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]
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.
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.
Is "energy capsules" a euphemism for amphetamines?
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.
This is one of those "important research with unbelievably flawed methods" sort of situations. Psych research before IRBs was crazy.
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.
An experiment where they sent normal people to mental institutes to see if professionals would be able to identify them.
And interestingly, how often the patients in the ward could spot these normal people while the medical staff did not.
sounds like the truth might be somewhere in the middle -- this is what chat jippity has to say
What is not clearly true
“We now know this was a spectacularly successful case of scientific fraud”
This is where the claim goes too far.
Fraud requires intent to deceive, not just:
Poor recordkeeping
Exaggeration
Selective reporting
Unverifiable claims
Cahalan herself:
Stops short of proving deliberate fraud
Argues the study is unreliable, not conclusively fabricated
No formal finding of scientific misconduct was ever made.
Some pseudopatients almost certainly existed, even if the study was embellished.
Most historians would say:
Rosenhan’s study is deeply flawed, possibly exaggerated, and scientifically indefensible by modern standards — but “proven fraud” is stronger than the evidence allows.
How experts usually frame it today
A more accurate consensus view would be:
Rosenhan’s paper was methodologically weak and poorly documented
Its conclusions were overstated
Its influence on DSM-III was real but indirect
Psychiatry’s reforms were driven by many factors, not Rosenhan alone
The study’s continued citation often reflects mythologizing, not careful scholarship
A more accurate rewrite of the statement
If you want something that would be defensible in an academic setting:
Rosenhan’s 1973 paper was highly influential in debates that preceded DSM-III and continues to be widely cited. However, subsequent investigation—most notably by Susannah Cahalan—has raised serious doubts about the study’s methodology, documentation, and reliability. While these findings undermine confidence in Rosenhan’s conclusions, claims that the study constitutes proven scientific fraud remain contested.
apologies in advance for copy-pasta AI (does it break site guidelines? idk) im just not an expert in this stuff (probably approximately none of us on this site are!)
It might not break guidelines, but LLM's should not be regarded as sources of truth, and copy-pasting from them is about as interesting as posting the results of a google search.
Totally unrelated but “chat jippity” made my day!
ahh now its getting spicy grabs popcorn
This experiment is now widely debated, the author may have made up or exaggerated details.
This is from the seventies. I wonder if things would be different fifty years later.
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
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.
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.
Is "energy capsules" a euphemism for amphetamines?
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.
This is one of those "important research with unbelievably flawed methods" sort of situations. Psych research before IRBs was crazy.
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.
An experiment where they sent normal people to mental institutes to see if professionals would be able to identify them.
And interestingly, how often the patients in the ward could spot these normal people while the medical staff did not.
This study was a fraud: https://doi.org/10.1177/0957154x221150878
sounds like the truth might be somewhere in the middle -- this is what chat jippity has to say
What is not clearly true “We now know this was a spectacularly successful case of scientific fraud”
This is where the claim goes too far.
Fraud requires intent to deceive, not just:
Poor recordkeeping
Exaggeration
Selective reporting
Unverifiable claims
Cahalan herself:
Stops short of proving deliberate fraud
Argues the study is unreliable, not conclusively fabricated
No formal finding of scientific misconduct was ever made.
Some pseudopatients almost certainly existed, even if the study was embellished.
Most historians would say:
Rosenhan’s study is deeply flawed, possibly exaggerated, and scientifically indefensible by modern standards — but “proven fraud” is stronger than the evidence allows.
How experts usually frame it today
A more accurate consensus view would be:
Rosenhan’s paper was methodologically weak and poorly documented
Its conclusions were overstated
Its influence on DSM-III was real but indirect
Psychiatry’s reforms were driven by many factors, not Rosenhan alone
The study’s continued citation often reflects mythologizing, not careful scholarship
A more accurate rewrite of the statement
If you want something that would be defensible in an academic setting:
Rosenhan’s 1973 paper was highly influential in debates that preceded DSM-III and continues to be widely cited. However, subsequent investigation—most notably by Susannah Cahalan—has raised serious doubts about the study’s methodology, documentation, and reliability. While these findings undermine confidence in Rosenhan’s conclusions, claims that the study constitutes proven scientific fraud remain contested.
apologies in advance for copy-pasta AI (does it break site guidelines? idk) im just not an expert in this stuff (probably approximately none of us on this site are!)
It might not break guidelines, but LLM's should not be regarded as sources of truth, and copy-pasting from them is about as interesting as posting the results of a google search.
Totally unrelated but “chat jippity” made my day!
ahh now its getting spicy grabs popcorn
This experiment is now widely debated, the author may have made up or exaggerated details.
This is from the seventies. I wonder if things would be different fifty years later.
Nope!
https://archive.is/tH0il
This isn't really the same situation.
That one is a case of mistaken identity, but the same process, same players, and same system.
The fact that we're hearing about it means that the process worked, doesn't it?