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Re: experts say...ditch schizophrenia label

Posted by alexandra_k on October 10, 2006, at 22:20:49

In reply to Re: experts say...ditch schizophrenia label alexandra_k, posted by Squiggles on October 10, 2006, at 20:40:10

> > But therapy works precisely by making neurological / biological alterations in the brain...

> I disagree only with the last sentence.

Is that the above sentance?
Er... If therapy doesn't help by changing the neurology... Then how does it work? Does flying spaghetti monster move his noodly appendage thus leading to a miraculous alteration in mind stuff? The only way to change behaviour is to change the brain. There are many ways to change the brain, however. Experience, social environment, therapy, learning, medication, surgery... Just consider learning how to do something. The repetition leads to neural changes. Consider remembering something, the experience led to neural changes.

> The BBC article made it roughly sound like a big part of the the concern was that people with so many diverse problems with so many diverse causes were being lumped together as "same"- therefore getting "same"kinds of treatments instead of more finely tuned ones.

Yes, that is a problem. Lets say that they say '80% of people with dx xxx get better with treatment yyy you have dx xxx therefore we shall give you treatment yyy'. But... It turns out that you are more similar (with your symptoms) to people with dx zzz... Treatment yyy doesn't work for you... People conclude you are chronic... The perils of inadequate diagnostic categories. It is an impediment to research. Trying to figure out what all people with schizophrenia have in common when they don't have anything in common...

> The term schizophrenia should be abolished, experts have said. They claim the category falsely groups a wide range of symptoms and encourages over-reliance on anti-psychotic drugs rather than psychological intervention.

Yeah. Because in other societies... They don't medicate the way western societies do instead they have social intervention and... A whole bunch of people get better. Are we really better off with all our drugs? Hard to say... Maybe the people who get better with social intervention are the people who aren't being helped so much with drugs... Maybe the people who are helped by drugs are the ones who wouldn't really benefit from social intervention alone... Unfortunately drug companies don't really fund studies on social intervention unless it is to undermine it...

> The academics also said the label stigmatised people as being violent, dangerous and untreatable.

Yes. And that isn't so good for people with the dx. Can lead to the 'looping kind' effect (which is to say 'everyone tells me I'm chronic so I may as well stop planning for a decent life and just accept my likely fate')

> But other scientists said the term should not be scrapped without finding another means of classifying patients with psychosis.

There is one.
Delusions - yup. severe.
Hallucinations - yup. severe.
Formal thought disorder - no.
Catatonia - no.
They can tally the sympoms...

> I think the concept is scientifically meaningless, clinically unhelpful and ultimately has been damaging to patients - Richard Bentall. Schizophrenia represents a complex mental health disorder. Symptoms vary from person to person, but include delusions, hallucinations and disordered perceptions of reality.

Yes. Bentall is an interesting figure...

> "But the concept of schizophrenia is scientifically meaningless. It groups together a whole range of different problems under one label - the assumption is that all of these people with all of these different problems have the same brain disease." He said this can misinform treatment, and has encouraged the widespread use of "drastic biomedical interventions" as the first-line of treatment, rather than psychological help.

So true.

> Professor Bentall suggested patients should be treated on the basis of individual symptoms, as opposed to an overarching category.

Yes. Dimensional approach instead of categorical.

> "If we don't have some way of distinguishing between patients, then those with bipolar disorder or obsessional disorder would be mixed up with those currently diagnosed as having schizophrenia and might receive treatments wholly inappropriate for them.

B*llshit they have different symptoms.

> "Most psychiatrists would still agree that the term schizophrenia is a useful, if provisional, concept...

But they would be wrong...

It is just... Easier to diagnose rather than assessing symptoms. Lazy psychiatry... No other way to say that.

> Til Wykes, professor of clinical psychology and rehabilitation at the Institute Of Psychiatry, said: "We should be careful not to throw the baby out with the bath water, as despite its limitations, a diagnosis can help people access much needed services.

That is only one aim of classification... There are three aims:
1) Ease of diagnosis and communicability.
2) To facilitate research
3) Treatment

It is unfortunate they all get lumped together.

The DSM shouldn't be catered for the health insurance companies, however, or it means it is dictated to by political agenda instead of science. Wakefield criticises the DSM as being overinclusive as it is. Thats because of health insurance. Wakefield says we should distinguish between mental disorder (caused by malfunction within the individual) and 'problems in living' which might well be worthy of treatment and yet do not constitute mental disorder. For example... There is a learning disorder category in the current DSM. Wakefield says that if someone meets criteria for learning disorder because they have inner malfunction which renders them unable to read then they have a mental disorder. If they meet criteria because they have never been shown how to read, on the other hand, then this does not constitute mental disorder though it does constitute a 'problem in living' that should be treated.

> "While we recognise that the term 'schizophrenia' can act as a stigmatising label, without identifying this condition as a serious illness how can there be any hope of researching it and providing better treatments?

What is 'it'? That is precisely the problem. There is no such thing as schizophrenia. There are people who have a number of symptoms like delusion and hallucination etc and those symptoms should be treated, however.

> "Simply replacing the term with another is unlikely to add to our understanding of this complex condition."

Indeed. Trouble is it isn't a single condition...




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