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Does schizophrenia exist?

A

Apotheosis

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Does schizophrenia exist?

Paper No. 12
Jim Van Os & Peter McKenna
Institute of Psychiatry, King’s College, London
Summary

Since the beginnings of medicine, physicians and their patients have assumed that a doctor’s ability to understand and alleviate illness relies on his expertise in distinguishing between different conditions. In turn, this process of diagnosis depends on the existence of an accepted system of classifying the different conditions, which the doctor is likely to encounter. Unfortunately, psychiatry has not kept pace with the advances in understanding and classifying disorders which have occurred in other areas of medicine.

Psychiatric diagnosis continues to rely on the clinician’s ability to recognise familiar patterns of symptoms and behaviour. For example, people with severe mental illness continue to be divided into those with schizophrenia and those with bipolar disorder on the basis of their history and behaviour. This distinction began over 100 years ago with Emil Kraepelin’s (1896) differentiation of the disorder he termed ’dementia praecox’ (soon re-christened schizophrenia by Eugene Bleuler) from manic-depression (the forerunner of today’s bipolar disorder). The concept of schizophrenia has changed little since the time of Kraepelin and we still know little about the aetiology of the disorder.

The use of schizophrenia as a diagnostic entity is often said to have both positive and negative aspects. This Discussion Paper sets out to review the pros and cons of continuing to use the term, and indeed concept, of schizophrenia. Jim Van Os, Professor of Psychiatry at the University of Maastricht, Holland, and Peter McKenna, Consultant Psychiatrist in Cambridge, are both highly distinguished psychiatrists. However, they have opposing views about the value of the term schizophrenia.

Jim Van Os regards the schizophrenia concept as harmful in clinical practice and research. He examines its impact in relation to factors such as: clinical usage, user satisfaction, reliability, translation into treatment needs, ability to account for psychological variables, stigmatisation, prediction of outcome, and aetiological research. Peter McKenna is more content with the traditional fare. He therefore takes the opposite position and outlines the strengths of the concept. In his view, schizophrenia has ’stood the test of time’ despite repeated attacks against it over the last century.

http://www.iop.kcl.ac.uk/departments/?locator=525

http://www.antipsychiatry.org/schizoph.htm

http://medind.nic.in/maa/t07/i2/maat07i2p104.pdf

Does schizophrenia really exist?

October 2006
Experts from The University of Manchester hit the headlines on World Mental Health Day (10 October), when they held a London briefing on why 'schizophrenia' should be abolished as a psychiatric category.

Professor Richard Bentall of the School of Psychological Sciences and Paul Hammersley of the School of Nursing, Midwifery and Social Work joined Professor Marius Romme - founder and principle theorist for the Hearing Voices Movement – and National Chair of the Hearing Voices Network, Jacqui Dillon, to issue a controversial call for the dropping of the term.
Speakers' opinions
According to the speakers, 'schizophrenia' is a scientifically worthless, stigmatising label, which falsely groups people with a wide range of conditions together. It also fails to inform prognosis and treatment, and actually reduces people's chances of recovery.

Paul Hammersley, a central player in the new Campaign to Abolish the Scizophrenia Label, said that a diagnosis of schizophrenia can instantly end a person's career.

According to Professor Bentall 'schizophrenia' doesn't exist as an objectively identifiable disease, and patients would do better if doctors focused on their individual symptoms, rather than trying to place them in a disease category. He continued that the symptoms currently classified as schizophrenia have often been triggered by traumatic life events; yet many patients are given only drug treatments rather than the option to try psychological therapies.

"Those suffering from the conditions grouped under the label actually do better in Africa - where psychiatric services are under-developed - than in the UK," he said. "In our country the current recovery rate is about 30%; it's better to have 'schizophrenia' in Nairobi where there’s a 50% chance of recovery."
http://www.nursing.manchester.ac.uk/aboutus/news/schizophreniaExist
 
D

Danage

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Of course schizophrenia, and by extension psychosis, and other mental illnesses, exist, although those are interesting statistics.
 
A

Apotheosis

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SCHIZOPHRENIA
A Nonexistent Disease
by Lawrence Stevens, J.D.

The word "schizophrenia" has a scientific sound that seems to give it inherent credibility and a charisma that seems to dazzle people. In his book Molecules of the Mind - The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin calls schizophrenia and depression "the two classic forms of mental illness" (Dell Publishing Co., 1987, p. 119). According to the cover article in the July 6, 1992 Time magazine, schizophrenia is the "most devilish of mental illnesses" (p. 53). This Time magazine article says "fully a quarter of the nation's hospital beds are occupied by schizophrenia patients" (p. 55). Books and articles like these and the facts to which they refer (such as a quarter of hospital beds being occupied by so-called schizophrenics) delude most people into believing there really is a disease called schizophrenia. Schizophrenia is one of the great myths of our time.

