Psychiatry: finally give the medical model!

Psychiatry: Finally give the medical model!

In the Corona Year 2020, the search for human trial canbins for new psychotropic lakes ran in full swing. Here is a billboard from the Berlin subway. Photo: telepolis / claw

Mental training pictures are treated medication, although they are not diagnosed biomedical – at the same time more and more cases are registered

According to the data situation of health insurance KHH, treatment-exercises in children and adolescents increased by around 60 percent in children and adolescents alone, such as the Ard-Tagesschau on 3. June reported. Already between 2009 and 2019 there was an increase of 13 percent here.

For other disruptions, the increase in this age group had been gross: Anxiety plus 45 percent, Burnout plus 55 percent, stalls plus 72 percent. In depression, between 2009 and 2019 even an increase of 97 percent had been established, almost a doubling. Experts agree that the Corona Pandemic had encouraged mental problems. In doing so, the problems not only often occurred, but also in greater in the life of those affected.

Old trend

The trend, however, is not new: In 2018, the Barmer replacement fund had published similar numbers about young adults. The development has already stopped since the 1990s – and the pharmaceutical industry suggests capital. Already in 1993, the US psychiatrist Peter D met. Kramer with his book on antidepressants, which in German 1995 under the title "Gluck on recipe" appeared, a nerve. In 1997, the Irish psychiatrist David Healy wrote about the "Ara of antidepressants" and thus pulled the anger of the pharmaceutical industry on himself, which afterwards his career torpedo. Healy, however, did not love themselves and revealed further critical articles and bookers.

In 1998, the French sociologist Alain Ehrenberg addressed "That seemed itself: depression and society in the present" The continued increase in depression. My now retired boss Trudy Dehue wrote in 2008 its Dutch bestseller on the depression epidemic and received many awards and honor, both from science and society.

In 2013, the well-known US psychiatrist criticized all Francis the endless expansion of psychic disruptions, which in German in the same year entitled "Normal: Against inflation of psychiatric diagnoses" shed. He was in particular the pathologization of natural mourning A in the loss of a close-out person as "depression" a mandrel in the eye. The list will definitely continue.

The medical model

And now, in 2021, is already talking about a sudden increase in diagnoses. The prevailing model in psychiatry, such as the long-term Leipzig Clinic Director and Chairman of Deutsche Depression’s help, Ulrich Hegerl, unavailably represents depression and other psychological disorders as diseases in the medical. As there is a pathogen, which one preferably treat drugs.

Under this pramisse can not be realized why more and more and more people get psychological-psychiatric diagnoses. The biomedical approach proceeds, namely, mental disorders are brain diseases. Why should it be more and more defects "Circle circuits" brain? And why can not be detected in individual cases?

For comparison, the history of attention to attention ADHS is recalled: Fruhe told simply, children with certain behaviors had one "Brain damage" (Minimal Brain Damage, MBD). In the 1950s and 1960s, this approach took more and more criticism – and they made a less serious sounding one "Brain language" (Minimal Brain Disorder, MBD). In 1980, this was then transferred to the attention creation ADS or 1987 for attention deficit / hyper activity scope of ADHD.

Soon thereafter, the number of drug letters of Ritalin and other stimulants exploded. In 2017, leading psychiatrists found that there are no structural brain differences between people with and without ADHD diagnosis.

For the scientific publication, however, the finding was poorly turned out: The minimum statistical differences between the two groups were prove final to ADHD by a brain location. So it demands the biomedical paradigm. Funny only that ADHS – as well as the many hundred other mental disorders – do not diagnose in the brain.


The medical model is reasonable for medical diseases. For this purpose, there is usually a corpulum cause or a corpulent disease center. With his elimination, the disease symptoms disappear. For a bacterial infection, for example, antibiotics are prescribed. Or one – detectable in the blood view – Capital restriction of insulin production is fixing with the critical intake of the hormone for regulating blood sugar levels.

Not so in mental disorders. As an influential US psychiatrist prepared the third edition of your DSM diagnostic manual (Diagnostic and Statistical Manual of Mental Disorders) of 1980, they wanted to put it on a scientific foundation. The first catch was based on procedures in the 1950s, with which the prosecution of soldiers was assessed during the Second World War. At that time, psychiatry was still strongly influenced by Sigmund Freud’s teaching. As the causes of the trunks were essentially parent-child conflicts.

This was the new generation of psychiatrists in the 1970s but less and less convincing. Therefore, the cause of the cause was removed in the DSM-III, or only shifted to an appendix because it’s natural to resistance from other psychiatrists.

To date, nothing has changed. The DSM-5 of 2013, which should be handled in the light of neuroscience, also knows risk factors, no causes. Since the edition of 1980, it is about pure symptom descriptions: deviating feeling, thinking and behavior patterns, which are mostly associated with subjective suffering or restrictions in everyday life. Just a psychotherapist or psychiatrist this for "clinically significant", Then a diagnosis can be done. On the basis of the family also diagnose such disturbances, but are usually not specifically trained.

Meanwhile, it should be clear that we have to do it here with social and statistical standards. For depression turns, as already said, much about the question of what normal mourning differs from a clinical depression. According to DSM-5, the experts should take into consideration, what "culturally appropriate" is. Aha.

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