The Philosophy of Psychiatry: A CompanionBMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7485.260 (Published 27 January 2005) Cite this as: BMJ 2005;330:260
All rapid responses
I welcome professor Michael King’s criticism of Professor Raj
Persaud’s book review.1
Since I first encountered the profound adverse effects of oral
contraceptives on mood and behaviour, I have been amazed at the lack of
“understanding” or interest shown by most psychiatrists.2,3
Persaud wrote, “It might be that the reduction of depression to
faulty wiring in the brain or chemical imbalance is actually an
impoverished understanding of the breadth and depth of the human
Any condition which precludes healthy reproduction could be regarded
as a disorder but homosexuals cannot be treated to become “normal”. In
fact medications may have been the cause. Inappropriate maternal exposures
to sex hormones during early foetal life and childhood are preventable
causes of faulty brain and sexual development and increased risk of mental
I have seen many patients who have rapidly been aided to cope with
life’s predicaments when current essential nutrient deficiencies have been
corrected. This is true for dyslexics who, besides having faulty brain
structure due to maternal zinc deficiency during their early foetal
development, are likely to be currently zinc deficient.7
Dyslexics, like homosexuals, are often creative and artistic, but
persistence of disturbed biochemical homeostasis, especially upsets in
copper/zinc balance, can impede expression of their talents. This also may
increase the risk of developing psychosis from cannabis or severe
reactions to minimal exposures.8
Most psychiatrists ignore modern scientific tests which diagnose
treatable cause of brain dysfunction, such as zinc, copper, magnesium, B
vitamin and essential fatty acid deficiencies. Developmental brain
anomalies are not correctable but many are preventable by good
preconception care, which precludes the use of hormones during pregnancy.9
Rather than harking back to ancient philosophies, we need recognise
damage caused by incontinent prescribing of sex hormones.
Professors of psychiatry need more, not less, understanding of the
benefits and severe adverse effects of modern science.
1 Raj Persaud. The Philosophy of Psychiatry: A Companion. BMJ 2005;
2 Grant ECG, Mears E. Mental effects of oral contraceptives. Lancet
1967; 1: 945-46.
3 Grant ECG, Pryce Davies J. Effect of oral contraceptives on
depressive mood changes and on endometrial monoamine oxidase and
phosphatases. BMJ 1968; 3: 777-80.
4 Schoental R. Precocious sexual development in Puerto Rico and
oestrogenic mycotoxins (zearalenone) Lancet. 1983 5; 1: 537.
5 Shoental R. Climatic changes, mycotoxins, plagues, and genius.
J R Soc Med. 1995; 88: 560-1.
6 Shoental R. Fusarial mycotoxins and behaviour: possible
implications for psychiatric disorder. Br J Psychiatry. 1985;146: 115-9.
7 Grant ECG, Howard JM, Davies S, Chasty H, Hornsby B, Galbraith J.
Zinc deficiency in children with dyslexia: concentrations of zinc and
other minerals in sweat and hair. BMJ 1989; 296: 607-9.
8 Grant ECG. Cannabis and copper and zinc upsets increase the risk of
http://bmj.com/cgi/eletters/330/7481/11#88043, 4 Dec 2004
9 Grant ECG. Nutritional supplements to prevent pregnancy
http://bmj.com/cgi/eletters/329/7458/152#67502, 16 Jul 2004
Competing interests: No competing interests
It was puzzling to see that Raj Persaud, who holds a Chair for public
understanding of psychiatry, himself misunderstands why homosexuality was
removed from international psychiatric glossaries (1). The American
Psychiatric Association moved on the matter primarily as a result of
protest from the public and human rights groups against “treating”
homosexuals (2) and growing evidence that homosexuality was compatible
with normal health (3). Reviewing this philosophy text does not seem to
have increased Professor Persaud’s skills of logic if he considers that
sexual paraphilias, such as fetishes and sexual masochism, come under
similar judgment to that of homosexuality. Psychiatry regards a sexual
relationship between two adults of either sex, which has capacity for
combining sex and emotions and for long-term attachment, to be the human
sexual response most compatible with health. Fetishistic arousal, which
is pervasive enough to preclude sexual arousal to other adults, cannot
come within that definition. The comparison made with a man who cannot
get an erection with his wife whom he no longer fancies was simply
spurious. Furthermore, whether or not a fetish causes distress to the
person is immaterial. In the long term it will reduce the human potential
for health in its fullest sense. Hypertension does not cause distress but
it increases risk of cardiovascular disease. I find it hard to credit
that The Companion to Philosophy Persaud reviewed could have posed such
arguments and can only presume that Persuad has a style of reading that
confirms his own views.
1. Persaud R. The Philosophy of Psychiatry: A Companion. BMJ 2005;
2. Mendelson G. Homosexuality and psychiatric nosology. Aus NZ J
3. Hooker E. The adjustment of the male overt homosexual. J
Prospective Techniques; 1957;21:18-31.
Competing interests: No competing interests