This article has not yet been rated on Wikipedia's content assessment scale. It is of interest to the following WikiProjects:

Medicine This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Wikipedia talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine ??? This article has not yet received a rating on the project's importance scale.

Archives

Index /Archive 1: Jun 2001 - Dec 2005 /Archive 2: Jan 2006 - Feb 2006 /Archive 3: Feb 2006 - May 2006 /Archive 4: Jul 2006 - Mar 2007 /Archive 5: Mar 2007 - Apr 2007 /Archive 6: Apr 2007 - Oct 2007 /Archive 7: Oct 2007 - Feb 2008

I, along with some other editors, have rewritten the article to address concerns listed above. All the new contributions have been referenced (nearly every sentence). The "Treatment settings" subsection still needs to be reworked. Further edits improving the rewrite are very much welcomed. Thanks, Chupper 00:05, 18 October 2007 (UTC)[reply]

Congratulations on moving forward with your hard work. I'm glad you kept in the section on professional ethics. Good luck to all in dealing with the anti-P and other controversies. Best wishes, HG | Talk 03:39, 18 October 2007 (UTC)[reply]

Thanks for your compliments HG. The article still needs a lot of work, even the sections I've rewritten, so I hope others continue revising. But hopefully we should be better than we were. Chupper 01:23, 23 October 2007 (UTC)[reply]

User:scuro recently tagged the sentence "Psychiatry's shift to the hard sciences was thought by many to signify psychiatrists' lack of concern for their patients.[17]" with a weasel word tag. Scuro, I've changed the sentence to "Psychiatry's shift to the hard sciences had been interpreted as a lack of concern for patients.[17]" Originally I intended for that weasel worded statement to exist from a historical context, and didn't recognize the problem. The way it is worded now should be more specific in that the switch was interpreted as a lack of concern - maybe not by all - but it was interpreted that way by at least some. I'm looking at the source right now and it doesn't state who these people were, but I'm assuming they mean other mental health professionals, antipsychiatry apologetics, patients and others in society. In other words, some people interpreted it this way, but there is no standard label or stereotype I would be able to apply. And again, this is speaking from a historical context. Does it read better now? Chupper 03:59, 18 October 2007 (UTC)[reply]

The weasel word tag actually shows as "attribution" on the article page. That sentence is quite a statement and I simply wanted to know who stated it.--00:05, 21 October 2007 (UTC) —Preceding unsigned comment added by Scuro (talk • contribs)

I think the rewrite is very good. But I do with Scuro that the sentence needs attribution. The second statement is just as weaselly as the first, even if it is more specific. Any wording like "was interpreted" or "has been interpreted" are, by definition, weasel words unless the statement is commonly accepted information , like "there is night and there is day". Mattisse 13:20, 23 October 2007 (UTC)[reply]

I noticed that scuro also changed the sentence discussing ECT & brain damage to state that there is no evidence that it causes brain damage and referred me to the ECT page. My reference stated that there was little evidence, but I had a feeling they just couldn't find any. Three distinct references from the APA (which is linked to on the ECT page) state that there is no evidence of brain damage from ECT. I transferred those references to this article so that statement is clearly referenced. Since my reference didn't state that I wanted to get one in here which clearly specified that. Now we've got three :). Thanks scuro. Chupper 04:13, 18 October 2007 (UTC)[reply]

Not a problem. :)--scuro 00:02, 21 October 2007 (UTC)[reply]

Psychiatry is one of the few medical specialties with a continuing, significant demand for research investigating its related diseases, classifications, origins, and treatments - erm, not sure exactly what this sentence means but I can't see a field of medicine where this doesn't apply...cheers, Casliber (talk · contribs) 13:48, 23 October 2007 (UTC)[reply]

Yea, here is an example of a sentence I needed to word better. Basically I was meaning to say that Psychiatry's research demand is so high because so little is known about the disorders themselves as well as treatments. Although you are right, almost all medical specialties have significant demand for research. Maybe it should be changed to Psychiatry, like many medical specialties, has a continuing, significant demand for research investigating its related diseases, classifications, origins, and treatments  ??? Chupper 15:27, 23 October 2007 (UTC)[reply]

