Cracked Book Summary - Cracked Book explained in key points

Cracked summary

James Davies

Why Psychiatry Is Doing More Harm than Good

4.4 (26 ratings)
18 mins

Brief summary

'Cracked' by James Davies explores how psychiatry's influence has shaped our understanding of mental health, outlining the negative effects of over-medicalization and offering alternative approaches to treatment.

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    Discrepancies in diagnosis are a major problem for psychiatrists, even with a new manual.

    Let’s start with a simple question: If you have a mental health issue, how can you be sure a psychiatrist will diagnose it correctly?

    Basically, you can’t. The process of diagnosing psychiatric conditions is more subjective than we might think, depending heavily on the whims and even location of the psychiatrist. One study conducted by Dr. David Rosenhan demonstrates the consequences of these highly individual diagnoses.

    He sent a group of eight academics to different hospitals, each of them with the complaint that they heard a voice in their heads saying the word “thud,” but were otherwise behaving normally. All of them were diagnosed with various mental disorders and prescribed strong antipsychotic pills. Most were held in hospitals for weeks, even after explaining that they were part of a study!

    Furthermore, statistics show that psychiatrists across the world only share a consensus on patient diagnoses for the same patient 32 to 42 percent of the time. However, there are regional similarities in diagnoses. For example, when we compare trends in psychiatric diagnoses across countries, we find that psychiatrists from the US and Russia are twice as likely to diagnose their patients as schizophrenic than their colleagues in Europe.

    These discrepancies arise despite the fact that psychologists have already standardized the diagnosis of mental disorders in the Diagnostic and Statistical Manual of Mental Disorders, or the DSM.

    The DSM contains all psychiatric disorders known in modern medicine and has been continually edited and refined since its first publication under the title DSM-I in 1952.

    However, the standards found in the DSM are based on the consensus of psychiatrists, not on scientific research. For example, homosexuality used to be categorized as a mental disease in DSM-II. This all changed during the gay rights movement in the 1970s, during which psychiatrists voted to remove homosexuality from the manual’s third edition, DSM-III.

    Unlike other medical sciences, where doctors can agree if a patient’s leg is broken based on the available evidence, e.g., an X-ray, psychiatrists cannot diagnose patients in a way that enjoys a unanimous consensus.

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    What is Cracked about?

    Cracked gives a clear and detailed overview of the current crisis in psychiatric science: malfunctioning scientific standards and the powerful influence of pharmaceutical companies have caused the overdiagnosis and overmedication of people all over the world.

    Best quote from Cracked

    By lowering the diagnostic thresholds for warranting a diagnosis more people may be unnecessarily branded mentally unwell.

    —James Davies
    example alt text

    Who should read Cracked?

    • Anyone involved in psychiatry
    • Anyone receiving psychiatric treatment or considering it
    • Anyone interested in the history of prescription drugs

    About the Author

    James Davies is a qualified psychotherapist with a Ph.D. in medical and social anthropology. In addition to writing for numerous publications, such as The Times, Daily Mail and The Guardian, he has also published three academic texts with Stanford University Press, Karnac and Routledge.

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