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Estelle Mallet-Dumas and François Gonon in Harvard Review of Psychiatry

On October 31, 2019, two psychiatrists from Harvard University wrote in the New England Journal of Medicine : “Ironically, although these limitations (of “biologic treatments”) are widely recognized by experts in the field, the prevailing message to the public and the rest of medicine remains that the solution to psychological problems involves matching the “right” diagnosis with the “right” medication. Consequently, psychiatric diagnoses and medications proliferate under the banner of scientific medicine, though there is no comprehensive biologic understanding of either the causes or the treatments of psychiatric disorders.”

Like other leaders in the field, Gardner and Kleinman admitted that the neurobiological analysis of psychiatric disorders has not yet been translated into improved clinical care. Moreover, they acknowledged, for the first time in a prestigious biomedical journal, that psychiatrists deliver another message to their non-psychiatric peers in medicine and to laypeople. Our team is working for ten years on the covering of biological psychiatry by mass media. Garner’s and Kleinman’ opinion letter prompted us to publish the present perspective article. We review the academic literature describing the misrepresentations of biological psychiatry, their sources, diffusion through mass media, possible causes and social consequences.

Figure. Dopamine transporter density in the striatum of patients with attention deficit hyperactivity disorder. The initial study by Dougherty et al. (1999) reported a 70% increase in 6 adult patients compared to 30 controls. Subsequent studies reported a smaller increase, no difference or a modest opposite effect. This initial study was widely covered by newspapers whereas all, but one, subsequent studies were not. This subsequent study was only covered by 3 newspapers and none mentioned that the initial study was disconfirmed. This example illustrates how biological psychiatry is often misrepresented in mass media. Because initial studies are more often published in high impact factor journals, they are echoed in mass media whereas subsequent studies that disconfirm them are not. Moreover, mass media almost neither inform the public when an initial study they have covered is disconfirmed by subsequent investigations (from Gonon et al. (2012) and Dumas-Mallet et al. (2017)).

Estelle Dumas-Mallet, François Gonon
Team : Physiologie et physiopathologie des fonctions executives
IMN

Article

Messaging in Biological Psychiatry : Misrepresentations, their Causes and Possible Consequences
Dumas-Mallet, Estelle ; Gonon, Francois

Harvard Review of Psychiatry: 11/12 2020 – Volume 28 – Issue 6 – p 395-403
doi: 10.1097/HRP.0000000000000276
17/11/20