Objective: An empirical examination of the scientific status of psychiatry. Method and Results: Analysis of the publications policy of the major English-language psychiatric journals shows that no journal meets the minimum criteria for a scientific publishing policy. Conclusion: Psychiatry lacks the fundamental elements of any field claiming to be a science. Furthermore, its present policies are likely to inhibit scientific development of models of mental disorder rather than facilitate them. The psychiatric publishing industry is in urgent need of radical reform.
Keywords: psychiatric publishing; sociology of science; psychiatry as protoscience; self-deception in psychiatry
Psychiatry is part of medicine, and medicine is an applied science, therefore psychiatry is a scientific field in its own right. Very few psychiatrists would question this conclusion but, from time to time, it is appropriate to question our basic assumptions to see if they still apply. I have previously argued (McLaren, 2007) that all models used in psychiatry are invalid, meaning our field is no more than a protoscience. In particular, I have outlined a case against the attempt to explain mental disorder using biological reductionism (McLaren, 2008). Briefly, reductionism is the wrong conceptual approach to the question of human mental life. That is, the attempt to reduce mental life to matters of biology misunderstands the nature of mind, or is ontologically incorrect. My view is that since we do not have a valid model of normal mental life, or mind, we are not in a position to begin to explain disordered mental life. If we had an adequate theory of mind, then a model of mental disorder would flow from it and, hence, the correct technology for investigating and treating it. But, uniquely in medicine, we have nothing like this.
This appears contradictory: how can there be a field of science without an agreed model of what the field is about? At first glance, psychiatry has the trappings of a field of science. It has highly trained researchers working in dedicated centers, supported by government and industry grants that are allocated according to ethical processes; it has training programs, examinations, conferences, and a publishing industry. Grant procedures, courses, and so forth, evolve but the publication of scientific research is so basic to our concepts that we rarely consider it, and it has hardly changed in a hundred years. Its original purpose may have been educational but, these days, its major function is essentially epistemological, a matter of what we can rightly claim to know. Even though its applications may be covered by patents, and so forth, all basic scientific research takes place in the public domain. Theories must be free of bias, and the only way of ensuring this is to allow others to follow the arguments and to repeat the research. If there is a fault, somebody will find it. Publication serves other ends, of course, but its epistemological function is to eliminate error. Errors are discovered and corrected simply by placing the whole of the program, theories and research, before the critical audience of one's peers and the general public. Accordingly, every part of a field of science is open to challenge. Nothing is sacrosanct, not theories, models or methods, nor personalities, reputations, or ambitions. The idea that a field of science can be immune to criticism is self-contradictory, just because criticism is the only way we know of eliminating error. Indeed, criticism is the very engine of scientific progress.
As with all fields of science, psychiatry must meet certain requirements before it can be taken seriously. These include an agreed model of mental disorder (a single playing field), objectivity (a level playing field), accessibility (an open playing field), and accountability (a public playing field). In this article, I wish to examine the question of psychiatry's formal status as a …