by Thomas Szasz, 414 pp, $17.95, New York, John Wiley & Sons, 1987.
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In this provocative book, Dr Szasz's major theme is that insanity is an idea with consequences that have damaged society. Furthermore, mental illness, a necessary element for the establishment of insanity, is more of a concept that is used to control social behavior than an actual medical illness that needs to be treated.
Dr Szasz begins his argument by demonstrating that since mental illnesses are not discussed in pathology textbooks, they really are not a medical illness. He further debunks the notion by noting how various special-interest groups (eg, homosexuals) influence psychiatric diagnostic categories by social protest, and how these dynamics would not influence the practice of any true subspecialty of medicine.
Szasz notes that psychiatry has yet to prove brain disease is responsible for mental illness, and that there is a tendency to make the criteria for having mental illness so broad as to include anything. He contends that
Bell CC. Insanity: The Idea and Its Consequences. JAMA. 1987;258(2):269. doi:10.1001/jama.1987.03400020111046