The April 2014 issue of Journal of the History of Medicine and Allied Sciences includes several items that may be of interest to AHP’s readers. Titles, authors, and abstracts follow below.
“Efficacy and Enlightenment: LSD Psychotherapy and the Drug Amendments of 1962,” by Matthew Oram. The abstract reads,
The decline in therapeutic research with lysergic acid diethylamide (LSD) in the United States over the course of the 1960s has commonly been attributed to the growing controversy surrounding its recreational use. However, research difficulties played an equal role in LSD psychotherapy’s demise, as they frustrated researchers’ efforts to clearly establish the efficacy of treatment. Once the Kefauver Harris Drug Amendments of 1962 introduced the requirement that proof of efficacy be established through controlled clinical trials before a drug could be approved to market, the value of clinical research became increasingly dependent on the scientific rigor of the trial’s design. LSD psychotherapy’s complex method of utilizing drug effects to catalyze a psychological treatment clashed with the controlled trial methodology on both theoretical and practical levels, making proof of efficacy difficult to obtain. Through a close examination of clinical trials performed after 1962, this article explores how the new emphasis on controlled clinical trials frustrated the progress of LSD psychotherapy research by focusing researchers’ attention on trial design to the detriment of their therapeutic method. This analysis provides a new perspective on the death of LSD psychotherapy and explores the implications of the Drug Amendments of 1962.
“Neuro Psychiatry 1943: The Role of Documentary Film in the Dissemination of Medical Knowledge and Promotion of the U.K. Psychiatric Profession,” by Edgar Jones. The abstract reads,
In 1943, Basil Wright produced a documentary film about the treatment of servicemen and civilians with psychological disorders at Mill Hill Emergency Medical Service Hospital. Funded by the Ministry of Information, Neuro Psychiatry was shot to convince influential clinicians and policy makers in North America that the British had developed expertise in the management of psychiatric casualties. By emphasizing novel and apparently effective interventions and excluding severe or intractable cases from the film, Wright encouraged an optimistic sense of achievement. Filmed at a time when victory was considered an eventual outcome, the picture presented a health service to which all had access without charge. Children and unemployed women, two groups excluded under the 1911 National Insurance Act, had been required to pay for healthcare in the prewar period and were shown receiving free treatment from the Emergency Medical Service. However, the therapeutic optimism presented in the film proved premature. Most U.K. battle casualties arose in the latter half of the conflict and follow-up studies failed to confirm the positive outcome statistics reported in the film. Aubrey Lewis, clinical director of the hospital, criticized research projects conducted at Mill Hill for a lack of rigor. The cinematographic skills of Wright and director Michael Hankinson, together with their reformist agenda, created a clinical presentation that emphasized achievements without acknowledging the limitations not only of the therapies offered by doctors but also the resources available to a nation at war.
“The Cost of War—Then and Now: Commentary on ‘Neuro Psychiatry 1943′,” by Heiner Fangerau. The abstract reads,
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In his essay “Neuro Psychiatry 1943: The Role of Documentary Film in the Dissemination of Medical Knowledge and Promotion of the U.K. Psychiatric Profession” Edgar Jones provides a detailed case study of a single movie that was made under unusual wartime conditions. From this case, he builds a general analysis of the interpretation and portrayal of scientific expertise that shaped the production, distribution, and reception of this genre of documentary. The paper provides a fresh perspective for the historical analysis of film documentaries, while remaining highly topical and germane to present-day issues in medicine and health care.
The film that Jones studied was produced in a British hospital where war victims (mostly soldiers) were treated for war neuroses. The filmmakers documented the therapies employed and the apparently successful posttreatment reintroduction of patients into military service and civilian work. They hoped to convince informed audiences, especially those outside Britain in the United States and Canada, about the effectiveness of the British Health Care Service in …