Tea at Trianon: On the Psychiatric Treatment of Children

John Wilson Croker on Marie-Antoinette

"We have followed the history of Marie Antoinette with the greatest diligence and scrupulosity. We have lived in those times. We have talked with some of her friends and some of her enemies; we have read, certainly not all, but hundreds of the libels written against her; and we have, in short, examined her life with– if we may be allowed to say so of ourselves– something of the accuracy of contemporaries, the diligence of inquirers, and the impartiality of historians, all combined; and we feel it our duty to declare, in as a solemn a manner as literature admits of, our well-matured opinion that every reproach against the morals of the queen was a gross calumny– that she was, as we have said, one of the purest of human beings."

~from History of the Guillotine by John Wilson Croker, 1844

Edmund Burke on Marie-Antoinette

"It is now sixteen or seventeen years since I saw the queen of France, then dauphiness, at Versailles; and surely there never lighted on this orb, which she hardly seemed to touch, a more delightful vision. I saw her just above the horizon, decorating and cheering the elevated sphere she had just begun to move in, glittering like a morning star full of life and splendor and joy. Oh, what a revolution....Little did I dream that I should have lived to see such disasters fall upon her, in a nation of gallant men, in a nation of men of honor and of cavaliers! I thought ten thousand swords must have leaped from their scabbards, to avenge even a look which threatened her with insult. But the age of chivalry is gone; that of sophisters, economists, and calculators has succeeded...."

~Edmund Burke, October 1790

Saturday, January 11, 2014

On the Psychiatric Treatment of Children

From Zenit:

The accepted wisdom is that the arrival of chlorpromazine in asylum medicine in 1955 kicked off a psychopharmacological revolution, this great advance in care. Chlorpromazine is remembered today as the first "antipsychotic," and soon the field gained new antidepressants, and new anti-anxiety drugs. Then, starting in the late 1980s, a second generation of psychiatric drugs came to market, said to be safer and more effective than the first. That is a story of continual medical progress.

Yet, as this revolution has unfolded, the burden of mental illness in western societies has increased. Disability rates due to mental illness have soared, and this is particularly true during the past 25 years, since Prozac came to market. Furthermore, the long-term outcomes for major mental disorders have, if anything, gotten worse during the last 25 years.

Thus, you have a puzzle: if the medications are so helpful, why is the burden of mental illness increasing? Why haven't long-term outcomes improved?

The prescribing of psychiatric drugs in children really began in the United States in 1980, when the American Psychiatric Association created the diagnosis of attention deficit disorder for the first time, when it published the third edition of its diagnostic and statistical manual. Then, if you look at the growth of this practice, of prescribing psychiatric medications to children, it is easy to identify the commercial forces involved. And finally, this is being done in the absence of good evidence that the medications help the children over the long term. (Read more.)