Psychiatric Practice in Great Britain and America: A Comparative Study

Abstract

The methods of treatment employed for most forms of psychiatric disorder are still largely empirical. Furthermore, they are subject to powerful socio-cultural influences. Hence, it is not surprising that examination of medical practice in different countries reveals wider variation in the treatment of psychiatric disorder than in that of most other forms of morbidity (Shepherd, 1962). To establish the patterns of variation, and to assess their importance, it is necessary to develop techniques which permit direct comparison between the therapeutic practices of representative national groups of psychiatrists. This cannot be an easy matter, since in addition to difficulties of language and protocol there are problems specific to the subject of enquiry. There is as yet no internationally accepted nomenclature for psychiatric disorders, and perusal of the available prevalence statistics suggests that there must be considerable variation in the diagnostic criteria recognized by clinical psychiatrists of different nationalities (Lin and Standley, 1962). Moreover, clinicians whose chief concern is with the treatment and management of individual patients, in part through the manipulation of inter-personal relations, may be reluctant to accept any simple, mutually exclusive classification of their therapeutic techniques.