# Is psychiatry dishonest? Is it better for everyone if keeps faking diagnostic assurance? **URL:** \ **Category:** Great Debates\ **Created:** [May 6, 2013, 2:45am UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596 "2013-05-06T02:45:42Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [May 8, 2013, 4:57pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/61 "2013-05-08T16:57:15Z")
> [@lekatt](#): > > Observation, following all possibilities and forgetting all methods. > > Methods become rituals and doctrine, which is worthless in all human endeavors. I think I’m familiar with all of those words, but the way you’ve put them together makes me doubt myself. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [May 8, 2013, 5:23pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/62 "2013-05-08T17:23:39Z")
> [@AHunter3](#): > > Psychiatry is dishonest. Also in the news, sky is blue, news at 10. > > There is no reality behind the “chemical imbalance” explanation that you have all heard touted as proven scientific fact. Depression is not caused by a chemical imbalance in the brain that psychiatric pharmaceuticals fix. Neither is bipolar disorder. Neither is schizophrenia. Neither is attention deficit disorder. > > Psychiatric medications do help some people cope with some highly unpleasant emotional and cognitive conditions. > > We do not have a significantly better understanding of what those conditions actually entail than we had 125 years ago, though, unless you want to credit a decently large stack of discredited hypotheses and attempted approaches though. Which is actually true progress in research (albeit not the kind that tends to get media attention). But the field of psychiatry (and/or the field of psychiatric pharmacology) should not really get credit for that progress when they continue to lie about it and pretend that their disproven theories are actually scientific facts, should they? > > The ailments that lead people to seek psychiatric intervention for themselves are major sources of ongoing misery. Selling symptom relief that works for some is not a bad thing, but marketing it as perfectly crafted “magic bullets” or the psychiatric equivalent of insulin or synthroid, as if shrink-drugs were things that restored suffering brains to the condition of normal healthy brains by replacing missing hormones, etc, is downright criminal and should be stopped as an ethical violation. I can refute this with one sentence: _lekatt agrees with you 100%._ ---
**Author:** ![deltasigma](https://avatars.discourse-cdn.com/v4/letter/d/e5b9ba/32.png) [@deltasigma](https://boards.straightdope.com/u/deltasigma)\ **Post date:** [May 8, 2013, 5:34pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/63 "2013-05-08T17:34:01Z")
> [@AHunter3](#): > > Psychiatry is dishonest. Also in the news, sky is blue, news at 10. > > There is no reality behind the “chemical imbalance” explanation that you have all heard touted as proven scientific fact. Depression is not caused by a chemical imbalance in the brain that psychiatric pharmaceuticals fix. Neither is bipolar disorder. Neither is schizophrenia. Neither is attention deficit disorder. > > Psychiatric medications do help some people cope with some highly unpleasant emotional and cognitive conditions. > > We do not have a significantly better understanding of what those conditions actually entail than we had 125 years ago, though, unless you want to credit a decently large stack of discredited hypotheses and attempted approaches though. Which is actually true progress in research (albeit not the kind that tends to get media attention). But the field of psychiatry (and/or the field of psychiatric pharmacology) should not really get credit for that progress when they continue to lie about it and pretend that their disproven theories are actually scientific facts, should they? > > The ailments that lead people to seek psychiatric intervention for themselves are major sources of ongoing misery. Selling symptom relief that works for some is not a bad thing, but marketing it as perfectly crafted “magic bullets” or the psychiatric equivalent of insulin or synthroid, as if shrink-drugs were things that restored suffering brains to the condition of normal healthy brains by replacing missing hormones, etc, is downright criminal and should be stopped as an ethical violation. There’s a lot truth to that, but let’s not go too far off the other end. Sure, I can point to SSRI’s not working by means of increasing the availability of serotonin but of increasing neurogenesis in the hippocampus. But the fact of the matter is that these drugs do work for the vast majority of people who neatly fall into specific Dx categories. The fact that the precise mechanism by which a drug works may be obscure is largely irrelevant from the clinical point of view. In fact, pick any 10 drugs at random and look them up in the PDR and check the pharmacology section. If it doesn’t flat out say that the mechanism is unknown it will at least come with a bucket full of caveats. This is true even for non-psychotropics although possibly to a lesser degree since for something like a proton pump inhibitor, the cause and effect relationship is more easily investigated. ---