In his book Schizophrenia - The Sacred Symbol of Psychiatry, psychiatry professor Thomas S. Szasz, M.D., says "There is, in short, no such thing as schizophrenia" (Syracuse University Press, 1988, p. 191). In the Epilogue of their book Schizophrenia - Medical Diagnosis or Moral Verdict?, Theodore R. Sarbin, Ph.D., a psychology professor at the University of California at Santa Cruz who spent three years working in mental hospitals, and James C. Mancuso, Ph.D., a psychology professor at the State University of New York at Albany, say: "We have come to the end of our journey. Among other things, we have tried to establish that the schizophrenia model of unwanted conduct lacks credibility. The analysis directs us ineluctably to the conclusion that schizophrenia is a myth" (Pergamon Press, 1980, p. 221).

In his book Against Therapy, published in 1988, Jeffrey Masson, Ph.D., a psychoanalyst, says "There is a heightened awareness of the dangers inherent in labeling somebody with a disease category like schizophrenia, and many people are beginning to realize that there is no such entity" (Atheneum, p. 2). Rather than being a bona-fide disease, so-called schizophrenia is a nonspecific category which includes almost everything a human being can do, think, or feel that is greatly disliked by other people or by the so-called schizophrenics themselves. There are few so-called mental illnesses that have not at one time or another been called schizophrenia. Because schizophrenia is a term that covers just about everything a person can think or do which people greatly dislike, it is hard to define objectively. Typically, definitions of schizophrenia are vague or inconsistent with each other. For example, when I asked a physician who was the Assistant Superintendent of a state mental hospital to define the term schizophrenia for me, he with all seriousness replied "split personality - that's the most popular definition." In contrast, a pamphlet published by the National Alliance for the Mentally Ill titled "What Is Schizophrenia?" says "Schizophrenia is not a split personality".

In her book Schiz-o-phre-nia: Straight Talk for Family and Friends, published in 1985, Maryellen Walsh says "Schizophrenia is one of the most misunderstood diseases on the planet. Most people think that it means having a split personality. Most people are wrong. Schizophrenia is not a splitting of the personality into multiple parts" (Warner Books, p. 41). The American Psychiatric Association's (APA's) Diagnostic and Statistical Manual of Mental Disorders (Second Edition), also known as DSM-II, published in 1968, defined schizophrenia as "characteristic disturbances of thinking, mood, or behavior" (p. 33). A difficulty with such a definition is it is so broad just about anything people dislike or consider abnormal, i.e., any so-called mental illness, can fit within it. In the Foreword to DSM-II, Ernest M. Gruenberg, M.D., D.P.H., Chairman of the American Psychiatric Association's Committee on Nomenclature, said: "Consider, for example, the mental disorder labeled in the Manual as 'schizophrenia,' ... Even if it had tried, the Committee could not establish agreement about what this disorder is" (p. ix). The third edition of the APA's Diagnostic and Statistical Manual of Mental Disorders, published in 1980, commonly called DSM-III, was also quite candid about the vagueness of the term. It said: "The limits of the concept of Schizophrenia are unclear" (p. 181).

The revision published in 1987, DSM-III-R, contains a similar statement: "It should be noted that no single feature is invariably present or seen only in Schizophrenia" (p. 188). DSM-III-R also says this about a related diagnosis, Schizoaffective Disorder: "The term Schizoaffective Disorder has been used in many different ways since it was first introduced as a subtype of Schizophrenia, and represents one of the most confusing and controversial concepts in psychiatric nosology" (p. 208).

Source - http://www.antipsychiatry.org/schizoph.htm
 
T

Twylight

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I hope schizophrenia exists

I'd hate to think i'm taking these 'orrible tablets for nuffin
 
A

Apotheosis

Guest
Get Real! :rolleyes::rolleyes::rolleyes::rolleyes::rolleyes:
I have this label - I have yet to meet a psychiatrist who can answer the question fore-mostly of what schizophrenia is?, & secondly as to what categorically causes it? I think it's a long time overdue that orthodox psychiatry "got real".

We know there is "something" going on. No one is denying that there is not some underlying "condition" to which these labels refer. The pertinent point however - is that; is it helpful, therapeutic & rational to label such MH experiences under a blanket/umbrella term; which frankly explains very little; to put people in neat little boxes; & to falsely promote the "genetic predisposition - chemical imbalance theory" as fact? I for one think it's very unhelpful.
 
S

schizolanza

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My pdoc doesn't have a clue what's wrong with me in reality.Of that I'm sure.
 
