Andrew T. Scull
Person
Andrew T. Scull is a British-born sociologist and historian of psychiatry who is distinguished professor emeritus of sociology and science studies at the University of California, San Diego. He is known for his research on the social history of medicine and psychiatry and for books including *Madness in Civilization*, *Madhouse*, and *Desperate Remedies*.
Works by Andrew T. Scull
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What Andrew T. Scull has said on podcasts
49 statements
Psychiatry currently offers symptomatic treatments rather than cures.
“What we have available to us are symptomatic treatments, not cures.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 10:57
Trauma confrontation during PTSD treatment can worsen symptoms for many patients.
“for many patients, it actually makes things worse.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 12:07
Antipsychotics and antidepressants are partially effective and fail for many patients.
“they're at best partially effective and they don't work for a significant fraction of patients who are given them.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 12:27
DSM-III was created because psychiatrists showed poor diagnostic agreement.
“that diagnostic system came into being because psychiatrists had a very hard time agreeing with one another about what was wrong with somebody.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 14:00
Reliable DSM diagnoses may not validly represent underlying psychiatric reality.
“that conclusion may or may not reflect the underlying reality of things”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 17:25
NIMH-funded neuroscience and genetics research produced no improvement for mentally ill people.
“after spending $20 billion, the lot of the mentally ill has improved not one bit”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 20:04
NIMH increasingly treated mental illness as purely brain disease.
“NIMH increasingly focused on the idea that mental illness was purely a brain disease.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 20:55
Social factors play an important role in developing mental illness.
“there's abundant evidence from epidemiology that social factors play an important role, in the development of mental illness.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 23:13
Traditional psychiatric categories are increasingly viewed as unstable or potentially misleading.
“the categories that we have all become familiar with, that we've been told are real diseases like bipolar disorder, schizophrenia, major depression, are beginning to falter.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 26:47
Community care failed to provide adequate substitutes for psychiatric asylums.
“community care is a shell game without a pea.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 37:10
Early asylums helped some patients and enabled some recoveries.
“I do believe the early asylums actually did good work and that some patients did very well and recovered as a result of their stays.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 45:18
The scientific basis of lobotomy was weak.
“the science behind it was shaky”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 57:46
Claims about malarial treatment curing syphilitic insanity were greatly exaggerated.
“those claims were wildly exaggerated, but they were widely accepted.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:08:57
Insulin coma therapy failed controlled clinical testing.
“when they were subjected to a controlled trial, they failed it.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:25:39
ECT appears effective for severe, especially suicidal, depression.
“it seems to work in cases of depression, suicidal depression particularly.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:32:05
Muscle relaxants largely eliminated fractures associated with ECT.
“you did eliminate the fractures.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:34:47
ECT temporarily alleviates psychiatric symptoms rather than curing them.
“it temporarily alleviates the symptoms”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:35:20
Three hundred genetic variants explain about ten percent of schizophrenia susceptibility.
“if we use 300 small variations in the genome, we can account for about 10% of schizophrenia.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:42:34
Some psychiatrists predict schizophrenia and bipolar disorder may be abandoned as distinct entities.
“there's no such thing as schizophrenia, there's no such thing as bipolar disorder”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:43:40
Ketamine and psychedelics are being promoted as miracle cures for depression.
“I see ketamine and psychedelics being propounded as a miracle cure for depression”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:45:17
Evidence supporting ketamine and psychedelics as depression cures is very weak.
“the evidence for that is enormously weak”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:45:25
Negative findings are important for scientific progress.
“negative findings are very important in science.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:47:40
ECT was used as a disciplinary tool in many mid-century mental hospitals.
“ECT was used in the '50s and '60s as a tool of discipline in the hospitals.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 1:57:10
Recent controlled trials provide enough evidence that ECT benefits some patients.
“there's enough evidence now that it's hard to say this never works.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 2:01:03
Up to one-quarter of soldiers experienced psychological breakdown in combat conditions.
“In combat conditions, as much as 25% of the soldiers broke down.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 2:44:50
CBT-style therapies can be standardized, reproduced, and empirically tested.
“these therapies could be packaged. They could be reproduced. They could be tested to see whether they worked.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 2:50:37
CBT may outperform antidepressants for milder depression with fewer side effects.
“for the milder forms depression, I think CBT works better than the drugs without some of the side effects that the drugs have.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 2:54:58
CBT substantially improves outcomes for some patients.
“for some patients, this really does seem to improve things quite a lot.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 2:56:22
Psychopharmacology emerged accidentally rather than from planned psychiatric drug development.
“the idea that a drug might be used to actually attack the underlying problem, it emerged by accident”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 2:58:16
Antipsychotics reduce agitation, delusions, and hallucinations for many patients.
“they reduce the agitation, they reduce the delusions and the hallucinations”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:07:45
Antipsychotics have limited effect on schizophrenia’s negative symptoms.
“the negative side of things, not so much or not at all.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:09:19
A significant share of psychotic patients do not respond to antipsychotic drugs.
“a significant number of psychotic patients are non-drug responders”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:09:33
Drug companies controlled much psychiatric trial data and selectively released results.
“the studies were funded by the drug companies who owned the data and controlled the data and only released what they chose to release”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:15:04
FDA approval could follow two successful trials despite many failed trials.
“if you had 2 that worked, that was enough.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:15:31
Sixty-seven to eighty-two percent of CATIE participants discontinued treatment.
“Between 67 and 82% of the patients, depending on which drug they were on, dropped out of the trial”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:16:42
Second-generation antipsychotics commonly cause substantial weight gain and metabolic risks.
“If you take these pills, you will gain, in most cases, a of weight. 10, 20, 30, 40 pounds, 50 pounds.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:17:14
Clinicians lack biological markers predicting individual psychiatric drug response.
“we have no biological markers at the moment that would tell us.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:18:45
Depression is now an extremely common psychiatric diagnosis.
“depression is the common cold of psychiatry.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:21:49
Autism diagnosis growth is driven more by loosened criteria than increased underlying prevalence.
“the huge increase in the number of diagnoses of autism is more driven by the fact he loosened the criteria for the diagnosis than it is because there are more actual cases.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:24:04
Antidepressants consistently beat placebo statistically but not always clinically.
“Every time you do a controlled study of these antidepressants, they beat placebo in a statistically significant margin, but not necessarily in a clinically significant margin.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:29:11
Antidepressants provide only marginal benefit over placebo for most patients.
“for most patients, antidepressants are marginally better than placebo”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:30:08
Many antidepressant users experience complete loss of libido.
“lots of patients find a complete loss of libido”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:30:44
NICE recommends CBT before antidepressant medication in relevant cases.
“NICE in England are saying use CBT as the first line, not drugs.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:31:34
At least forty percent of depressed patients may not respond to antidepressants.
“we're talking 40 or north of 40% who aren't responding.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:32:12
People with severe psychiatric suffering should probably try medication.
“you probably need to try the drugs because the suffering is very intense”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:33:34
Psychiatric research should expand beyond drugs, neuroscience, and genetics.
“psychiatric research needs to broaden.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:33:49
Social support and interaction substantially benefit mental health.
“helping people as much as we can with social supports and social interaction is tremendously important to people's mental health.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:36:57
Major mental illnesses likely have biological components.
“I would be astonished if the major forms of mental illness didn't have a biological component to them.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:37:31
Medication can help but cannot solve the full problem of mental illness.
“a less reliance on something as simple as giving people pills because that can help, but it's clearly not going to be the solution to the whole thing.”
Open the episode · #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & JungListen at 3:40:46
Statements are attributed to the speaker as said on the episode and reflect their view at the time, not PodLume's. They are not advice.
