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(The New York Times)   The new DSM is full of shiat says uninformed layperson Dr. Thomas R. Insel, director of the National Institute of Mental Health   (nytimes.com) divider line 73
    More: Hero, DSM, National Institute of Mental Health, executive directors, Broad Institute, psychiatric medication, secular, Statistical Manual of Mental Disorders, diagnostic  
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3580 clicks; posted to Geek » on 08 May 2013 at 9:07 AM (2 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-05-08 09:09:50 AM  
Something something Director of NIMH.

/Not even trying anymore.
 
2013-05-08 09:12:12 AM  
Given how these categories change every ten years, how objectively real are they?

I always wonder why there aren't more ADD cases in the jungle.
 
2013-05-08 09:19:26 AM  
Shhhh.  It's a secret.
 
2013-05-08 09:26:27 AM  
DSM-V: There's a drug for that!
 
2013-05-08 09:28:35 AM  
Please correct me if I'm wrong, but last I heard, one of the criteria for the new DSM was to increase the ability for doctors to enable patients to get HMOs to cover treatment, specifically things besides medications.
 
2013-05-08 09:35:24 AM  

HotIgneous Intruder: DSM-V: There's a drug for that!


And a bill for future "therapy", a justification for half-baked, ridiculous "diagnosis" from "therapists" who would be grooming dogs at the local vet or bagging groceries if not for their current "profession".
 
2013-05-08 09:44:10 AM  

HotIgneous Intruder: DSM-V: There's a drug for that!


I've been hearing a lot of similar complaints about the DSM-V.
 
2013-05-08 09:44:56 AM  
Subby, he didn't say the DSM is full of shiat. He noted repeatedly how valuable it was. All he is stressing that instead of treating the DSM like the psychological scripture, the community should remember that medicine is both a practice and science needing research and understanding, while specifically exploring new areas and idea for the causes of mental illness instead of just grouping them together and treating them like the currently do and merely treat and categorize symptoms.
 
2013-05-08 10:17:57 AM  
Perhaps that's true, but does it recognize Never Nude Syndrome?
 
2013-05-08 10:22:49 AM  
The problem with psychology is that all diagnoses are fundamentally subjective.

I'm not saying mental illness doesn't exist or that it isn't devastating.

What I'm saying is that in no other branch of medicine is disease defined by vote. Until the 70s homosexuality was a disease, and then suddenly it wasn't due to a vote. Nowhere else in medicine can a disease cease to be a disease by vote.

The other problem is that, while the DSM gives strict criteria for diagnosis, every other ad on TV presents a list of vague symptoms and then tells you to "talk to your doctor". Whether or not your doctor agrees with the diagnosis, I think you're more likely to be prescribed a medication if you bring it up first. I think advertising for drugs in unethical - your doctor should examine your symptoms and you should decide together on a course of treatment.

Finally, going back to the vote thing: many diagnoses in the DSM have religious exemptions. In other words, if you believe something crazy but it's your religion, you're not crazy (yes I realize its more subtle than that but I'm typing on a phone). Diseases shouldn't have religious exemptions.

Once again, I'm not saying mental illness doesn't exist or that psychopharmacology doesn't work; obviously both are true. I'm saying that when disease can be defined by fiat, we need to be very sure we're not pathologizing normal behavior.
 
2013-05-08 10:26:28 AM  
Of course it's out of touch
it doesn't even address crank walk.
 
2013-05-08 10:29:44 AM  

blackartemis: Of course it's out of touch
it doesn't even address crank walk.


You win the prize and a free ticket to F&F6
 
2013-05-08 10:32:02 AM  
Well, duh.

There's no such thing as "mental illness". Some people just work in a weird way. Beat them to death with a shovel if it bothers you.
 
2013-05-08 10:33:54 AM  
In a perfect world, DSM-V will be the last of its kind: an attempt to "diagnose" brain illnesses by categorizing externally presenting symptoms along with subjective judgment of their severity.

