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Thursday, June 23, 2005

Not as many crazies
Paul McHugh , professor of psychiatry at Johns Hopkins University in his article A Nation of Crazy People? Overestimating mental illness in America discusses the results of recent studies that cost $20 million to the taxpayer, and supposedly showed that "55 percent of Americans suffer from mental illness in their lifetime". Dr. McHugh asks,
But this simply raises the question, Why would anyone dream that an inventory of psychic aches and pains would reliably identify mental impairments and distinguish them from the kinds of mental distresses that are part of every person's life?
McHugh considers alternatives,
They might, for example, start following people over time, as cohorts with particular life circumstances: They might consider the long-term performance of children with particular classroom-identified dispositions or children exposed to various forms of deprivation or trauma early in life, seeking to discover how these people manage the hurdles they face and which vulnerabilities to mental problems and which resiliencies they manifest in later life. Epidemiologists should attend to studies where patients with particular characteristics--such as temperament, upbringing, or stress--are compared with nonpatients with similar characteristics (so called case-control studies) testing whether these characteristics provoke, protect against, or are incidental to the patients' mental unrest or illness. They should enhance cross-cultural knowledge of how mental impairment, as opposed to mental distress, is expressed by people of differing cultures and exactly what measures help to prevent or treat the case examples.
And that tax-funded $20 million would be better spent.

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