Scientific research and corporate influence: smoking, mental illness, and the tobacco industry

Mentally ill individuals have always smoked at high rates and continue to do so, despite public health efforts to encourage smoking cessation. In the last half century, the tobacco industry became interested in this connection, and conducted and supported psychiatric and basic science research on the mental health implications of smoking, long before most mental health professionals outside the industry investigated this issue. Initially, representatives of tobacco industry research organizations supported genetics and psychosomatic research to try to disprove findings that smoking causes lung cancer. Tobacco industry research leaders engaged with investigators because of shared priorities and interests in the brain effects of nicotine. By the 1980s, collaborative funding programs and individual company research and development teams engaged in intramural and extramural basic science studies on the neuropharmacology of nicotine. When mental health researchers outside the industry became interested in the issue of the mentally ill and smoking in the mid-1990s, they increasingly explained it in terms of a disease of nicotine addiction. Both the idea that smoking/nicotine does something positive for the mentally ill and the conclusion that it is the result of nicotine dependence have the potential to support corporate agendas (tobacco or pharmaceutical).     

Historical essay: electroconvulsive therapy, memory, and self in America

Electroconvulsive Therapy (ECT) practitioners and anti-ECT activists have divergent interpretations of both the treatment and its history. Despite claims by ECT opponents that practitioners do not acknowledge memory side effects, the published literature on the procedure demonstrates psychiatrists' awareness of this issue. And though current ECT practitioners claim that memory side effects were mostly the result of outmoded methods, investigators continue to publish studies that indicate ongoing memory problems. This article explores the conflict between pro- and anti-ECT groups around the issue of memory side effects in the broader context of changes in American psychiatry and society.     

Science, gender, and the emergence of depression in American psychiatry, 1952-1980

Between the first (1952) and the third (1980) editions of psychiatry's Diagnostic and Statistical Manual of Mental Disorders, depression emerged as a specific disease category with concrete criteria. In this article, I analyze this change over time in psychiatric theory and diagnosis through an examination of medication trials and category formation. Throughout, I pay particular attention to the ways in which psychiatrists and researchers invoked science in their clinical trials and disease theories, as well as the ways in which gender played an important but largely unspoken role in the formation of a category of depression.