What can we learn from the asylum? Historical study of the Essex County Asylum reflects the perennial functions of the mental health system

Summary My historical study of the Essex asylum, just outside London, which was recently published in Psychological Medicine, finds that those who were admitted showed significant disturbances of behaviour or evidence of organic disease. Almost two thirds of those who had psychological, as opposed to organic, disorders were discharged recovered or improved (mostly recovered). The…

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What does ‘relapse’ mean? Definitions used in long-term antipsychotic treatment trials are inconsistent and unclear.

We are told that long-term antipsychotic treatment reduces the risk of someone having a ‘relapse’ of schizophrenia or psychosis. What ‘relapse’ actually refers to in the studies that are supposed to establish this has not been examined though. Our recent study of relapse definitions, published in Schizophrenia Research, shows that there is no consistent or…

Philosophy / Politics

The uniqueness of life: a review of Peter Hacker’s “Human Nature: the Categorial Framework” and its implications for the mind-body problem and our understanding of mental disorder

Peter Hacker is an eminent philosopher and one of the world’s leading authorities on Wittgenstein. He has published a four volume analytical commentary on the Philosophical Investigations and a brilliant little book on Wittgenstein’s philosophy of mind, now sadly out of print (1). He is also well known for his debunking of neuroscientific reductionism in…

Antidepressants in pregnancy – turning a blind eye, again

The psychiatric establishment are keen to reassure people, but the evidence suggest few benefits and many potential risks of taking antidepressants in pregnancy.

Wishful thinking dressed up in scientific terminology: a reply to Awais Aftab

Awais Aftab’s blog about the Sunday Times article on my new book, Chemically Imbalanced, was predictable. Like previous reactions to our serotonin paper, it illustrates how elements of the psychiatric profession attempt to control the message that gets out to the public. Aftab even subtitled his blog ‘British journalists and editors this is for you’.…

Desperate measures: Ghaemi’s response to our review of lithium and suicide prevention

We argue that Nassir Ghaemi’s extraordinarily pejorative response to our review demonstrates how strongly attached the biological psychiatric establishment is to the idea that treatments target disease processes and how angrily it reacts when this notion is challenged. We refute Ghaemi’s criticisms.

Lessons from the RADAR trial

The RADAR trial is complete. Disappointingly it showed that people who gradually reduce their antipsychotic medication are more likely to relapse than people who continue it. At 2-year follow-up there were no differences in social functioning, symptoms, side effects or quality of life. Yet relapse was far from inevitable and the qualitative analysis showed that…

Contradictory responses to our review of serotonin and depression

After the publication of our umbrella review of serotonin last summer, several psychiatrists wrote letters to the journal, Molecular Psychiatry, as usually occurs after the publication of a major finding. We were invited by the editor of the journal to respond to the points raised in the letters, again a routine procedure in scientific literature.…

How profit and professional interests have misled us about antidepressants

Our umbrella review that revealed no links between serotonin and depression has caused shock waves among the general public, but been dismissed as old news by psychiatric opinion leaders. This disjunction begs the questions of why the public have been fed this narrative for so long, and what antidepressants are actually doing if they are…

‘First they ignore you. Then they ridicule you. And then they attack you …’*

Summary: I respond to some of the points in the recent Rolling Stone article and correct the many inaccuracies and distortions. Ignoring is no longer working, so champions of big Pharma and mainstream psychiatry have gone into attack mode. The strategy is to undermine the messenger (me) in order to neutralise the message. In this…

How to take the news that depression has not been shown to be caused by a chemical imbalance

Summary TL;DR For decades people have been told that depression is caused by a serotonin deficiency. This was the rationale behind the introduction of the SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants in the 1990s, which were thought to work by boosting low levels of serotonin. Our research shows no evidence of low serotonin in depression,…

Systematic umbrella review finds no evidence that serotonin abnormalities are associated with depression (but don’t stop your drugs suddenly)

Our new review of serotonin research collated research from six different areas. We looked at research on serotonin levels in body fluids, levels of the main metabolite (breakdown product) of serotonin in the cerebro-spinal fluid (brain fluid), serotonin receptors, the serotonin transporter protein (the protein that removes serotonin from the synapse where it is active-…

The functions of the mental health system under capitalism

In this blog I look at the functions of the mental health system as they relate to the economic and social structure of society using Marx’s economic framework. I conclude that the mental health system is essentially a system of care and control, that is legitimated by the concept of mental illness and that plays…

Joanna Moncrieff

Books, papers and blogs by Joanna Moncrieff