Separation of anxiety and depressive disorders: blind alley in psychopharmacology and classification of disease.
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Anti-Anxiety Agents↗
Biomedical subjects
Edward Shorter
Publications and source records attributed to Edward Shorter.
Notes on antipsychiatry.
The present paper aims to provide a review of the history and basic principles of the antipsychiatric movement, as well as to discuss the work of its most important theorists. The authors searched recent literature, as well as drawing upon some of the basic antipsychiatric texts. Antipsychiatry emerged as an international movement during the 1960s as part of the historic tumult of the period rather than as a result of the evolution of scientific ideas. Antipsychiatrists radically opposed what they understood as a hospital-centered medical specialty legally empowered to treat and institutionalize mentally disordered individuals. Indeed, many antipsychiatrists argued against the very existence of mental disorders themselves. After the 1970s, the antipsychiatry movement became increasingly less influential, due in particular to the rejection of its politicized and reductionistic understanding of psychiatry.
History, 20th Century↗
From railway spine to whiplash--the recycling of nervous irritation.
The search for a specific structural basis for chronic whiplash and other chronic pain and fatigue syndromes has been in progress for decades, and yet currently there remains no "structural" solution to these enigmata. In light of the failure of research to identify the chronic "damage" or pathology as lying in a muscular, bony, or "connective tissue" sites for many chronic pain syndromes like whiplash, fibromyalgia, et cetera, more recent attention has been paid to nervous system structures. Nerve irritation has been implicated as the basis for the pain and other symptoms that are common to many chronic disability syndromes. We postulate here, however, that the concept of nervous irritation has been prostituted for centuries whenever more concrete structural explanations for chronic pain and other controversial illness have been untenable. We suggest that, after each cycle of nervous irritation as a disease, and subsequent dismissal of the notion, the doctrine of irritation as a disease was too good to go away. First, with the hypersthenic and asthenic diseases of the nineteenth century, then railway spine, whiplash, thoracic outlet syndrome, and now brachial plexus irritation, we detect the same pattern: patients with symptoms, but no objective evidence of nerve disease. Nervous irritation has repeatedly served this purpose for the last 200 years. It is our intent that bringing an understanding of this trend will encourage current clinicians and researchers to appreciate the need to abandon this form of speculation without historical insight when dealing with today's controversial syndromes.
Chronic Disease↗
Looking backwards: a possible new path for drug discovery in psychopharmacology.
The history of psychopharmacology is littered with type II errors--the rejection of effective compounds in the specious belief that they were inefficacious because they had failed to beat placebo in a controlled trial. Revisiting some of these drugs to establish their receptor profile, and then determining what patentable compounds now on the shelf match that profile, might represent a possible future pathway to drug discovery. This article looks at the special circumstances in which numerous potentially effective drugs were withdrawn in the United States.
Clinical Trials as Topic↗