The current state of psychiatry is akin to a mechanic diagnosing your car trouble purely from the way it sounds and pulls to the right under braking, and treating it by changing the fluids.

The psychiatric profession is terrified that real scientists are coming and their business is going to go away.
 
2013-05-08 10:44:31 AM  
Why do so many Farkers have a grudge against the DSM-V?
 
2013-05-08 10:50:34 AM  

karmaceutical: Why do so many Farkers have a grudge against the DSM-V?


because they all read it front to back and have a deep understanding of psychiatry.
 
2013-05-08 10:54:30 AM  
THE SECRET OF NI -- oh, someone already did that joke.
 
2013-05-08 11:07:58 AM  

karmaceutical: Why do so many Farkers have a grudge against the DSM-V?


Well, one of my main problems is that the researchers working on it were required to work in secret and forbidden from sharing their reasoning about the diagnoses with outside sources - it's not science if external sources can't recreate it. Another problem is, unlike previous editions of the DSM, the majority of the researchers working on it were employed by or received major contributions from the pharmaceutical industry.
 
2013-05-08 11:08:45 AM  

karmaceutical: Why do so many Farkers have a grudge against the DSM-V?


I dunno but I'm pegging this thread at around 50% Scientologist right now.
 
2013-05-08 11:12:53 AM  

czetie: In a perfect world, DSM-V will be the last of its kind: an attempt to "diagnose" brain illnesses by categorizing externally presenting symptoms along with subjective judgment of their severity.

The current state of psychiatry is akin to a mechanic diagnosing your car trouble purely from the way it sounds and pulls to the right under braking, and treating it by changing the fluids.

The psychiatric profession is terrified that real scientists are coming and their business is going to go away.


I agreed with you completely until your last point - I would argue that all research psychiatrists are real scientists, just like all research doctors. Their field is just younger than most other fields in medicine, so they're still discovering more. Eventually psychiatry and psychology will become a sub-discipline of neurology, but that's decades and decades away.
 
2013-05-08 11:23:15 AM  

Lord Dimwit: The problem with psychology is that all diagnoses are fundamentally subjective.

I'm not saying mental illness doesn't exist or that it isn't devastating.

What I'm saying is that in no other branch of medicine is disease defined by vote. Until the 70s homosexuality was a disease, and then suddenly it wasn't due to a vote. Nowhere else in medicine can a disease cease to be a disease by vote.

The other problem is that, while the DSM gives strict criteria for diagnosis, every other ad on TV presents a list of vague symptoms and then tells you to "talk to your doctor". Whether or not your doctor agrees with the diagnosis, I think you're more likely to be prescribed a medication if you bring it up first. I think advertising for drugs in unethical - your doctor should examine your symptoms and you should decide together on a course of treatment.

Finally, going back to the vote thing: many diagnoses in the DSM have religious exemptions. In other words, if you believe something crazy but it's your religion, you're not crazy (yes I realize its more subtle than that but I'm typing on a phone). Diseases shouldn't have religious exemptions.

Once again, I'm not saying mental illness doesn't exist or that psychopharmacology doesn't work; obviously both are true. I'm saying that when disease can be defined by fiat, we need to be very sure we're not pathologizing normal behavior.


My big stick with the new DSM is the redefining of Autism to prune the diagnosis of cases.

Now I know that everyone's going to jump up my ass about 'Not real disease' or 'Self diagnosis', but It's one of my biggest issues. You had a mental problem, and now according to us, you don't, and you won't get any coverage, or support, and fark you.
 
2013-05-08 11:29:52 AM  
My biggest gripe is that the DSM-IV was only $50 and the DSM-V is going to be $200
 
2013-05-08 11:31:46 AM  

Fano: karmaceutical: Why do so many Farkers have a grudge against the DSM-V?

I dunno but I'm pegging this thread at around 50% Scientologist right now.


I was thinking it was more along the lines of "My personality orders would exist if the DSM-V didn't catalog their symptoms!"
 
