Changing minds

DESPERATE REMEDIES, by Andrew Scull (Allen Lane, hb $65)

Among medical specialists practising today, psychiatrists continue to rank among the least trusted by patients and their medical peers – an unenviable situation for professionals who spend more than a decade studying.

The most charitable assessments express concern at the lack of diagnostic testing available in the field – all major mental illnesses are diagnosed by a symptom checklist and close interviewing – and the heavy reliance on psychoactive drugs that often have dubious rates of success: no one knows how or why lithium helps stabilise mood; Prozac is fully effective in treating only about a third of patients prescribed it.

The least charitable continue to regard psychiatry and those who practise it as – Asperger’s has recently been scrapped, but disruptive mood dysregulation disorder added.