On being sane in insane places (1973) [pdf]

Posted by dbgrman 4 hours ago

On being sane in insane places (1973) [pdf](www.weber.edu)

55 points | 32 comments

ggreer 2 hours ago|

It's unclear if this experiment actually happened the way Rosenhan claimed. A journalist went through Rosenhan's archives and tried to verify his story. She managed to track down one of the pseudopatients, who disputed some of Rosenhan's claims such as the amount of preparation, and whether Rosenhan had worked out a legal backup plan in case the institution refused to release the patient.[1] She also noted large discrepancies in various numbers. Apparently she wrote a book about the whole thing, but I haven't had the chance to read it.[2][3]

1. https://sci-hub.red/10.1038/d41586-019-03268-y

2. https://www.npr.org/2019/11/13/777172316/the-great-pretender...

3. https://www.susannahcahalan.com/the-great-pretender

dbgrman 10 minutes ago|

Thanks for sharing, will read these.

dang 42 minutes ago||

Related. Others?

The Rosenhan Experiment: On Being Sane in Insane Places - https://news.ycombinator.com/item?id=45785783 - Nov 2025 (1 comment)

On Being Sane in Insane Places (1973) - https://news.ycombinator.com/item?id=32686098 - Sept 2022 (2 comments)

David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades - https://news.ycombinator.com/item?id=22155529 - Jan 2020 (119 comments)

Troubling discrepancies in Rosenhan's “On Being Sane in Insane Places”? - https://news.ycombinator.com/item?id=21437852 - Nov 2019 (16 comments)

On being sane in insane places - https://news.ycombinator.com/item?id=10885181 - Jan 2016 (1 comment)

On being sane in insane places - https://news.ycombinator.com/item?id=4371212 - Aug 2012 (2 comments)

Rosenhan experiment (1973) - https://news.ycombinator.com/item?id=1469370 - June 2010 (2 comments)

ossicones 4 hours ago||

If you've ever taken a depression screener at a wellness visit, that's a consequence of this work. This paper describes how unreliable psychiatric diagnosis used to be. There were standards, but they ultimately came down to physician judgment. This created demand for more objective standards, which resulted in the "checklist" approach that we have now.

dbgrman 9 minutes ago||

I wonder what's the false negative rate for these checklists.

dillydogg 3 hours ago||

It's true. You wouldn't believe how many people I've SIGECAPS'd during my medical training. I didn't realize this article was the beginning of this approach, but it certainly helped get care to people who previously wouldn't have received it. Though I'm sure there are also many who may require intervention that aren't captured by a SIGECAPS exam. The double edged sword of the checklist manifesto, though I overall think it has been beneficial.

SIGECAPS is an acronym taught in US medicine for the diagnosis of major depressive disorder: Sleep disturbance, Interest loss, Guilt, Energy loss, Concentration loss, Appetite changes, Psychomotor agitation, Suicidality. And must have Depressed mood or Anhedonia (inability to enjoy things previously enjoyable).

The history of the SIG E CAPS acronym is also interesting, I've heard it was short for SIG (old shorthand for "to be prescribed") Energy CAPsules.

post_break 17 minutes ago|||

I had to look up SIGECAPS before I read the rest of your comment. Big oof when I did. Never heard of Anhedonia, but I sure have it.

RodgerTheGreat 3 hours ago|||

Is "energy capsules" a euphemism for amphetamines?

dillydogg 2 hours ago||

I was taught that it was more a memory device for recognizing major depressive disorder as a state of sadness and low energy. The treatment, I presume was still SSRIs first line.

ameliaquining 2 hours ago||

This study was a fraud: https://doi.org/10.1177/0957154x221150878

dbgrman 4 hours ago||

An experiment where they sent normal people to mental institutes to see if professionals would be able to identify them.

lostlogin 3 hours ago|

And interestingly, how often the patients in the ward could spot these normal people while the medical staff did not.

nibles_and_bits 39 minutes ago||

Hello from a wildcat alumnus class 2006, never thought I would see a weber state link in HN top 20.

dbgrman 7 minutes ago|

lol, that's the first pdf link i could find of this article.

wumms 1 hour ago||

Reminds me of: Man’s Search for Meaning (1946) https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning

12_throw_away 2 hours ago||

This is one of those "important research with unbelievably flawed methods" sort of situations. Psych research before IRBs was crazy.

TZubiri 2 hours ago|

Nowadays there's a lot of FUTON bias in research. There's so much power in just hitting the streets or reaching out to your circle.

For the most part, you care the most about your circle, so if that isn't representative of the whole of society, it sounds like somebody else's problem. Who said all research needed to be perfect.

cm2012 2 hours ago|

This experiment is now widely debated, the author may have made up or exaggerated details.

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