2013-05-08 11:33:58 AM  
media.motortopia.com


i didn't know they got back to making new stuff
 
2013-05-08 11:35:13 AM  
media.liveauctiongroup.net
 
2013-05-08 11:36:03 AM  

karmaceutical: Fano: karmaceutical: Why do so many Farkers have a grudge against the DSM-V?

I dunno but I'm pegging this thread at around 50% Scientologist right now.

I was thinking it was more along the lines of "My personality orders would NOT exist if the DSM-V didn't catalog their symptoms!"


FTFM
 
2013-05-08 11:45:02 AM  

blackartemis: Of course it's out of touch
it doesn't even address crank walk.


Or the walk of shame.
 
2013-05-08 11:56:16 AM  

Lord Dimwit: I agreed with you completely until your last point - I would argue that all research psychiatrists are real scientists, just like all research doctors.


Sorry, I should have been more explicit. I was referring to the practice of psychiatry, which still frighteningly often clings to laughable practices long after research psychiatrists have demonstrated that those practices are no better than phrenology.

(Yes, it's true that medical doctors can often be slow to adapt to medical research, but compared to psychiatric practitioners...)
 
2013-05-08 11:57:45 AM  

Lord Dimwit: karmaceutical: Why do so many Farkers have a grudge against the DSM-V?

Well, one of my main problems is that the researchers working on it were required to work in secret and forbidden from sharing their reasoning about the diagnoses with outside sources - it's not science if external sources can't recreate it. Another problem is, unlike previous editions of the DSM, the majority of the researchers working on it were employed by or received major contributions from the pharmaceutical industry.


But other than how it was done, who did it, and what it says, we're fine with it.
 
2013-05-08 12:04:52 PM  

Bandito King: There's no such thing as "mental illness".


But the people on TV are so happy. I even bought that car which made the guy so happy in the commercial, and it did nothing. There must be something wrong with me.

Sadly, that's really what a lot of it comes down to. People are fooled into having unrealistic expectations. Oh, and they're stupid. So very very stupid.
 
2013-05-08 12:05:45 PM  

Lord Dimwit: I think advertising for drugs in unethical - your doctor should examine your symptoms and you should decide together on a course of treatment.


To be honest I am surprised there is even one other country than the US that allows it (New Zealand).
 
2013-05-08 12:12:12 PM  

Lord Dimwit: czetie: In a perfect world, DSM-V will be the last of its kind: an attempt to "diagnose" brain illnesses by categorizing externally presenting symptoms along with subjective judgment of their severity.

The current state of psychiatry is akin to a mechanic diagnosing your car trouble purely from the way it sounds and pulls to the right under braking, and treating it by changing the fluids.

The psychiatric profession is terrified that real scientists are coming and their business is going to go away.

I agreed with you completely until your last point - I would argue that all research psychiatrists are real scientists, just like all research doctors. Their field is just younger than most other fields in medicine, so they're still discovering more. Eventually psychiatry and psychology will become a sub-discipline of neurology, but that's decades and decades away.


Bingo.  This quote fron Insel nicely sums up where it's all headed...and quite frankly can't happen fast enough.

"reshape the direction of psychiatric research to focus on biology, and neuroscience so that scientists can define disorders by their causes, rather than their symptoms. "
 
2013-05-08 12:12:52 PM  

J. Frank Parnell: Bandito King: There's no such thing as "mental illness".

But the people on TV are so happy. I even bought that car which made the guy so happy in the commercial, and it did nothing. There must be something wrong with me.

Sadly, that's really what a lot of it comes down to. People are fooled into having unrealistic expectations. Oh, and they're stupid. So very very stupid.


Wanna know how I know that  you have ever known someone with mental illness?
 
2013-05-08 12:15:21 PM  

czetie: Lord Dimwit: I agreed with you completely until your last point - I would argue that all research psychiatrists are real scientists, just like all research doctors.

Sorry, I should have been more explicit. I was referring to the practice of psychiatry, which still frighteningly often clings to laughable practices long after research psychiatrists have demonstrated that those practices are no better than phrenology.