**Author:** ![Orr\_G](https://avatars.discourse-cdn.com/v4/letter/o/ee59a6/32.png) [@Orr\_G](https://boards.straightdope.com/u/Orr_G)\ **Post date:** [May 8, 2013, 6:39pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/64 "2013-05-08T18:39:04Z")
> [@Czarcasm](#): > > I can refute this with one sentence: _lekatt agrees with you 100%._ Someone remind me what this fallacy is called? Or is it just a version of _Ad Hominem_? My own view is similar to (but not as well-informed as) **AHunter3** ’s. The dark ages of psychiatry, where non-science and pseudoscience dominated the field, seem to be much more recent than in medicine. I would like to think that further research into psychopharmacology and the explosive increase in understanding I expect to come from neuroscience will bring psychiatric practice fully into the light and somewhat on par with medicine when it comes to diagnosis and treatment. What I fear is that the fields of psychiatry and psychopharmacology will instead be driven more by market forces than by science, leading to continued or increasingly weakened integrity of those who make a living selling mental health. ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [May 8, 2013, 6:50pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/65 "2013-05-08T18:50:18Z")
I think it’s important to recognize the differences between the OP, which was focused on the validity of disorder categories or diagnoses, and this latter issue, which is about pharmacotherapy. (For some reason, other types of therapy are not included in these recent condemnations, but perhaps that is due to the focus on psychiatry rather than mental health at large?) There is a lot more to be concerned about when it comes to pharmacotherapy, but there are some very well established medication treatments for specific disorders. For instance, antipsychotic medications have been far more successful in terms of treating schizophrenia than any other treatment strategy. Lithium is superior for bipolar disorder. Stimulant medication treatment is very effective as a treatment for ADHD. SSRIs, in combination with cognitive behavioral therapy is effective for OCD. Evidence for pharmacotherapy for other anxiety disorders is somewhat weaker. Questions about pharmacotherapy for depression exist. No pharmacotherapy is established for oppositional defiant disorder or conduct disorder. The “chemical imbalance” model may remain prominent in the public, but are not particularly mentioned otherwise. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 8, 2013, 6:50pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/66 "2013-05-08T18:50:51Z")
> [@Czarcasm](#): > > How do you make it out of bed each morning? I imagine the same way others do. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 8, 2013, 6:52pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/67 "2013-05-08T18:52:35Z")
> [@Hentor\_the\_Barbarian](#): > > I think I’m familiar with all of those words, but the way you’ve put them together makes me doubt myself. Self doubt is the beginning of wisdom. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [May 8, 2013, 6:53pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/68 "2013-05-08T18:53:30Z")
> [@lekatt](#): > > I imagine the same way others do. Methodically? ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [May 8, 2013, 7:05pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/69 "2013-05-08T19:05:07Z")
> [@lekatt](#): > > Self doubt is the beginning of wisdom. it’s also not the beginning of wisdom. It’s also the beginning of non-wisdom. Saying from motivational posters provide only so much utility. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [May 8, 2013, 7:16pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/70 "2013-05-08T19:16:01Z")
> [@AHunter3](#): > > Psychiatry is dishonest. Also in the news, sky is blue, news at 10. > > There is no reality behind the “chemical imbalance” explanation that you have all heard touted as proven scientific fact. Depression is not caused by a chemical imbalance in the brain that psychiatric pharmaceuticals fix. Neither is bipolar disorder. Neither is schizophrenia. Neither is attention deficit disorder. > > Psychiatric medications do help some people cope with some highly unpleasant emotional and cognitive conditions. > > We do not have a significantly better understanding of what those conditions actually entail than we had 125 years ago, though, unless you want to credit a decently large stack of discredited hypotheses and attempted approaches though. Which is actually true progress in research (albeit not the kind that tends to get media attention). But the field of psychiatry (and/or the field of psychiatric pharmacology) should not really get credit for that progress when they continue to lie about it and pretend that their disproven theories are actually scientific facts, should they? > > The ailments that lead people to seek psychiatric intervention for themselves are major sources of ongoing misery. Selling symptom relief that works for some is not a bad thing, but marketing it as perfectly crafted “magic bullets” or the psychiatric equivalent of insulin or synthroid, as if shrink-drugs were things that restored suffering brains to the condition of normal healthy brains by replacing missing hormones, etc, is downright criminal and should be stopped as an ethical violation. > [@Czarcasm](#): > > I can refute this with one sentence: _lekatt agrees with you 100%._ **AHunter3** is making some intelligible observations that can be responded to. **lekatt** is saying… who knows. > [@Hentor\_the\_Barbarian](#): > > Saying from motivational posters provide only so much utility. “Hang in there, baby!” would be considerable step up from this stuff. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [May 8, 2013, 7:20pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/71 "2013-05-08T19:20:52Z")
> [@Marley23](#): > > **AHunter3** is making some intelligible observations that can be responded to. **lekatt** is saying… who knows. Point taken. I don’t really know _what_ **lekatt** thought he was agreeing with. ---
