Psychiatry is not robust. We don't know how the brain works. We're not even close to understanding how parts of the brain interact, we rely on coarse tools and irreplicable neuroscience to try to guess out the intersection of biology, chemistry, neuroscience, etc.
When we consistently see that studies are designed poorly (in many cases by selecting poor metrics, think self-assessed productivity on adderall or amortizing results of SSRIs over multiple severity levels of depression) and mechanisms are poorly understood, what do you think that it is?
Science is in many cases filled with perverse incentives that only complicate this relationship -- do you want citations, a popular publication, tenure, influence on policy decisions? Does your hypothesis align with the ideas which are popular enough to get funding?
The fact of the matter is that science is political, psychiatry is in its infancy, and results are not great in a lot of cases. We treat everything like we couldn't possibly be developing our generations' version of phrenology and it's hubris.
When we consistently see that studies are designed poorly (in many cases by selecting poor metrics, think self-assessed productivity on adderall or amortizing results of SSRIs over multiple severity levels of depression) and mechanisms are poorly understood, what do you think that it is?
Science is in many cases filled with perverse incentives that only complicate this relationship -- do you want citations, a popular publication, tenure, influence on policy decisions? Does your hypothesis align with the ideas which are popular enough to get funding?
The fact of the matter is that science is political, psychiatry is in its infancy, and results are not great in a lot of cases. We treat everything like we couldn't possibly be developing our generations' version of phrenology and it's hubris.