(Yes, it's true that medical doctors can often be slow to adapt to medical research, but compared to psychiatric practitioners...)


I'm sorry to say that that clinging is, sadly, characteristic of "real" science.  It shouldn't be-- once presented proper, repeatable evidence that an idea explains a phenomenon better than the current explanation, all "real" scientists should take that new idea and never look back.  Yes, I overstate a bit, but you get the idea.  But, sadly, in science and psych{ology, iatry}, old theories don't die... old practitioners do.
 
2013-05-08 12:21:48 PM  
Did they classify religious belief as a mental disorder in this one like a good number of people on here said they would?
 
2013-05-08 12:42:40 PM  
This is why I suggest that, if you need a psychiatrist, find one who is regularly engaged in research.  It makes a huge difference in terms of getting the newest meds, knowing what's outdated practice, availability of clinical trials, etc.
 
2013-05-08 12:43:43 PM  

treesloth: czetie: Lord Dimwit: I agreed with you completely until your last point - I would argue that all research psychiatrists are real scientists, just like all research doctors.

Sorry, I should have been more explicit. I was referring to the practice of psychiatry, which still frighteningly often clings to laughable practices long after research psychiatrists have demonstrated that those practices are no better than phrenology.

(Yes, it's true that medical doctors can often be slow to adapt to medical research, but compared to psychiatric practitioners...)

I'm sorry to say that that clinging is, sadly, characteristic of "real" science.  It shouldn't be-- once presented proper, repeatable evidence that an idea explains a phenomenon better than the current explanation, all "real" scientists should take that new idea and never look back.  Yes, I overstate a bit, but you get the idea.  But, sadly, in science and psych{ology, iatry}, old theories don't die... old practitioners do.


Now I'm really depressed, so thanks. I need some talk therapy and/or medication.
 
2013-05-08 12:52:11 PM  

Egoy3k: Wanna know how I know that you have ever known someone with mental illness?


I'm making a distinction between the 90% of the population who is falsely deemed mentally ill just to feed them pills, and the 5-10% that is genuinely mentally ill. That's why i said "that's what a lot of it comes down to".

But even though i recognize genuine mental illnesses like Schizophrenia or Sociopathy, i tend to think they're also a result of our profoundly screwed up society. Studies are now showing social interaction helps Schizophrenia more than any pill ever could. Social isolation tends to bring on Schizophrenia and worsen it, and we as a society ostracize anyone who acts the slightest bit unusual, which only contributes to the problem. I once had a friend who was about as Schizophrenic as you can get, and watched him slowly recover over many years. Last i heard he's married with kids now.

Sociopathy is probably the only one i'd consider completely incurable, because those with it, and even society as a whole, don't really see it as a problem unless the person is out killing people. For the most part the traits of a sociopath are considered positive and serve to make them more successful in our society. For that reason i'd put the actual percentage of people with it at much higher than 10%, but they're largely unrecognized because of how well they integrate with our society.
 
2013-05-08 12:56:17 PM  

czetie: Now I'm really depressed, so thanks. I need some talk therapy and/or medication.


Seet on mein couch, now, and tell me about dine muddare.
 
2013-05-08 01:26:26 PM  

J. Frank Parnell: Egoy3k: Wanna know how I know that you have ever known someone with mental illness?

I'm making a distinction between the 90% of the population who is falsely deemed mentally ill just to feed them pills, and the 5-10% that is genuinely mentally ill. That's why i said "that's what a lot of it comes down to".

But even though i recognize genuine mental illnesses like Schizophrenia or Sociopathy, i tend to think they're also a result of our profoundly screwed up society. Studies are now showing social interaction helps Schizophrenia more than any pill ever could. Social isolation tends to bring on Schizophrenia and worsen it, and we as a society ostracize anyone who acts the slightest bit unusual, which only contributes to the problem. I once had a friend who was about as Schizophrenic as you can get, and watched him slowly recover over many years. Last i heard he's married with kids now.

