I’ve recently come across (courtesy of Tallaght Trialogue) an article in Current Psychiatry (Feb 2013) on this topic. The author is Henry A. Nasrallah, M.D., and you can see it here.
Dr. Nasrallah, who is Editor-in-Chief of Current Psychiatry, states that there are 273 bio-markers for schizophrenia. But wait. Dr. Nasrallah goes on to say:
“None of the individual 273 biomarkers alone can serve as a diagnostic tool for the schizophrenias because there will be high rates of false positives and false negatives.”
One of the reasons for this, according to Dr. Nasrallah, is that schizophrenia is not a single condition. There are “many schizophrenias.”
He continues:
“The complex heterogeneity of most psychiatric syndromes means that biomarkers will help unravel the rich neurobiology of those disorders and help elucidate the multiple neurobiologic underpinnings of these syndromes.”
Of course he’s correct, with regards to the heterogeneity, but he clearly conceptualizes this not as the variations intrinsic to human existence, but rather as a multiplicity of brain diseases!
Note what’s happened. For decades the neurobiology of schizophrenia (and other “mental illnesses”) has been psychiatry’s holy grail. Now, as it’s becoming increasingly clear that it doesn’t exist, we have a new quest – the neurobiology of multiple schizophrenias. All the earlier attempts failed because – get this – they were looking for the wrong thing! But now that they’re getting it right, Dr. Nasrallah tells us that it’s happy times ahead.
“Psychiatrists should look forward with great optimism to a bright future for psychiatric diagnosis, combining a set of clinical signs and symptoms with a confirmatory cluster of lab tests. It may take time, but psychiatric clinicians will be using biomarkers in the future and the media and the public finally will perceive psychiatry as a “mature” medical discipline.”
Dr. Nasrallah describes a survey he did of psychiatric practitioners. Reportedly “…60.5% of responders predicted that the DSM-6 (approximately a decade from now) will contain laboratory tests for psychiatric diagnosis.”
So just hang in there for another decade, and psychiatry will be a mature medical discipline. Perhaps in the meantime there should be a sign outside every psychiatrist’s office that says: “Psychiatry is NOT a mature medical discipline”
Incidentally, according to ProPublica (Dollars for Docs), Dr. Nasrallah received $897,079 from various pharmaceutical companies between 2009 and 2012.
Also incidentally, here are the names of other members of Current Psychiatry’s editorial staff who received money from pharmaceutical companies in the same period. (Also per ProPublica.)
$169,324 Joseph Goldberg MD, Deputy Editor, 2009-12
$17,303 Robert A. Kowatch MD, PhD, Section Editor, 2010
$80,178 George Grossberg MD, Section Editor, 2010-12
$298,738 Sheldon Preskorn MD, PhD, Section Editor, 2009-12
$401,278 Robert Anthenelli MD, Section Editor, 2009-12
$46,423 Dale D’Mello,MD, Dept. Editor, 2010-11
$394,376 Leslie Lundt MD, Dept. Editor, 2009-12
$134,037 Robert McCarron DO, Section Editor, 2009-12
Of course it is entirely possible that all of this pharmaceutical money has no effect whatsoever on the content of the journal. Current Psychiatry also has 16 editorial consultants, five of whom have taken pharmaceutical money in recent years.(Also per ProPublica.)