title: Psychiatry and fads: why is this field different from all other fields?
abstract: Fads in psychiatry are little more than bad ideas with short half-lives. They have arisen because of the great discontinuities that have swept psychiatry unlike other specialties in the 20th century: the transition in the 1920s from asylum-based biological psychiatry to psychoanalysis, and the transition in the 1960s from psychoanalysis to a biological model based on psychopharmacology. In no other medical specialty has the knowledge base been scrapped and rebuilt, and then again scrapped and rebuilt. In these great transitions, when psychiatry each time has had to reconstruct from scratch, bad ideas have crept in with good. Psychiatry, in its heavy use of consensus conferences, is often unable to employ science as a means of discarding fads, which, once installed, are often difficult to remove. Each of the great paradigms of psychiatry in the last hundred years has given rise to fads, and psychopharmacology is no exception, with faddish uses of neurotransmitter doctrine claiming centre stage. Only when psychiatry becomes firmly linked to the neurosciences will its subjugation to the turbulence of faddism be moderated.
authors.affiliation: Hannah Professor of the History of Medicine, Professor of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario.
authors.forename: Edward
authors.initials: E
authors.lastname: Shorter
mesh_terms: D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D009488:Neurosciences / Q000266:history; D011570:Psychiatry / Q000266:history / Q000639:trends*; D011572:Psychoanalysis / Q000266:history; D011600:Psychopharmacology / Q000266:history
keywords: DSM-5; Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition; classification; dexamethasone suppression test; diagnosis; diagnostic categories; fads in psychiatry; psychiatric diagnosis; selective serotonin reuptake inhibitors