Bad Medicine

I enjoy Spence’s monthly polemics on bad medicine.¹ There is a lot of it about and it concerns me as current trends would seem to rob patients of their resilience and responsibilities. In my work as a tribunal member assessing appeals over eligibility to Employment and Support Allowance and Personal Independence Payments, I frequently see appellants whose doctors seem to diagnose anxiety. Anxiety is an emotion that everyone experiences. Where anxiety is abnormal it is anxiety disorder. Your own journal falls into this trap on its front cover.² I frequently see what doctors describe as low mood being treated with antidepressants, especially as we know that depression is over-treated and, by inference, over-diagnosed.³ Post-traumatic stress disorder is frequently mentioned but enquiry often fails to show evidence of the exposure criteria laid down as a requirement of the diagnosis.⁴ These are examples of bad medicine that rob individuals of their resilience. It is small wonder that the press talk of a crisis in mental health if we as a profession make diagnoses on such a poor basis.