The Disease-Centred Model of Drug Action in Psychiatry

Abstract

Since the 1960s we have lived in an age characterised by the idea that drugs can cure the problems that are now referred to as ‘mental illness’, but have previously been known as insanitymadness, lunacy and neurosis, among other terms. By ‘cure’ Imean the idea that drugs can improve symptoms by helping to rectify the underlying pathological mechanism that is presumed to give rise to the symptoms in the first place. Increasingly this way of thinking has spread outside psychiatry and drugs have also come to be seen as having acurative role in all sorts of situations in which people feel they are not performing or functioning as well as they should. Such situations are ‘diagnosed’ as depression, dysthymia, anxietysocial phobia, substance misuse, compulsive shopping, menstrual dysphoric disorder,etc. and drugs are prescribed for their treatment. The storybywhich drugs first came to be seen in this wayasspecific treatments for specific mental disorders or collections of symptoms, and whether or not this way of thinking about drugs and their actions is justified are the subjects of this book.

Parts of this chapter and the next one are based on two papers I wrote with David Cohen: Moncrieff & Cohen (2005, 2006).