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Unhinged: The Trouble with Psychiatry - A Doctor's Revelations about a Profession in Crisis Hardcover – May 18, 2010

4.2 out of 5 stars 46 customer reviews

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Editorial Reviews

Review

"Unhinged is a searingly honest and articulate account of modern psychiatry's failure to think outside the box of psychopharmacology in treating patients." (Alison Bass, author of Side Effects: A Prosecutor, a Whistleblower and a Bestselling Antidepressant on Trial,winner of the NASW Science in Society Award for 2009)

“A psychiatrist looks deeply into the mirror and takes stock of his profession and what it has become. Whether you are a patient, student, trainee, clinician, or “KOL” (key opinion leader”), this frank and insightful book will definitely make you think.” (Erick Turner, M.D., Department of Psychiatry and Center for Ethics in Health Care, Oregon Health & Science University)

"Unhinged provides crucial insights for anyone who cares about the future of Psychiatry. Must reading for psychiatrists and patients alike." (Keith Ablow, MD, author of Living the Truth)

"Terrific book, terrific insights! Daniel Carlat is the kind of psychiatrist we wish we all had." (Manny Alvarez, MD, Senior Managing Health Editor at Fox News Channel)
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Product Details

  • Hardcover: 272 pages
  • Publisher: Free Press; 1 edition (May 18, 2010)
  • Language: English
  • ISBN-10: 9781416590798
  • ISBN-13: 978-1416590798
  • ASIN: 141659079X
  • Product Dimensions: 6 x 1 x 9 inches
  • Shipping Weight: 15.5 ounces
  • Average Customer Review: 4.2 out of 5 stars  See all reviews (46 customer reviews)
  • Amazon Best Sellers Rank: #119,463 in Books (See Top 100 in Books)

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Top Customer Reviews

Format: Hardcover
This is essentially a whistle blower reporting on the corruption of psychiatry by Big Pharma. Dr. Carlat went to UCSF med school in 1985 as psychiatry was rapidly transiting to psychopharmacology. He is practicing at Massachussetts General Hospital (MGH) where many of the key drug trials had taken place and where faculty members had received millions from Big Pharma to conduct such trials. He also used to accept Big Pharma's money ($30,000 in total, a very small amount relative to others) to lecture to pitch its drugs until his conscience regained the better of him. Thus, he had a front seat and was an active participant in psychiatry's' corruption. His confession is very insightful.

Carlat feels that psychiatry is in a state of crisis, as it has lost much credibility with the public. He mentions a recent Gallup poll that uncovered that only 38% of Americans trust psychiatrists, on par with chiropractors (36%) and even bankers (37%) and way below regular physicians (69%). There are several themes to Carlat's analysis of psychiatry devolution.

First, psychiatrists have given up on understanding their patients. They don't do psychotherapy anymore. They essentially just prescribe drugs (mainly anti-depressants). They now call themselves psychopharmacologists instead of psychotherapists. For psychotherapy, you have to go to a psychologist (who got a graduate degree in psychology, but did not go to med school, and is not allowed to prescribe drugs).

Second, psychiatrists overdiagnose their patients. Way too many children are overdiagnosed with ADHD and even bipolar disorder (the latter being often meaningless for young children). From 1994 to 2003, children and adolescent treated for bipolar disorder rose by 8,000%! The majority of cases are misdiagnosed.
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Format: Hardcover
Dan Carlat's Unhinged: The Trouble with Psychiatry is a brutally honest account of the gaps in understanding psychiatric illnesses, the relative lack of knowledge about the actions and effects of psychiatric medications, and the importance of psychotherapy. This book should be required reading for all psychiatry residents and psychiatry faculty and on the bookshelves of both early and late career psychiatrists. It is also a must read for clinical psychologists training to prescribe. Prescribing and Medical Psychologists do not want to make the same mistakes that lead psychiatry to where it is today.

Bret A. Moore, Psy.D., ABPP
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Format: Hardcover Verified Purchase
The spotty record of the efficacy for psychotropics comes as no surprise, I have seen this on a daily basis for 20 years. But, the degree of deceit and fraudulent behavior by pharmaceuticals was astounding (why I should be so astounded is beyond me). This is a well written book, readable, sensible and helpful. His recommended solution to the problems with psychiatry are totally sensible, although its not likely at this time I would want to go back for the training needed.
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Format: Hardcover
Author Daniel Carlat wrote in the first chapter of this 2010 book, "I will take you on a guided tour of the landscape of modern psychiatry. I will show you what we actually know about the mind---versus what we only pretend to know. I will argue that we psychiatrists spend our days splitting our patients into two: one is a repository of neurotransmitters, and the other is a person with relationships, a job, and aspirations. We treat the neurotransmitters, and we refer the person to someone else. The surprise is that our treatments are remarkably helpful to patients, even though we hobble ourselves in this way. Imagine how effective we could be if we embraced all the tools at our disposal." (Pg. 16)

He admits, "Most people are under the misconception that an appointment with a psychiatrist will involve counseling, probing questions, and digging into the psychological meanings of one's distress. But the psychiatrist as psychotherapist is an endangered species. In fact, according to ther latest data ... only one out of every ten psychiatrists offers therapy to all their patients. Doing psychotherapy doesn't pay well enough. I can see three or four patients per hour if I focus on medications... but only one patient in that time period if I do therapy... psychiatrists have generally followed the money." (Pg. 4-5) He adds, "There was a time when I thought this shift in the profession was a natural evolution. Why put patients through months and years of weekly therapy if simply taking pills worked as well if not better? As it turns out, we were wrong in two ways. We both exaggerated the effectiveness of the new drugs and gave psychotherapy a premature burial." (Pg. 12)

He states, "The tradition of psychological curiosity has been dying a gradual death... In the past...
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Format: Hardcover
Unhinged is the politically correct criticism of psychiatry that is safe enough to get Carlat interviews on mass media including NPR but which says nothing that will truly upset establishment psychiatry. Everything Carlat says here has been reported for a decade in the corporate media. Yes, psychiatrists are bribed by drug companies to push drugs - old news! Yes, most psychiatrists are nothing but drug pushers who farm out psychotherapy - old news! Yes, as Carlat quite timidly implies, psychiatry has little hard science to back up its biochemical claims - again old news.

Want to read the kind of critique of psychiatry that is BIG NEWS? Read investigative reporter Robert Whitaker's Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown Publishers, April 2010). It is the most important book on psychiatric treatment in a generation. Whitaker, as a reporter for the Boston Globe, won a George Polk Award for medical writing and was a finalist for a Pulitzer Prize. Whitaker is in the tradition of Michael Pollan, Eric Schlosser, and other investigative reporters who get taken seriously. A decade from now, nobody will remember Unhinged, but Whitaker's Anatomy of an Epidemic may do what Rachel Carson's Silent Spring was able to do - wake up an entire nation to the dangers of the arrogance of another chemical industry.
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