Sociopathy is probably the only one i'd consider completely incurable, because those with it, and even society as a whole, don't really see it as a problem unless the person is out killing people. For the most part the traits of a sociopath are considered positive and serve to make them more successful in our society. For that reason i'd put the actual percentage of people with it at much higher than 10%, but they're largely unrecognized because of how well they integrate with our society.



I would ask for a citation but after looking at your profile i know it's not necessary.

Also, your are full of shiat. Good day mate.
 
2013-05-08 01:32:35 PM  
Kinek:
My big stick with the new DSM is the redefining of Autism to prune the diagnosis of cases.

Now I know that everyone's going to jump up my ass about 'Not real disease' or 'Self diagnosis', but It's one of my biggest issues. You had a mental problem, and now according to us, you don't, and you won't get any coverage, or support, and fark you.


I've heard both ways on this.  They got rid of "Aspergers" and merged it with Autism.  Additionally since its now a spectrum disorder a bunch more kids are going to get the label. I think this is going to end up increasing funding for autism and forcing insurance to do something about it.

/Mom of autistic boy.
 
2013-05-08 01:48:08 PM  

Lord Dimwit: karmaceutical: Why do so many Farkers have a grudge against the DSM-V?

Well, one of my main problems is that the researchers working on it were required to work in secret and forbidden from sharing their reasoning about the diagnoses with outside sources - it's not science if external sources can't recreate it. Another problem is, unlike previous editions of the DSM, the majority of the researchers working on it were employed by or received major contributions from the pharmaceutical industry.


Ooh that explains a lot.

Multiple diagnoses here: PTSD, general anxiety, plus 2 sleep disorders. Docs wanted to put me on so many meds, when really all I need is an anti-anxiety, therapy for the PTSD, and my MJ so I can sleep. But the free clinic here refuses to give long-term therapy (I used the annual allotment of 6 sessions in the first three months of the year), and labelled me as a drug addict, so they won't do anything for anything else unless I'm "clean" (repeated drug tests have only ever shown MJ, and I've been honest from the get go about it--why they insist on treating me like a heroin-addled meth addict. . . .) Bonus: Even the substance abuse counselor at the clinic didn't understand why the doc had referred me and told me rehab and getting clean wouldn't help.

I'm like no, I'm not playing guinea pig with pill soup, while we add more meds to counteract the side effects of all the other meds. No no no no no no no no. Doesn't help that the second drug they put me on (Seroquel for PTSD-related insomnia--this was after trying Trazadone that it didn't work for shiat) has been linked to several deaths when used as a treatment for PTSD in combination with other drugs. No no no no no no no. I'm not going to die just because you aren't listening to me.

Sorry, I know my body better than you do. Do not give me a drug for nightmares caused by PTSD when I'm having hallucinations from my RISP. I can tell the difference between a dream and a hallucination, and it can't be PTSD if I've been having them for a lot longer than I've had the PTSD. Telling me I'm just having nightmares and I should take this pill and go away does not encourage trust and completely destroys the capacity for effective therapy.

Do your job instead of writing a script. You may actually do some good.
 
2013-05-08 01:51:40 PM  

czetie: In a perfect world, DSM-V will be the last of its kind: an attempt to "diagnose" brain illnesses by categorizing externally presenting symptoms along with subjective judgment of their severity.

The current state of psychiatry is akin to a mechanic diagnosing your car trouble purely from the way it sounds and pulls to the right under braking, and treating it by changing the fluids.

The psychiatric profession is terrified that real scientists are coming and their business is going to go away.


You were doing great until that last sentence. I know several of these people, and they are anything but terrified. They're excited over the prospect of better treatments; saddened that it's taking so long to happen; and fully accepting that their jobs will change...not go away, anymore than robot-assisted surgery put surgeons out of business.
 
2013-05-08 01:55:09 PM  
Coach_J:
Bingo.  This quote fron Insel nicely sums up where it's all headed...and quite frankly can't happen fast enough.

"reshape the direction of psychiatric research to focus on biology, and neuroscience so that scientists can define disorders by their causes, rather than their symptoms. "


Those who forget history are condemned to repeat it.