**Author:** ![deltasigma](https://avatars.discourse-cdn.com/v4/letter/d/e5b9ba/32.png) [@deltasigma](https://boards.straightdope.com/u/deltasigma)\ **Post date:** [May 8, 2013, 7:24pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/72 "2013-05-08T19:24:20Z")
> [@Hentor\_the\_Barbarian](#): > > I think it’s important to recognize the differences between the OP, which was focused on the validity of disorder categories or diagnoses, and this latter issue, which is about pharmacotherapy. (For some reason, other types of therapy are not included in these recent condemnations, but perhaps that is due to the focus on psychiatry rather than mental health at large?) > > There is a lot more to be concerned about when it comes to pharmacotherapy, but there are some very well established medication treatments for specific disorders. For instance, antipsychotic medications have been far more successful in terms of treating schizophrenia than any other treatment strategy. Lithium is superior for bipolar disorder. Stimulant medication treatment is very effective as a treatment for ADHD. SSRIs, in combination with cognitive behavioral therapy is effective for OCD. Evidence for pharmacotherapy for other anxiety disorders is somewhat weaker. > > Questions about pharmacotherapy for depression exist. No pharmacotherapy is established for oppositional defiant disorder or conduct disorder. > > The “chemical imbalance” model may remain prominent in the public, but are not particularly mentioned otherwise. Well, mental disorders I think by and large have a neurochemical basis. For example the importance of the [HPA axis in the genesis of depression is very well established.](http://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis#Stress_and_disease) However treatment regimes unfortunately are still often discovered mostly by accident or by chemical manipulation of other older psychotropics. Take ketamine for example. This is an anesthetic drug for the most part but it was recently discovered that it could provide nearly instantaneous relief even treatment resistant depression. The [research into the mechanism of action](http://en.wikipedia.org/wiki/Ketamine#Antidepressant_use) has been fascinating. > [@](#): > > However, a new study in mice by Zarate _et al._ showed blocking the NMDA receptor is an intermediate step. According to this study, blocking NMDA increases the activity of another receptor, [AMPA](http://en.wikipedia.org/wiki/AMPA_receptor), and this boost in AMPA activity is crucial for ketamine’s rapid antidepressant actions. NMDA and AMPA are receptors for the [neurotransmitter](http://en.wikipedia.org/wiki/Neurotransmitter) [glutamate](http://en.wikipedia.org/wiki/Glutamic_acid#Neurotransmitter). The glutamate system has been implicated in depression recently. This is a departure from previous thinking, which had focused on [serotonin](http://en.wikipedia.org/wiki/Serotonin) and [norepinephrine](http://en.wikipedia.org/wiki/Norepinephrine). The glutamate system may represent a new avenue for treatment and research.[[78]](http://en.wikipedia.org/wiki/Ketamine#cite_note-78) In addition (see same link) it appears that ketamine stimulates the release of BDNF which may increase neurogenesis, thus providing a link with the mechanism implicated for some SSRI’s. ---
**Author:** ![AHunter3](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ahunter3/32/368_2.png) [@AHunter3](https://boards.straightdope.com/u/AHunter3)\ **Post date:** [May 8, 2013, 8:51pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/73 "2013-05-08T20:51:52Z")
> [@deltasigma](#): > > There’s a lot truth to that, but let’s not go too far off the other end. Sure, I can point to SSRI’s not working by means of increasing the availability of serotonin but of increasing neurogenesis in the hippocampus. But the fact of the matter is that these drugs do work for the vast majority of people who neatly fall into specific Dx categories. The short-term efficacy is pretty good. Brains, unfortunately, tend to adapt. Throw a bunch of reuptake inhibitors at them and the receptor sites may atrophy or the rate at which the original neurotransmitter is being produced may decline, either of which offsets the pharmaceutical’s actions and, in doing so, creates a drug dependency. There’s no evidence that people with a psychiatric diagnosis have a different neurochemical nature than control groups of the nondiagnosed “normal” folks. ---
**Author:** ![pravnik](https://avatars.discourse-cdn.com/v4/letter/p/8edcca/32.png) [@pravnik](https://boards.straightdope.com/u/pravnik)\ **Post date:** [May 8, 2013, 9:02pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/74 "2013-05-08T21:02:30Z")
> [@lekatt](#): > > Self doubt is the beginning of wisdom. I used to think that, but now I’m not so sure. ---
**Author:** ![deltasigma](https://avatars.discourse-cdn.com/v4/letter/d/e5b9ba/32.png) [@deltasigma](https://boards.straightdope.com/u/deltasigma)\ **Post date:** [May 8, 2013, 9:34pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/75 "2013-05-08T21:34:33Z")
> [@AHunter3](#): > > The short-term efficacy is pretty good. > > Brains, unfortunately, tend to adapt. Throw a bunch of reuptake inhibitors at them and the receptor sites may atrophy or the rate at which the original neurotransmitter is being produced may decline, either of which offsets the pharmaceutical’s actions and, in doing so, creates a drug dependency. > > There’s no evidence that people with a psychiatric diagnosis have a different neurochemical nature than control groups of the nondiagnosed “normal” folks. I’d have to do some research but I think the mere fact that treating someone with say debilitating OCD with say Luvox returns them to being a functional human being tends to indicate that \*something \*on a neurochemical basis different - don’t you think? As for feedback loops and up regulation, down regulation and all that goes with it, it’s not at all clear how those mechanisms work at this point. It does seem that over a period of many years that some subset of people will experience some level of adaptation. However if you have bought them a decade or two of relative normalcy as a result of treatment, I’m not sure I see a problem with that. ---
