chapter  15
10 Pages



Psychiatry as presently understood is barely 150 years old and current concepts of mental health and illness are considerably younger. Prior to the 1950s there were no antidepressants as currently understood, and prevalence of clinical depression was around 100 per million, according to Porter.1 Prevalence currently runs at around 10 per cent: a 1000-fold increase. The reasons for this are complex, but include, for example, the increasingly rights-based individualism inherent in modern Western societies2 and inconsistencies in historical definitions of depression.3 In the pre-prescription era no records exist as to what drugs people took. Even serious episodes warranting hospitalisation offered no clues, as the discharge summary didn’t indicate drug treatment as patients were expected to get this for themselves.