2023-12-26 07:10:49
Psychiatrists, who certainly do their job with empathy and humanity, must suffer from their cruel lack of results.
The prevalence of mental disorders is estimated at 25%, and one in three people will have at least one during their lifetime. A large survey of people over 65 reveals that during their life, 47% of people have had a psychiatric illness, 26% major depression, 30% anxiety disorders, 11% generalized anxiety, 21% phobias, 3.7% a suicide attempt, 4.7% a psychosis.
The prevalence of psychiatric disorders during pregnancy remains unchanged, although these disorders very often have repercussions on their offspring.
The prevalence of anxiety and mood disorders has not decreased, despite the abundance of treatments. The significant resources allocated to psychiatric problems never have an impact on indicators of psychological distress. Quadrupling budgets and doubling the number of psychiatrists, as New Zealand did, had the sole effect of doubling the consumption of psychotropic drugs without reducing morbidity: 13.7% of citizens received antidepressants and 3.1% neuroleptics. .
All meta-analyses show a doubled mortality risk among mentally ill people. Their life expectancy is reduced by 8 to 20 years. Mental illnesses contribute to 14% of global deaths, or 8 million per year. This excess mortality is not only linked to suicides and accidents but also to treatments and various socio-economic factors. These factors, whose major effect on the psyche has been known since ancient Greece, make it possible to put the epidemiological failure of psychiatry into perspective.
Psychiatrists can be criticized for having unstable and vague diagnoses. Their coding for anxiety-depressive disorder shows a kappa close to zero. There is no consensus on the concept of severity of a mental disorder. Paranoid ideation in the population varies from 2% for some to 30% for others. For four serious psychoses: schizophrenia, bipolar illness, psychotic depression and drug-related psychosis, half of the patients did not have the same diagnosis ten years later. The 176 criteria studied in the two classification systems for psychiatric illnesses (ICD and DSM) differ for 99.9% of illnesses.
Certainly, their task is not easy, because half of patients with a psychiatric disorder also meet the criteria for another disorder. Genome-wide, neurobiological, and epidemiological data suggest a shared risk architecture for diagnoses as diverse as bipolar disorder, schizophrenia, ADHD, major depression, and addiction.
The only great fault of psychiatrists is not having been able to prevent the creation of diagnoses for all the misfortunes of life and still not having found an objective measure to differentiate the normal from the abnormal.
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