What he conveniently ignores is that the reason psychology moved to diagnosis based upon symptoms was because that was perceived at the time as the more objective measure rather than defining disorders based upon their causes. Indeed, it was none other than William James who famously declared that "cause is an alter to an unknown God."  My own opinion is that neither system works well but that we should stick with symptoms not because they are a better taxonomy than causes but because at the end of the day it is better not to play musical chairs with causes vs symptoms, a debate that will always remain unresolvable.

/subby
 
2013-05-08 02:02:01 PM  

Coach_J: Lord Dimwit: czetie: In a perfect world, DSM-V will be the last of its kind: an attempt to "diagnose" brain illnesses by categorizing externally presenting symptoms along with subjective judgment of their severity.

The current state of psychiatry is akin to a mechanic diagnosing your car trouble purely from the way it sounds and pulls to the right under braking, and treating it by changing the fluids.

The psychiatric profession is terrified that real scientists are coming and their business is going to go away.

I agreed with you completely until your last point - I would argue that all research psychiatrists are real scientists, just like all research doctors. Their field is just younger than most other fields in medicine, so they're still discovering more. Eventually psychiatry and psychology will become a sub-discipline of neurology, but that's decades and decades away.

Bingo.  This quote fron Insel nicely sums up where it's all headed...and quite frankly can't happen fast enough.

"reshape the direction of psychiatric research to focus on biology, and neuroscience so that scientists can define disorders by their causes, rather than their symptoms. "


Popped in just to say exactly this.  Insel has got it right.  It's not that the DSM-V has no value, it is just the best that we have at the moment.  The brain isn't just any other organ - it is the most complex organ in the human body. Neuroscientists are just starting to get a handle on how the collective activity of around a hundred billion neurons results in behavior.   It'll take time, but the neurobiological origins underlying these diseases will be discovered and from there these disorders will be redefined for the better.
 
2013-05-08 02:14:19 PM  

worlddan: Coach_J:
Bingo.  This quote fron Insel nicely sums up where it's all headed...and quite frankly can't happen fast enough.

"reshape the direction of psychiatric research to focus on biology, and neuroscience so that scientists can define disorders by their causes, rather than their symptoms. "

Those who forget history are condemned to repeat it.

What he conveniently ignores is that the reason psychology moved to diagnosis based upon symptoms was because that was perceived at the time as the more objective measure rather than defining disorders based upon their causes. Indeed, it was none other than William James who famously declared that "cause is an alter to an unknown God."  My own opinion is that neither system works well but that we should stick with symptoms not because they are a better taxonomy than causes but because at the end of the day it is better not to play musical chairs with causes vs symptoms, a debate that will always remain unresolvable.

/subby


Agree with this too.  I think Psychiatry would be better served by moving away from using symptoms as their only form of criteria though. I remember hearing an analogy used by the RDoC folks along the lines of 'imagine trying to diagnose a bacterial or viral infection based solely on the symptoms presented by the patient'.  It seems that is where Psychiatry is stuck at the moment.  There is a great deal of overlap in the symptoms presented in many psychiatric illnesses, however, when it comes to knowing whether or not the etiology is the same, we haven't got a clue. So for now the DSM-V performs a useful function, but as information regarding the biological basis for these diseases/symptoms the field needs to reevaluate the criteria they are using for diagnosing mental illness.
 
2013-05-08 02:22:42 PM  

neurodoclove: Coach_J: Lord Dimwit: czetie: In a perfect world, DSM-V will be the last of its kind: an attempt to "diagnose" brain illnesses by categorizing externally presenting symptoms along with subjective judgment of their severity.

The current state of psychiatry is akin to a mechanic diagnosing your car trouble purely from the way it sounds and pulls to the right under braking, and treating it by changing the fluids.

The psychiatric profession is terrified that real scientists are coming and their business is going to go away.

I agreed with you completely until your last point - I would argue that all research psychiatrists are real scientists, just like all research doctors. Their field is just younger than most other fields in medicine, so they're still discovering more. Eventually psychiatry and psychology will become a sub-discipline of neurology, but that's decades and decades away.