Am thinking when expanded and explained the sentence can be dispensed with eventually but sounds a bit better and will do for now. going in the right direction anyway. cheers, Casliber (talk · contribs) 03:55, 24 October 2007 (UTC)[reply]

Is it weird to have like half the references from the same source? I mean, the article looks like it is (mostly) well referenced, but if half of those are from the same source, doesn't it kind of dilute it? Is there some style guide over how to not over-reference a single source? Rhetth 16:23, 23 October 2007 (UTC)[reply]

No there isn't but I am aware of it. If/when this ever goes to FAC it will be about 1.5 times as long and have a whole bunch of other refs. I often put in sources like these as place-holders until better ones turn up. cheers, Casliber (talk · contribs) 21:42, 23 October 2007 (UTC)[reply]

Well, this depends. Like Casliber says it needs a lot of expansion for a FAC and more references will come. But if you compare it to the number of refs beforehand, it has improved dramatically. The bottom line is during the rewrite I only had access to about 16 books. Of those maybe 70% contained information helpful to the article. And I'm not sure half the references are the "same source". Beyond " A History of Psychiatry: From the Era of the Asylum to the Age of Prozac", I'm actually seeing a good variety of references. From a historical context I wasn't able to find a book much better than that one. It just presents so much information from an analytical perspective. And remember to differentiate the frequency references are used vs. the number of references. One of the reason that the History of Psychiatry book is listed so frequently is because page numbers were used in the references. That causes a lot of material in the same section to "look" the same. Of course, Rhetth, you are always welcome to add in more material with other references. Chupper 23:52, 23 October 2007 (UTC)[reply]

User:Mihai cartoaje recently reintroduced the controversy section back into the article. I left a message on his talk page about this. I don't see why we need to make the article worse again by segregating POV content into one section. Some other editors, along with myself, spent a lot of time trying to integrate these points throughout the article. I even added more "controversy" stuff by including more detail on the Rosenhan experiment. Am I way off base here, or haven't we already integrated everything??? Chupper (talk) 17:32, 23 November 2007 (UTC)[reply]

I haven't simply reintroduced the Controversy section; I also made additions. --Mihai cartoaje (talk) 01:49, 24 November 2007 (UTC)[reply]

And these "additions" aren't mentioned in the rest of the article? Mihai cartoaje, controversy sections should not be used in Wikipedia. First of all, I'll address these "additions":

There exist movements opposed to the practices of – and, in some cases, the existence of – psychiatry. These movements mostly originated in the 1960s and 1970s. Presently antipsychiatry encompasses a broad range of professional views, including a scholarly journal devoted exclusively to criticism of biopsychiatry, Ethical Human Psychology and Psychiatry[82], published by ICSPP.

"This is already mentioned in the history section. Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

I haven't added this but copied it from a previous version. I didn't know what to do with this. Anti-psychiatry is mentioned in the history section, but it seems to be something current and not only historical. It seemed unsuitable to have a controversy section with no mention of anti-psychiatry. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

Right, but in the history section it states this is where anti-psychiatry movements emerged, not emerged and died out. No where in the prose does it say these movements no longer exist. Compare this to the biological perspective of psychiatry. It is also discussed at great length in the history section, but that doesn't mean its historical. We're just presenting its roots.

The point is the article dedicates an entire subsection to the anti psychiatry movement and a fabulous picture which says "Psychiatry kills". I don't know why you keep pushing this idea of having a "controversy" section. Wikipedia's NPOV policy page clearly discusses how "Segregation" of text or other content into different regions or subsections, based solely on the apparent POV of the content itself should be avoided. Chupper (talk) 19:36, 25 November 2007 (UTC)[reply]

The efficacity, adverse effects and the widespread and growing use of psychiatric medications has been challenged. The close relationship between psychiatry (and those prescribing psychiatric medication such as general physicians) and pharmaceutical companies has become increasingly controversial; same for the influence pharmaceutical companies are exerting on mental health policies [83] [84]. Pharmaceutical companies censored opposing ideas: [85]. Studies of pharmacogenetic polymorphism indicate that people of various ethnicities have an increased risk of side effects and toxicity.

