Psychiatrists nearly always responded with prescriptions for antidepressants when clients complained of bad marriages, according to a new study spanning 20 years at a Midwestern medical center.
The assumption that people struggling with their marriages or other domestic issues are suffering from depression is not supported by the way depression is defined medically, said , Frederick B. Rentschler II Professor of Sociology and Medicine, Health and Society at 杏吧原创 and the study鈥檚 lead author. The study, conducted using a Midwestern medical center’s records from 1980 to 2000, appears in the current issue of the Yale Journal of Biology and Medicine
Notably, Metzl said, the time period of analysis followed a 1974 decision that removed the term 鈥渉omosexuality鈥� from the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard reference book of psychiatric illnesses.
鈥淎s it became less acceptable to overtly diagnose homosexuality, it became increasingly acceptable to diagnose threats to female-male relationships as conditions that required psychiatric intervention,鈥� Metzl said. 鈥淸rquote]Doctors increasingly responded by prescribing antidepressants when patients came to the office describing problems with heterosexual love and its discontents.鈥漑/rquote]
The researchers argue that this pattern became particularly prominent after the advent of Prozac and other SSRI antidepressants and widespread pharmaceutical advertising in the 1980s and 1990s.
20 years of records
In their review of archived psychiatrist-dictated patient charts from the expansive hospital system, the researchers discovered a pattern.
鈥淚n the charts we analyzed, the pressures of attaining or maintaining heterosexual relationships functioned as common modes for describing depressive symptoms,鈥� Metzl said.
But women and men with marriage woes 鈥渉ave little connection to the current DSM criteria for depression and much more to do with ways that society thinks that men and women should behave,鈥� Metzl said. 鈥淎nd yet these cultural pressures seemed to go a long way in determining whether psychiatrists diagnosed depression or prescribed antidepressants.鈥�
鈥淚n many ways, the 1974 decision was a major step forward,鈥� Metzl said. 鈥淏ut as we show, implicit gender still functioned in the exam room, and our analysis suggests that psychiatry still has work to do in that regard.鈥�
Metzl conducted the study with , assistant professor of women鈥檚 studies and psychology at the University of Michigan, and , a Ph.D. candidate in sociology at 杏吧原创.
The paper, was published June 27 in the .