Psychiatrists Cast Doubt On Biomedical Model of Mental Illness

jones_supa writes "British Psychological Society's division of clinical psychology (DCP) will on Monday issue a statement declaring that, given the lack of evidence, it is time for a 'paradigm shift' in how the issues of mental health are understood. According to their claim, there is no scientific evidence that psychiatric diagnoses such as schizophrenia and bipolar disorder are valid or useful. The statement effectively casts doubt on psychiatry's predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs. The DCP said its decision to speak out 'reflects fundamental concerns about the development, personal impact and core assumptions of the (diagnosis) systems', used by psychiatry. The provocative statement by the DCP has been timed to come out shortly before the release of DSM-5, the fifth edition of the American Psychiatry Association's Diagnostic and Statistical Manual of Mental Disorders. The manual has been attacked for expanding the range of mental health issues that are classified as disorders."

Psychology VS Psychiatry

[comp.sci]

It is worth noting that the central distinction between psychiatrists and psychologists is that generally psychiatrists can prescribe medications (they are doctors). It's therefore not surprising that some psychologists would issue a statement like this. Honestly, this single statement by what appears to be a spokesperson discredits their entire ramblings: "it was unhelpful to see mental health issues as illnesses with biological causes". It's quite shocking to see professionals show such ignorance of their own field, just because they specialize in one aspect of it. While we are certainly still in the dark ages of neuroscience and psychiatry, there is a reason why we can control a ton of psychiatric illnesses with medications. We have many decades worth of research that specifically shows you what goes wrong in a person's brain with many psychiatric illnesses.

Re:Psychology VS Psychiatry and BPS==morons!

[girlinatrainingbra]

Re: It's therefore not surprising that some psychologists would issue a statement like this.
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I completely agree with you. In fact, the rambling statement by these psychologists (which does not appear to be scientific) is readily disproven by the biggest and most successful example of medical treatment of a mental health disorder: schizophrenia ( http://en.wikipedia.org/wiki/Schizophrenia#Medication [wikipedia.org] ) and the 1950's discovery of an antipsychotic medication [wikipedia.org] which greatly improved the hallucinations and psychotic breaks undergone by schizophrenic patients: chlorpromazine [wikipedia.org] was found while looking for anti-histamines (for allergies).
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The wikipedia article on chlorpromazine points out:

In 1955 it was approved in the United States for the treatment of emesis (vomiting). The effect of this drug in emptying psychiatric hospitals has been compared to that of penicillin and infectious diseases.[50] But the popularity of the drug fell from the late 1960s as newer drugs came on the scene. From chlorpromazine a number of other similar antipsychotics were developed. It also led to the discovery of antidepressants.[53]

Chlorpromazine largely replaced electroconvulsive therapy, psychosurgery, and insulin shock therapy.

In other words, chlorpromazine actually worked so well that the psychiatrists no longer had to resort to ECT, brain surgery, or screwing with the patient's sugar and insulin levels.
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You'd have to be a complete moron to claim that there is no evidence for medical and pharmacologic treatment of schizophrenia: the evidence is almost 60 years old. The only conclusion to draw from this is that the British Psychological Society is, in fact, composed of vast groups of complete morons who do not believe in science or the scientific method.

Re:Replacement needed

[cold fjord]

Pardon me for pointing out that DSM-5 is the replacement. Currently they're using DSM-IV, which is a lot smaller.

The larger point, exposed by this "update", is that the categories are essentially arbitrary and apparently not based on anything falsifiable, ie not anything resembling science.

Yes, I know. That is why it need to be replaced, preferably with something systematic, as indicated above.

As it stands, brain imaging can identify psychopaths [reuters.com], and is showing useful things about Post Traumatic Stress Disorder [sfgate.com]. I expect there will be more to come in that regard. Then there is also the fascinating feedback that can occur between behavior and brain function and activity. Good and bad behavior can become self-reinforcing. Then there is the role of nutrition [usda.gov] in various aspects of brain function and behavior. Biochemistry is continuing to provide new insights, and new approaches. We are continuing to learn important lessons about something so seemingly common as sleep [wsj.com] and its disorders that effect people's memory, attention, and behavior. Even classic psychology and psychiatry have insights that will have to be considered. It all plays a part. On the other hand, in a lot of ways it seems like we are still groping in the dark there is so much to learn. One thing seems likely to me is we are likely to find more conditions that will end up requiring a multidisciplinary approach to treat.

Another interesting question will come when various aberrant behaviors are scientifically identified as such, but they end up being politically protected in either the scientific community, or the political establishment.

Choices, choices.

Re:Psychology VS Psychiatry

[ceoyoyo]

Many mental illnesses are at least partly heritable (including the two examples in the summary) and many are associated with measurable physical (as well as chemical) changes in the brain (including the two examples in the summary). At least some mental illness does have biological causes.

Re:Would most people be better off undiagnosed?

[NicBenjamin]

Your example's wrong. Back in the olden days when they still repaired computer boards rather then simply throwing them out, the way they figured out which chip needed to be replaced was by using electrical equipment to test circuits. It took forever even back then, with much simpler circuits, but if you had the right tools you could still do it today. It's not a great way to solve every computer issue, but for some extremely severe problems this is the only solution besides throwing out the hardware.

This is why using pills to treat mental illness has such great results. Most of the dumb criminals you read about in the news are people who have been diagnosed with major psychiatric issues, but stopped taking their meds. I've been on and off anti-depressants for years, and I can tell you I feel tons better when I'm on the pills. I feel better, I focus better, instead of deciding to sit at home and BS on Slashdot I go to work, etc.

Yeah there are many issues that could be better handled with therapy, or simple good parenting, that get into the DSM. But that's because all medical specialties have diagnoses that are silly, or obvious, or not that big a deal. If you check out the Wikipedia page on paper cuts you'll note that Paper Cuts have a Medical Billing Code.

Re:Replacement available

[NicBenjamin]

I can confirm anti-depressants work fine if you're correctly diagnosed with depression. I can feel the pills wear off. And if you read your link, you'll note the actual paper you quote says they work better then placebo, too. Only 33% better, but better is better.

Being misdiagnosed is not unusual. Strokes also have the same symptoms as many other diseases. Women having heart attacks are frequently told they're having a panic attack. That doesn't mean that the numerous diseases that look like strokes are complete BS made up by some idiot, it just means that you have to have a Doctor whose smart enough to tell a stroke from a migraine.