POV. Who is it controversial to? Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

In the first case, I only copied it. In the second case, everyone with a conscience, and that is enough people for it to have two article citations.--Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

Just stating its controversial means you are using weasel words. In addition this article isn't about psychopharmacology, its about psychiatry. While psychopharmacology is a big treatment option in psychiatry, its not the only one. I would think this would be better included in the psychopharm or psychiatric medication articles after the weasel words are removed. If it is to be included here, the same thing goes - weasel words need to be included, and it should be integrated into an appropriate section, such as "Treatment". Chupper (talk) 19:36, 25 November 2007 (UTC)[reply]

I found a citation for "The close relationship between psychiatry (and those prescribing psychiatric medication such as general physicians) and pharmaceutical companies has become increasingly controversial": [1]. --Mihai cartoaje (talk) 06:31, 28 November 2007 (UTC)[reply]

What "influence"?Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

The title of the first article says it: "Pharmaceutical Industry Agenda Setting in Mental Health Policies". For the exact method, you would have to read the article. From the second article, "The National Alliance on Mental Illness, an outspoken patient advocate, lobbies for treatment programs that also benefit its drug-company donors." --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

Fair enough, see above comments. Chupper (talk) 19:36, 25 November 2007 (UTC)[reply]

This is whole section is POV. And why is "Studies of pharmacogenetic polymorphism indicate that people of various ethnicities have an increased risk of side effects and toxicity" included? Are you trying to make a point here? Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

I only copied that. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

So, why does it need to be included? I'm assuming you mean it doesn't. Chupper (talk) 19:36, 25 November 2007 (UTC).[reply]

In addition, the diagnostic reliability (Williams et al, 1992; McGorry et al, 1995; Hirschfeld et al, 2003]), has been challenged, especially when comparing the criteria of the different psychiatric manuals (van Os et al, 1999) .[86]

Rosenhan info already included. This adequately covers that topic. Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

This was copied from a previous version. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

Again, so why does it need to be included? Chupper (talk) 19:36, 25 November 2007 (UTC)[reply]

Another concern centers on the issue of involuntary commitment, which centers on issues of civil liberties and personal freedoms.

This article isn't a list of complaints about psychiatry. This is something adequately covered in anti psychiatry and involuntary commitment. If this MUST be included in this article, it belongs somewhere else should be integrated. Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

I copied this. This is something psychiatry survivors sometimes complain about, though. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

There have been multiple reports of wrongful treatments in psychiatry [87] [1] [2].

This information is already included. Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

It has been included for developping countries not western societies. --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

I'm not sure you've taken a close look. Read this: Incidents of physical abuse by psychiatrists took place during the reign of some totalitarian regimes as part of a system to enforce political control with some of the abuse even continuing to our present day.[50] Historical examples of the abuse of psychiatry took place in Nazi Germany [51], in the Soviet Union under Psikhushka, and in the apartheid system in South Africa.[52] It never states these just happened or still only happen in western societies. It just says its happened and it still happens. Theres even a "non western society country" included as an example. Both "non western society countries" and "western society contries" are included as examples. Chupper (talk) 19:36, 25 November 2007 (UTC)[reply]

Second, please stop trying to use this controversy section as your own POV fork, or should I say soapbox. One of the big reasons this article was rewritten was to integrate this info to the rest of the article and eliminate the "controversy" section. Honestly, the fact that you feel the need to consistently reintroduce it is making me a bit angry. Chupper (talk) 07:50, 24 November 2007 (UTC)[reply]

Is there anyone else who has an opinion on this? --Mihai cartoaje (talk) 08:59, 25 November 2007 (UTC)[reply]

Well, lets find out. I'll create a new section below to get some more opinions. Chupper (talk) 19:36, 25 November 2007 (UTC)[reply]

Mihai cartoaje has essentially proposed the reintroduction of a controversy section into this article. During the article rewrite I, along with another editor, tried to integrate these controversy points throughout the article. I even created a whole subsection called "Anti-psychiatry and deinstitutionalization". However, this doesn't seem to make everyone happy and I'm aware that others have different opinions. So I wanted to try and establish a consensus as to how to move forward.

Please state whether you believe the controversy section should be reintroduced, why or why not, and if you think it should be then what it should include or what should be moved back into it.

