In a recently published article "From neuroleptics to neuroscience and from Pavlov to psychotherapy: more than just the ‘emperor’s new treatments’ for mental illnesses?", well-regarded psychologists Jürgen Margraf and Silvia Schneider claim that from the data and evidence we now know, "in the long term, the drugs do not work".
The authors note it is commonly perceived that antidepressant and anti-anxiety drugs have improved our way of treating mental illness, however, mental health issues have noticeably increased in the past fifty years. Margraf and Schneider make the assumption that the therapeutic progress is indeed much less than is being told. The authors further suppose: "could it be that we cannot make therapeutic progress because the concept of mental illness and its treatment is deeply flawed?"
To support these assumptions, the psychologists find several flaws in the way we treat mental health issues. Namely, the "reification of diagnostic constructs", e.g. Depression, as a category of illness rather than a factor in human behaviour which occurs on a spectrum. Another mistake in the common approach is the emphasis which is put on "bottom-up" causal pathways, rather than external (social and psychological) influences.
“After decades of proclaimed therapeutic breakthroughs and promises of imminent better treatments based on the translation of basic science into clinical practice, neither neurobiology nor neuroscience has led to measurably better long-term outcomes for any of the major mental disorders,” the researchers write. “Although psychotropic drugs are by far the most often used treatment modality in industrialized countries, there is no compelling evidence for the long-term stability of their small to moderate short-term results.”
The authors conclude that “a realistic assessment of our current treatment options and the close cooperation of clinicians and neuroscientists would help us to overcome the current stagnation and put us back on the track forward."
The article can be accessed online here.
Margraf, J., & Schneider, S. (2016). From neuroleptics to neuroscience and from Pavlov to psychotherapy: more than just the “emperor's new treatments” for mental illnesses?. EMBO Molecular Medicine, e201606650.