G

GrizzlyBear

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"According to the speakers, 'schizophrenia' is a scientifically worthless, stigmatizing label, which falsely groups people with a wide range of conditions together. It also fails to inform prognosis and treatment, and actually reduces people's chances of recovery."

I would argue this to be the case for most illness. I am fortunate that my psychologist seems to be less concerned with diagnosis.

I tend not to be concerned with labelling what is wrong with me (or what is causing me to feel awful). I feel there is a trap there that I just don't want to get caught up in. Ever.
 
A

Apotheosis

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I tend not to be concerned with labelling what is wrong with me (or what is causing me to feel awful). I feel there is a trap there that I just don't want to get caught up in. Ever.
Yes - true. Rather than re-type what I have already done tonight; in as many words - I have just posted this on another forum -

"Then I thought about it a bit, and decided that it's not just the 'norms' who want to sweep mental illness under the carpet. I can be just as guilty of that too. If Time To Change wasn't needed so much, perhaps I wouldn't have felt so horrified to be outed?" - Yorkiegal.
This is a very good point - I have been very "self discriminatory" in the past. It is very surprising how much a MH label can impact a persons life, in this regard- from accepting limitations to embracing the "illness" & the label. For anyone that has had diagnoses changed; will know the impact that has. For the very reason that we build identity around the "diagnosis", or label.

How many people who are labelled want to hide the illness? If it is nothing to be ashamed of; which it isn't; then why are not people standing up to be counted?

A lot of stigma & discrimination comes from within the "social groups" of the "mentally ill". Very often "addicts" & "alcoholics" are very stigmatised by "MI" (mentally ill) people. Also people finding & exploring "med free", alternative; & more holistic recoveries; are very often stigmatised against by other more "orthodox" sufferers.

I don't think people will like this - but candidly & honestly - although stigma & discrimination has come from outside of the MI as well; most of it has been from the MI themselves!

As to the use of language - I use all the terms there are in common everyday language to refer to myself & others - i.e. Nutter, lunatic, fruit cake; mad, crazy ect ect. I see nothing wrong in this language & think it should be re-claimed by the MI. Of course there is the intent or context in which it is spoken - but personally I don't care what terms people use. The real problems are with the psychiatric system & the larger society.
& this -

I have been researching this subject recently & I have looked into it in the past. The problem is that most people don't think very much - & they interpret any mention of the subject of abolishing the label or questioning the label - as questioning the validity of the underlying condition. Most people like having the label (in relation to "illness"); it is a comfort; it explains things to them; it removes their guilt.
http://www.rethink.org/applications/discussion/view.rm?post_id=8636&id=0
 
A

Apotheosis

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I'd add that "negative" connotations are far more pronounced with schizophrenia than any other label. From BP being an almost fashion accessory in certain celebrity circles to a lot of acceptance now being given to stress related & depression.
 
G

GrizzlyBear

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"The problem is that most people don't think very much - & they interpret any mention of the subject of abolishing the label or questioning the label - as questioning the validity of the underlying condition. Most people like having the label (in relation to "illness"); it is a comfort; it explains things to them; it removes their guilt."

I think this is very true. People are very keen, naturally enough, to want to distance themselves from 'guilt' and sometimes even responsibility. I can understand the why this is appealing - I am finding it hard to cope right now and might like to feel less responsibility for a while, perhaps even having someone else take care of me. But it's not really the answer in the long-term....perhaps not even in the short-term. People keep saying to me (and I like to hear it - perhaps it distances me from guilt and responsibility!!?) that it is my illness that is responsible for my poor choice of (in)actions in the past 7 months. Whether it is a choice or not is another question.

I'd add that "negative" connotations are far more pronounced with schizophrenia than any other label. From BP being an almost fashion accessory in certain celebrity circles to a lot of acceptance now being given to stress related & depression.
I would agree with this to a point. I don't think BP is much of a fashion accessory but I agree that schizophrenia is terribly stigmatized, probably more so than most other mental health diagnoses.

It is true that depression is so common nowadays that it has become generally well-accepted by society. Any deviation, however, from the 'norm', in terms of symptoms, is not. I also believe there are many people who appear mentally unwell but to whom no diagnoses can be applied. The first doctor put it all down to my personality - which may well be the case - but label-seekers will persist and people like me will continue to argue the point.

One label attributed to me during my 2nd hospitalization was 'Emotional Dis-regulation'. Maybe I am emotionally dis-regulating but that one amuses me somewhat.
 
Bluemoon

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Interesting topic - I just wish I had something to say right now lol.
 
Bluemoon

Bluemoon

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I have to agree, there is rather alot of take in, but I say that this general term should probably be split up into more specific terms for specific types.
I remember reading about a Psychiatrist who said exactly the same thing - and I agree !
 
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