A reappraisal of American psychiatry

Remarkable changes have taken place in American psychiatry over the past twenty years. The era of psychoanalytical supremacy has passed, and realism is replacing the exaggerated claims which were made of psychiatry's ability to produce personal, social, and even political change. The importance of phenomenology and accurate diagnosis is increasingly recognised, and American researchers have made many impressive contributions to psychiatric genetics and to psychopharmacology. Despite these advances, office practice generally continues to function on an outmoded model and psychiatric resources remain inequitably distributed.