Kingdom), which has been promoting excellence in mental health care since 1841. Produced by the same editorial team who publish The British Journal of Psychiatry, they sell books for both psychiatrists and other mental health professionals; and also many written for the general public. Their popular series include the College Seminars Series and the NICE mental health guidelines.
RCPsych publishes in all areas of psychiatry and mental health, including but not limited to:
Clinical psychiatric practice
Intellectual disability
Mental health services for children, adolescents, adults and the elderly
Psychopharmacology
Psychotherapy
Rehabilitation psychiatry
Family mental health
Service provision
RCPsych Publications books can help with the following disorders:
Addictions
Affective disorders
Attention deficit hyperactivity disorder (ADHD)
Bereavement
Borderline personality disorder
Cognitive-behavioral therapy (CBT)
Dementia
Depression
Eating disorders
Perinatal psychiatric disorder
Post-traumatic stress disorder (PTSD)
Psychosis
Schizophrenia
Sleep problems
