It sounds like the whole field is contaminated with mind-body dualism. But there's a bigger problem; even once you accept that humans are fully physical, embodied minds in a sea of whatever chemicals can cross the blood-brain barrier, the scope is wider. Humans are part of a society that can harm them without effective means of redress.

Also, from the original paper, via the linked LJ: https://siderea.dreamwidth.org/1388220.html

"I began taking blood samples from everybody who came to the clinic. At times it seemed like Transylvania Station. The state Department of Public Health's laboratory tested blood free for anyone under the age of 12 and provided plastic pipettes, finger puncture equipment, and even mailing envelopes at no cost. So, for a while, everyone in the clinic was declared to be under 12 years of age."

Both a nice public healthcare hack and a risky thing to admit in a journal article.

Cops should do the same test. There was an NPR story a while back about a school, mostly black, that did poorly on a standardized test. The school officials declared the test racist. The science teacher couldn’t find that from the test. He wondered about lead. Low and behold the school was full of lead poisoned children. They started treatment and the scores improved by the end of the year ( the also abated the houses with grant money).

We know lead causes aggression issues. We know poor communities have higher incidence of lead in their homes. How many criminals could be prevented, or reformed with lead treatment?

Surprised it hasnt been mentioned yet, but just in case there is a HN reader who hasn’t read the lead article by Drum - it’s good.

https://www.motherjones.com/environment/2016/02/lead-exposur...

Fair warning, this is a bit of a comment trap, insofar as the post is less about lead per se, and more about a class of decision-making problems involving the allocation of scarce resources and massive uncertainty.

But incidentally, public health and governing bodies should definitely work to reduce lead in communities, regardless of the duty of psychiatrists.

And maybe some researcher should improve chelation? But there are other things to work on, and that might be simply intractable, so maybe not.

If the patient is chronically not well, they will often show symptoms of depression. Diagnosis of exclusion that can't find the cause often ends with depression diagnosis.

In this sense depression is a trashcan diagnosis. It's the default end for short decision tree.

Why don't doctors give patients a choice? Some people may wish to pay for more extensive testing.

Yes.

They should also look at environmental toxins. "Sick" houses, etc.

And physiological problems.

Anecdotally, I've seen a lot of mental health treatment that went after symptoms while ignoring root causes.

P.S. Over time, physically induced problems can lead to outright mental problems. PTSD, for example.

Also, IANAD.

Heavy metal poisoning is a cause of mental illness that is reversible and does not require the patient to take drugs for the rest of their lives. We like selling drugs to people for the rest of their lives in this country.

Link should be: http://slatestarcodex.com/2018/05/23/should-psychiatry-test-...