Psychiatrists protest criticism from well-known physician

Psychiatrists say two recent book reviews by Dr. Marcia Angell, the former editor of the New England Journal of Medicine and a Harvard lecturer, are inaccurate and misinformed.

The debate was set off when Angell, whose training is in internal medicine and pathology, wrote two book reviews in the New York Review of Books on June 23 and July 14. She reviewed several books that are critical of various aspects of psychiatric diagnosis and treatment and also evaluated work on the rewriting of the Diagnostic and Statistical Manual of Mental Disorders that is schedule for publication in 2013.

Angell’s review supports the charges in several of the books that psychiatry is too reliant on medication, too wedded to the pharmaceutical industry and often over-diagnoses people and even mistreats young children diagnosed with mental disorders.

“In view of the risks and questionable long-term effectiveness of drugs, we need to do better,” Angell admonishes in the July 14 essay.

In response the American Psychiatric Assn. submitted a rebuttal to Angell’s essay, now online.

“We regret that a more balanced approach was not taken,” the letter begins, adding that is incorrect to say that psychiatrists treat only with drugs and in a cavalier manner. “The bottom line is that these medications often relieve the patient’s suffering, and this is why doctors prescribe them,” APA leaders wrote.

Moreover, some of the issues raised by Angell, such as the influence of industry on medical practice, are not unique to psychiatry, said Dr. John Oldham, president of the APA, in a report Friday in Psychiatric News. “There’s a lot of very bad distortion in [Angell’s reviews] for someone with her stature to be promoting.”

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