It is not True That Thomas Insel Ever Wanted to Prevent Schizophrenia Or He Would Have Had A Public Health Alert Warning About Increasing Paternal Age

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August 1, 2008
Psychiatric Times. Vol. 25 No. 9
From Prevention to Preemption: A Paradigm Shift in Psychiatry
by Thomas R. Insel, MD


Dr Insel is director of the National Institute of Mental Health, a division of the NIH in Bethesda, Md.

UNIVERSAL PREVENTION HAS NEVER BEEN THE FOCUS OF PSYCHIATRIC RESEARCH SELLING PHARMACEUTICALS AND DOING MEANINGLESS RESEARCH HAS. A PERCENTAGE OF PSYCHIATRIC ILLNESS IS FAMILIAL AND A LARGE PERCENTAGE IS DUE TO INCREASING PATERNAL AGE --------------------------------------------------------------------------------

Universal prevention has been a focus of psychiatric research for the past 4 decades. Using a public health approach, research has shown that mitigating major risk factors, such as poverty and early life stress, and promoting protective factors can improve behavioral outcomes. In other areas of medicine, we have observed how similar preventive approaches have reduced deaths from cancer and infectious disease. By contrast, while reducing environmental stress and providing better maternal support improve general behavioral outcomes (by preventing the development of antisocial behavior, for example), there are few, if any, examples of preventive approaches in psychiatry that reduce either the morbidity or the mortality of our most disabling illnesses—such as schizophrenia and bipolar disorder.1,2