• Don't include controversy section. Here's why:
  • I have always felt that controversy and criticism sections conflict with WP:NPOV (see - WP:NPOV#Article structure & WP:NPOV#Undue weight).
  • In addition the controversy section of this article in the past has become a soapbox for several editors. Sections like these, and in this specific situation, encourage unhelpful and POV edits, IMO. (Take a look at the edit history or past few archived talk pages)
  • All relevant information has been integrated into other parts of the article. Specifically, take a look at the lead section - 2nd paragraph, "Anti-psychiatry and deinstitutionalization" section, "Ethics" section, and "Transinstitutionalization and the aftermath" section. Future additions could also be easily introduced into appropriate sections.

Chupper (talk) 19:36, 25 November 2007 (UTC)[reply]

• Oppose controversy section. On my last review of the article (a few days ago) I was amazed by the balance it has finally struck between the mainstream "we look after people with mental illness" and the controversial "psychiatrists are in the pay of the drug industry and administer SSRI/CBT/ECT inappropriately". This is a well-sourced, balanced, warts-and-all account that does not need a new "controversy" section. It complies very well with Wikipedia:Guidelines for controversial articles, and obviously WP:NPOV. Controversy sections are evil. JFW | T@lk 20:09, 25 November 2007 (UTC)[reply]

(edit conflict)

• Don't include controversy section. for all the reasons Chupper has expressed plus the following:

Every discipline has controversy. For some reason Psychiatry has become a focal point for social and political criticisms that are not specific to Psychiatry but may apply equally to Psychology or other mental health fields, or even social policies as a whole. The term "Psychiatrists" is often applied in a very loosely when describing political behaviors that have nothing to do with Psychiatry as a scientific field. I do not think it falls under the label of "controversy" that the field of Psychiatry is still evolving and that there may be differing views, just as there are in Physics. If I go to the article, Physics, I want to learn what the field of physics encompasses, not all the squabbles, controversies, fringe theories or a section on "Controversies" about how physicists should bear moral blame for inventing the Bomb or are tearing down our moral fabric by reducing God to sub particles etc. IMO, this should be a clear, concise article on what the field of Psychiatry encompasses including differing views without sensationalizing it or turning Psychiatry into a politics. Mattisse 20:25, 25 November 2007 (UTC)[reply]

• Don't include controversy section, but pls be willing to elaborate on controversial issues, as long as they are not given weight. I think the current rewrite, kudos to Chupper, sets out a strong framework for the article and elegantly incorporates several key controversies. Nonetheless, there may be other controversial issues that deserve to be woven into the article (without the need for a separate section). For instance, you might consider mentioning concerns over pharmacological treatments and linking to more expansive coverage elsewhere. Likewise, involuntary commitment. Furthermore, is there any reason the Ethics section can't be expanded a bit? For instance, I see no other place to mention notable political abuses of psychiatry, as in Punitive psychiatry in the Soviet Union. (FYI Chupper msg'ed me about commenting, since I had previously added Ethics and worked on the controversy section.) Thanks. HG | Talk 21:33, 25 November 2007 (UTC)[reply]
• Oppose a separate reintroduction of controversy section as to how it stands now. There may be some scope for ethical issues to be talked about under General Considerations and other stuff sprinkled through the text in context, or possibly better as a heading in this area and raised in more detail. As it stands there needs to be a little more elaboration of the critiques in appropriate places. I am a bit busy for a couple of weeks but will try to do what I can.cheers, Casliber (talk · contribs) 22:09, 25 November 2007 (UTC)[reply]
• Include: there can be sourced notable content about controversies and as such it can be added on Wikipedia. --Mihai cartoaje (talk) 06:53, 28 November 2007 (UTC)[reply]
  • Comment - Mihai cartoaje, thanks for your comments, but you have failed to address the issue at hand. Sourced, notable content about controversies can be added and is included. We are trying to determine whether the Controversy section needs to be reintroduced. I know the current stance seems to be not to include it, but I'm still curious why you feel this section could be included...? Chupper (talk) 00:12, 29 November 2007 (UTC)[reply]
• Comment - on the subject of Involuntary commitments - the problem in the United States is that it is not possible to involuntarily commit a person for any length of time, other than incarceration as a law enforcement issue having nothing to do with psychiatry. (The only exception is the commitment in some states of repeat sex offenders. Also, in most states (I know it may be different in other countries) by far the greatest amount of involuntary holds are by police. Also, psychologists, social workers, and others can involuntarily commit (depending on the jurisdiction) and no one can be committed for more than a short time (72 hours in my state) without a court order. Mattisse 00:05, 29 November 2007 (UTC)[reply]