**Author:** ![RedFury](https://avatars.discourse-cdn.com/v4/letter/r/ec9cab/32.png) [@RedFury](https://boards.straightdope.com/u/RedFury)\ **Post date:** [May 8, 2013, 9:38pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/76 "2013-05-08T21:38:53Z")
> [@AHunter3](#): > > The short-term efficacy is pretty good. > > Brains, unfortunately, tend to adapt. Throw a bunch of reuptake inhibitors at them and the receptor sites may atrophy or the rate at which the original neurotransmitter is being produced may decline, either of which offsets the pharmaceutical’s actions and, in doing so, creates a drug dependency. > > **There’s no evidence that people with a psychiatric diagnosis have a different neurochemical nature than control groups of the nondiagnosed “normal” folks**. Coming from left-field as I know very little about the topic under discussion – but would it be possible for you to provide a cite (or three) for the **bolded** statement? Logically, it does make a lot of sense to me – what’s “normal” anyway? Why not just different from the norm? Especially if they are not harming anyone but themselves? And I mean that in the sense of people that choose suicide over life…might just be the “best” choice available to them. Moreover, it gives them the choice of _when_ to do it and not let it become an anxiety-driven, depression-inducing, random event that inevitably occurs the older you get. That seems ‘sane’ to me. But I’m probably nuts. ---
**Author:** ![AHunter3](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ahunter3/32/368_2.png) [@AHunter3](https://boards.straightdope.com/u/AHunter3)\ **Post date:** [May 8, 2013, 10:09pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/77 "2013-05-08T22:09:50Z")
> [@RedFury](#): > > Coming from left-field as I know very little about the topic under discussion – but would it be possible for you to provide a cite (or three) for the **bolded** statement? Start with [Whitaker](http://en.wikipedia.org/wiki/Anatomy_of_an_Epidemic). Consider him a meta-cite as his own claims and data are heavily cited; his book is a summary of research pointing to this conclusion. ---
**Author:** ![deltasigma](https://avatars.discourse-cdn.com/v4/letter/d/e5b9ba/32.png) [@deltasigma](https://boards.straightdope.com/u/deltasigma)\ **Post date:** [May 8, 2013, 10:24pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/78 "2013-05-08T22:24:19Z")
> [@AHunter3](#): > > Start with [Whitaker](http://en.wikipedia.org/wiki/Anatomy_of_an_Epidemic). Consider him a meta-cite as his own claims and data are heavily cited; his book is a summary of research pointing to this conclusion. So your cite is a popular book by a [journalist](http://en.wikipedia.org/wiki/Robert_Whitaker_%28author%29)? No peer-reviewed journal articles, no meta-analysis of studies of drug efficacy? That’s hardly something that can be taken too seriously. Even he happens to rely on reputable sources, you’re relying on him to understand them properly in context of the field of study in which they were published and I’m sorry, I don’t have that sort of faith in anyone. ---
**Author:** ![HoneyBadgerDC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/honeybadgerdc/32/1033_2.png) [@HoneyBadgerDC](https://boards.straightdope.com/u/HoneyBadgerDC)\ **Post date:** [May 8, 2013, 10:26pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/79 "2013-05-08T22:26:48Z")
I have to wonder how much research has been done on people who have successfully turned their lives around and actually became sane after years or decades of being really screwed up. TV preachers, motivational speakers and all types of con artists could proably teach phychiatry a thing or two. I believe in the term’ fake it till you make it’. Proper behavior can elicit positive responses from those around us which will inturn generate some of the right chemicals we need. I would like to see the Dr’s get more into behavioral modification. ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [May 8, 2013, 10:48pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/80 "2013-05-08T22:48:26Z")
> [@HoneyBadgerDC](#): > > I have to wonder how much research has been done on people who have successfully turned their lives around and actually became sane after years or decades of being really screwed up. TV preachers, motivational speakers and all types of con artists could proably teach phychiatry a thing or two. I believe in the term’ fake it till you make it’. Proper behavior can elicit positive responses from those around us which will inturn generate some of the right chemicals we need. I would like to see the Dr’s get more into behavioral modification. The most well established treatments for depression, anxiety and the behavioral disorders are cognitive behavioral therapies. Why would you assume that professionals were ignorant of such things? Also, people cannot will themselves out of psychopathology, or fake it til they make it. [Previous page](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596.md?page=3) [Next page](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596.md?page=5)