Drug Ads: Let's Use Them as Learning Tools

By Metzal, Jonathan M. | Clinical Psychiatry News, September 2004 | Go to article overview

Drug Ads: Let's Use Them as Learning Tools


Metzal, Jonathan M., Clinical Psychiatry News


Pharmaceutical advertisements are having problems with women. The latest evidence comes from a group of scholars at the Women's Health Program at the University of Toronto. Their study. "Who Is Portrayed in Psychotropic Drug Advertisements?" (J. Nerv. Ment. Dis. 192[4]:284-88, 2004), coded advertisements from the American Journal Of Psychiatry and its British and Canadian counterparts between 1981 and 2001. What they found sounds like a throwback from yesteryear: White women patients were over-represented, compared with psychiatric epidemiologic data in all three countries.

Even worse, the most concerning numbers came not from the early time periods but from the later ones. The researchers found consistent increases in the numbers of women who appeared in the ads over time and in the numbers appearing "in the garden or in a social situation" and, predictably, as mothers, in "family settings." (Men, conversely, appeared almost exclusively in "professional settings.")

The authors also discovered that the American ads were far and away the most egregious offenders: In the 2001 issues of the American Journal of Psychiatry, a whopping 88% of ads depicted women, up from a mere 48% in 1981.

Are we returning to the 1960s and 1970s, that era when psychiatric medications became infamously known as "mother's little helpers"? "Doctor, please/Some more of these," sang the Rolling Stones. Jacqueline Susann's The Valley of the Dolls suggested that psychotropics were a "woman's best friend" when it came to dealing with the pressures of working in a man's world, while Barbara Gordon's I'm Dancing as Fast as I Can informed "millions of Americans" about the untoward effects of a woman's treatment with, addiction to, and withdrawal from Valium.

We as a profession worked very hard to overcome the stigma inherent in the belief that psychiatric medications treated the pressures of motherhood, singlehood, and other aspects of womanhood.

Research between 1965 and 1979 found that psychotropic medications were over-prescribed to mothers and other women by rates of up to 70%, compared with men--findings that ultimately produced reforms in prescription practices.

Scholarship also focused on representations of women in pharmaceutical advertisements. Studies such as Jane Prather's and Linda Fidell's "Sex Differences in the Content and Style of Medical Advertisements" (Soc. Sci. Med. 9[1]:23-26, 1975) and Joellen Hawkins's and Cynthia Aber's "The Content of Advertisements in Medical Journals: Distorting the Image of Women" (Women Health 14:[2]:43-59, 1988) established that women were overrepresented in psychiatric drug ads in the 1970s and 1980s in ways that emphasized their passivity, emotionality, and most of all, their motherhood.

These and other discoveries led to changes in the depictions of women in these ads, and, it was assumed, in the psychiatrists who read them.

And yet an emerging body of literature now suggests that the stereotype has returned, as if a symptom has returned from the repressed. For example, in the current issue of the journal Gender and Society, a study by Linda Blum and Nena Stracuzzi analyzed articles about Prozac from mass-circulation magazines and found that women in these articles were shown to reproduce "stereotypes of normative femininity."

These findings mirror my own analysis of the nation's leading newspapers and magazines between 1987 and 2000, which demonstrates that popular articles about depression increasingly described women's problems with marriage, motherhood, and menstruation as suggestive of the need for treatment with SSRIs (Soc. Sci. Med. 58[3]: 577-584, 2004).

What should we do about this problem? The Toronto authors suggest that psychiatry should push, once again, for changes in advertisements, particularly by increasing the numbers of men and minorities shown in the ads. …

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