Bingo.  This quote fron Insel nicely sums up where it's all headed...and quite frankly can't happen fast enough.

"reshape the direction of psychiatric research to focus on biology, and neuroscience so that scientists can define disorders by their causes, rather than their symptoms. "

Popped in just to say exactly this.  Insel has got it right.  It's not that the DSM-V has no value, it is just the best that we have at the moment.  The brain isn't just any other organ - it is the most complex organ in the human body. Neuroscientists are just starting to get a handle on how the collective activity of around a hundred billion neurons results in behavior.   It'll take time, but the neurobiological origins underlying these diseases will be discovered and from there these disorders will be redefined for the better.



Until the 70s, homosexuality was considered a mental illness - if we discover the biological underpinnings of it, does it become a disease again? Or does it stay a normal variant of behavior?

I guess the point I'm trying to make is that when we reduce something as complex as "behavior" to its ultimate mechanistic underpinnings, we still have to decide which behaviors are abnormal and which aren't.

/ I'm not saying homosexuality is a mental disorder; it isn't
// just using it as an example
/// obsessively putting three slashies
 
2013-05-08 02:49:19 PM  
Oh, I've known, or met in passing, at least a couple dozen people who exhibit aberrant behavior. It's just that when someone is aggressive and says things that make no logical sense I am simply aware that it's not much different from someone whacked out of their head on crystal meth, so I treat them roughly the same. It's not something they need to talk about, they just need to stay out of reach. Not interfering with other people is sadly a dying art.
 
2013-05-08 02:57:04 PM  
Lord Dimwit: Eventually psychiatry and psychology will become a sub-discipline of neurology, but that's decades and decades away.

I disagree with you on this point. Psychiatry and psychology are concerned with behaviour, which has an inherent social component. It's well known that both nature and nurture have an impact on psychological development and health, and a strick focus on neurology would be counterproductive in addressing the social phenomena that affect psychological problems. Looking at someone's neurons can't tell you that they are socially isolated and stressed from overwork, or any of the myriad other social factors that can trigger the onset of mental illness. Many psychological problems respond extremely well to cognitive therapy of various sorts - not just talk therapy, but also lifestyle changes of various sorts that require understanding the patient as an individual within a particular social context. You just can't address those through neurology. It's better when possible to help a person change their life slowly in order to actually resolve their issues rather than just prescribing a drug to mitigate the symptoms, and I don't know a single psychological therapist worth the name that will tell you otherwise.

I do agree that neurology will be an ever-increasing part of the picture, and we will get better and better at determining exactly what the problems are through neurological techniques, but there is always going to be more to it on the therapeutic side, for exactly the same reasons (except much moreso) that things like a doctor's bedside manner, pleasant surroundings and social support are critical in medicine for good patient response to treatment and recovery.

All that said, I do agree that anyone basing research funding decisions on the DSM categories is completely and utterly missing the point. Heck, it was drilled in to me in my first year of my psych undergrad that the DSM is a diagnostic aid ONLY, and that it was deliberately intended to say as little as possible about the underlying causes - because the theories were not settled and there was still much disagreement. That's still a sound policy. Heck, that's why it is changed and revised periodically - because it is not and never was intended to be a definitive resource for the science! The DSM is intended as a practical aid to helping people in distress, not as some kind of objective guide to psychological fact. Anyone who is using it as the latter is completely doing it wrong.
 
2013-05-08 03:06:26 PM  

KiltedBastich: Looking at someone's neurons can't tell you that they are socially isolated and stressed from overwork, or any of the myriad other social factors that can trigger the onset of mental illness.


No, but maybe looking at what parts of the brain light up might?

I think that's his point. Eventually we may be able to see links between the physical/mental that we don't have yet.

/any sufficiently advanced technology blah blah blah
//when did people get so unimaginative? Like this right now is the best technology will ever be able to do??? We need to bring back Star Trek for realz. NOW!
 
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