Mental Health The Concept of Schizophrenia is Dying

[herbavore]

This article, The Concept of Schizophrenia is Dying, from The Conversation US by Simon McCarthy-Jones claims that the concept of schizophrenia needs to have new language to embrace the continuum of experience that all currently gets squeezed into one narrow diagnosis.

Here is the link to the full article: http://theweek.com/articles/731238/concept-schizophrenia-dying

 

[PriestTheyCalledHim]

Schizophrenia is very real, and the word/term Schizophrenia describes the mental illness extremely well in a way that anyone who speaks/comprehends English and knows about mental illnesses can understand. It's also not an outdated term.

 

[spacejunk]

Jim van Os, a professor of psychiatry at Maastricht University, has argued that we cannot shift to this new way of thinking without changing our language. As such, he proposes the term schizophrenia "should be abolished." In its place, he suggests the concept of a psychosis spectrum disorder.

Interesting article, thanks herby. I think we have a lot of unhelpful terms that have become a big part of our understanding (or misunderstanding) of mental illness, and it's always useful to challenge these sorts of orthodoxies, especially outdated ones.

 

[Kittycat5]

Negative symptoms arent the opposite of positive symptoms. If I remember correctly, they are called positive symptoms because they are something additional to the normal psyche and negative because they were traits or emotions once had but now absent. Positive symptoms include delusions, hallucinations, and paranoia and negative include anhedonia, apathy, lethargy, sexual issues and others.

And dopamine isnt the whole story. While its true positive symptoms can be largely diminished by typical antipsychotics which are primarily D2 antagonists, the negative symptoms seem to only improve with atypicals which have a combo of agonism and antagonism at dopamine and serotonin receptors.

 

[Kittycat5]

Many medical conditions, such as diabetes and hypertension, can be reached by multiple routes that nevertheless impact the same biological pathways and respond to the same treatment. Schizophrenia could be like this. Indeed, it has been argued that the many different causes of schizophrenia discussed above may all have a common final effect: increased levels of dopamine.

From the article. We dont have diabetes spectrum disorder so not sure why we should throw out schizophrenia. It seems many of the conditions that would be on a psychosis spectrum are really just other diseases.

 

[PriestTheyCalledHim]

I very much think they should not dissect schizophrenia and make some bullshit spectrum disorder. There's positive symptoms off medication, and negative symptoms on medication. There's supposedly too much dopamine in the brain and thoughts get faster, more disorganized, delusions become present, and thoughts can start merging with what you hear causing hallucinations, mystical events and states can happen. negative symptoms are the opposite of that basically. it doesn't need to be made a spectrum, schizophrenia is schizophrenia


pink Floyd is my medical textbook

I agree with all of what you posted. It does make me wonder if the author of the original article and people who are promoting this dissection/destruction of the term Schizophrenia have ever actually even been around people who really actually are Schizophrenic when they are in psychosis? It's very real.

Now, can people be misdiagnosed as being schizophrenic when they are actually something else like being manic/bipolar, or schizoaffective disorder, yes, but this is not to say that we should get rid of schizophrenia as a mental illness diagnosis, or make it part of some spectrum as you posted about.

 

[Kittycat5]

I dont think they are saying its not real rather arguing that not all schizophrenia is the same.

 

[Buspersons Holiday]

Interesting article, but anyone who works or knows several people with a Schizophrenia diagnosis, or have just read the facts about it, will be well aware that the symptoms, experiences and treatment are vastly different from one person to the next and that 'Schizophrenia' isn't a one-size-fits-all mental illness

I find this statement misleading

The potential for different treatments to work for different people further explains the schizophrenia wars. The psychiatrist, patient, or family who see dramatic beneficial effects of antipsychotic drugs naturally evangelically advocate for this approach. The psychiatrist, patient, or family who see drugs not working, but alternative approaches appearing to help, laud these. Each group sees the other as denying an approach that they have experienced to work. Such passionate advocacy is to be applauded, up to the point where people are denied an approach that may work for them.

as it suggests that if a treatment is working for one person, the Psychiatrist assumes that is the only successful treatment & does not consider other treatments for different people, which just isn't the case most of the time & dismissive of the mental health professionals who consider all approaches if one doesn't work

I don't believe that the concept of Schizophrenia is the problem or what needs to disappear; what needs addressing are the misconceptions, judgements and beliefs of a vast amount of people, fuelled hugely by the press, around what it is and how it is experienced in many different ways by those with a Schizophrenia diagnosis

Everyone reads the horror stories in the paper of Schizophrenics killing people in the street, but 'Schizophrenic gets first class honours degree' or 'Schizophrenic lives a successful life without harming anyone or acting on his voices' doesn't make for interesting reading does it

 

[no_id]

as it suggests that if a treatment is working for one person, the Psychiatrist assumes that is the only successful treatment & does not consider other treatments for different people, which just isn't the case most of the time & dismissive of the mental health professionals who consider all approaches if one doesn't work

Sadly it's often at least marginally like that

 

[herbavore]

I dont think they are saying its not real rather arguing that not all schizophrenia is the same.

this.

@Buspersons: I agree that we need more voices about the spectrum of experience within schizophrenia. To me I don't really care whether it is all called schizophrenia or schizophrenic spectrum disorder--that is just semantics. But the invention of the terminology in autism made for huge real life improvements for kids at the milder end of the spectrum--including more funding for research into the condition, rights to education, etc. So sometimes, semantics have incredibly positive effects on not only perception but day to day lives of the people living both with the condition and the label.

 

[Tubbs]

^^^ very much so. its moreso sub-classifications. Different combinations of symptoms respond to different treatments

 

[ahint]

It's a term capturing so many wildly different experiences... I think as a term it can be near useless because it tells you nothing about what the person is experiencing, what might be leading to their psychosis, or what will work in helping them. And if it does none of this, I don't see the point in the term.

I'm sure the concept of schizophrenia is useful for some (I've definitely met people who feel their life has been positively impacted by the incorporation of schizophrenia into their identity), but it's a concept that needs to be refined, as it's near useless and in some cases harmful (Rufus May, Eleanor Longden, Elisabeth Svanholmer, and Rachel Waddinham talk about the harms a diagnosis can carry).