OK - Mihai please don't attempt to override consensus - now see where I have placed drug controversy and also we do need to discuss ethics of involuntary treatment and patient incarceration under inpatient treatment - all other controversies I believe are mentioned though the text. In this way the pros and cons of each issue can be touched upon without some clumsy controversy section tacked on at the bottom.cheers, Casliber (talk · contribs) 14:04, 28 November 2007 (UTC)[reply]

Per my comment above, in the United States at least, involuntary commitment is really not an issue of abuse. Rather, the opposite is the case. The homeless population is blamed on the closing of so many state hospitals so that the mentally ill are turned out on the street (where they might prefer to be anyway). As for other countries, I don't know. But I do not think that political abuse should be blamed on psychiatrists. Mattisse 00:10, 29 November 2007 (UTC)[reply]

• Comment - Thomas Szasz is a psychiatrist. Since he has earned that distinction, it would seem wrong to describe him only under a section for "critics" or "anti-psychiatrists". But if Szasz's beliefs should be detailed in the main section, then what cannot be? But then again, where in the main section should this be covered? On a related note, I'd also inquire about "the anti-psychiatry movement" mentioned in the text. Should there be an article anti-psychiatry movement? Should it be merged into this one as a subsection? Or is the concept ludicrous - a lumping of Daniel Defoe and Szasz and Zhores Medvedev and surrealists and Scientologists all into one assemblage that never met? (Based on the latter thought perhaps the text needs a rework...) While I cannot but marvel at the long succession of discredited ideas, mythological ailments, and pathological cures offered up in psychiatry, it seems like a field too weakly or inconsistently grounded on any theoretical basis to be universally wrong, or to have a unified opposition. 70.15.116.59 (talk) 15:55, 8 January 2008 (UTC)[reply]

There has been talk to turn Biopsychiatry controversy into Controversies in Psychiatry (or under a better name). That could be a generic article on the ethical, scientific and theoretical problems with psychiatry. Already there is a section on the criticism of genetics theory, chemical imbalance theory and a stub on the pharmacy industry. In this article the "big names" in psychiatric discourse could be named without disturbing this article which is about the "status quo" of psychiatry. --Benjaminbruheim (talk) 23:57, 8 January 2008 (UTC)[reply]

An RfC has been created on Talk:Biopsychiatry controversy on the subject: "Is the majority viewpoint of the psychiatric profession, and particularly of the psychiatric research community, that the biopsychiatric model of psychiatry is, by and large, accepted or rejected?" Comments from editors involved in this article/project may prove useful. Hrafn^Talk_Stalk 06:49, 6 January 2008 (UTC)[reply]

Is it worth putting a section about the overlap of psychiatry with neurology. Does any body know to what extent this is? —Preceding unsigned comment added by 217.35.93.92 (talk) 23:42, 6 January 2008 (UTC)[reply]

I'm not sure if it needs its own section, but I think this is discussed somewhat in the history section and theory and focus section. Do you think it needs to be expanded? Chupper (talk) 00:58, 8 January 2008 (UTC)[reply]

This recent edit made me curious. I find conflicting report in literature. So stating it outright that it is the "best" treatment is problematic and seems defensive and should be attributed. Ie. some studies state that satisfaction is a complex factor, whilst other studies suggest that magnetic stimulation to be just as effective. The side effects are also reported to be stronger in qualitative studies. This makes me think that the current strong wording is inappropriate since the issue is complex; at least in an article on psychiatry, and not ECT. --Benjaminbruheim (talk) 19:32, 7 January 2008 (UTC)[reply]

I know I didn't even notice that addition until now. While the ref seems reputable, there is sometimes conflicting evidence for certain statements. If I have time, or if you want to, try to find some meta-analyses discussing ECT and maybe we can get a bigger picture. If I remember right - in my own personal studies - ECT is about the same as some antidepressants+psychotherapy combos. Of course this varies from person to person, but this might be something good to look at with a larger scale. Chupper (talk) 00:56, 8 January 2008 (UTC)[reply]