W. Edwin Fann: A History of the Tennessee Neuropsychiatric Institute


Aitor Castillo’s comment on Barry Blackwell’s comment on Thomas Ban’s comment


        I am greatly impressed reading Barry Blackwell’s 2020 comments on Thomas A. Ban’s comments titled “Central theme of clinical research at the TNI from the mid-1970s to the 1980s.”

        As I posted last May, I spent a training period at the TNI in 1979 when Tom Ban was Director of the Clinical Division. During those days and later on I was also involved in some of his research activities and I became a privileged witness to his consistent efforts to develop the Composite Diagnostic Evaluation (CODE) system in order to establish a more scientifically identified group of patients whose diagnoses could be better associated with clear-cut psychopharmacological responses.

        Taking into consideration that Tom has dedicated around four decades to develop a pharmacologically valid psychiatric nosology and that he has published many papers on this issue with a good level of evidence, I always wondered why the APA never considered the CODE system to improve the reliability and validity of the DSM system.

        Now, Dr. Blackwell expresses his concerns on this matter and also extends his focus to the very heart of the NIMH. He provocatively states that this happens, at least partially, because the pharmaceutical industry only put money for profit revenues and is not interested in the healthy development of the psychiatry and psychopharmacology disciplines. Apparently, some academics prefer to close their eyes to this regrettable situation and, in some way, contribute to maintain it.

        I think, for example, that this is illustrated by the failure to undertake some research in order to identify the specific responses of women and men to various psychopharmacologic agents. I suppose it is economically more convenient to say that, for example, a given antidepressant works the same for both groups.

        Maybe, as a clinical practitioner, I would say that it could be very hard to apply the CODE system routinely. But, at the same time, as a clinical researcher I would say that the CODE system should be given serious consideration by the pharmaceutical industry, a very positive step toward ending the “me-too compounds” era.



Blackwell B. comment on Thomas A. Ban‘s comment titled “Central theme of clinical research  at the TNI from  the mid-1970s to the 1980s” (W. Edwin Fann: A History of the Tennessee Neuropsychiatric Institute).  inhn.org. perspectives. February 13, 2020.

Castillo A. Comment. My TNI experience (W. Edwin Fann: A History of The Tennessee Neuropsychiatric Institute). inhn.org.perspective. May 9, 2020.


June 25, 2020