Psychiatry has problems. Our diagnoses may be reliable but they are far from valid. More and more people are being diagnosed from an ever-expanding compendium of conditions. We are prescribing pills in ever-increasing numbers to treat problems of living. The medications we use are little better than placebos and are more toxic than we acknowledge. We peddle neurobiological explanations of the disorders we diagnose without these having any real scientific basis. We only pay lip service to psychosocial factors. We take money and other inducements from pharmaceutical companies and are beguiled by their sophisticated marketing strategies. Through our exuberance we have contributed to the medicalisation of everyday life and the virtual abandonment of traditional societal approaches to human distress.

At least, that is how psychiatry appears through the lens of James Davies in his new book, Cracked: Why Psychiatry is Doing More Harm Than Good. Davies neatly summarises the arguments made in a series of recent books by Irving Kirsch, Robert Whittaker, David Healy, Daniel Carlat, Allen Frances, Ben Goldacre and others. He includes interviews with key figures, such as DSM-III psychiatrist Robert Spitzer; Royal College of Psychiatrists' president, Sue Bailey; US Congress member, Chuck Grassley; and a variety of critical psychiatrists. He even claims the final interview with Thomas Szasz before his recent death.

Although there is much truth in Davies' claims, there is also much that he leaves out: for example, there is no mention of the millions internationally who are deprived of highly effective treatments for severe mental illnesses. The excesses of other branches of medicine or of other professional groups are ignored. There is little acknowledgement of the legitimacy and importance of neurobiological research into disorders of the mind. The most interesting chapter for me was that on psychiatric imperialism, where Davies reflects on medical historian Edward Shorter's work on the shifting manifestations of emotional distress over time and across cultures and examines the efforts of the pharmaceutical industry to shape these expressions in order to sell more drugs.

I found the experience of reading the book to be rather like listening to a pharmaceutical sales representative trying to persuade me of the merits of their product: colourful but replete with distorted evidence, hyperbole, simplistic arguments and anecdotes to support their claims. The tone is moralistic and the language unnecessarily emotive: ‘[ECT] involves inducing severe seizures in depressed patients by administering intense electric shocks to the brain’ (emphasis mine). There are also many inaccuracies, for instance: ‘About 1 million people in the US had been lobotomised by the 1970s’. Davies presents himself travelling around the world, gawping as one psychiatrist after another admits to him that there are no tests for psychiatric diagnoses or other such shocking revelations. If this line in rhetoric is to your fancy, perhaps this is the book for you, but if you want a more nuanced critique of the problems facing psychiatry, I would recommend another very recent book: Tom Burns' Our Necessary Shadow: The Nature and Meaning of Psychiatry.