Is psychiatry a pseudoscience?

[mixmaster.mewthree]

I'm doing a report on schizophrenia right now for one of my classes, and I've received a lot of different information about it and I'm kind of confused.

I researched the physiological aspects of schizophrenia a bit, and it's saying that sufferers have smaller temporal lobes than average or enlarged ventricles and reductions in gray matter, then I watch this youtube video stating that an alleged child with schizophrenia doesn't have an illness at all and is being falsely medicated and that schizophrenia isn't even a disease, it's just labelled as one so that people with keep buying drugs and be medicated zombies or something.

Basically, I'm confused if mental illnesses are actually something that could be studied physiologically or if it's just the result of personal experiences. I don't know what to believe, there's too much conflicting information!

 

[Myzozoa]

Youtube and wikipedia are always strong sources of information on diseases, clearly schizophrenia is a result of poor mothering in childhood years.

 

[Lanturn314]

Okay, if you think schizophrenia is not a real mental illness, you're retarded. I'm a neuroscience major at Johns Hopkins, and I've taken tons of classes on the neurological bases of various mental disorders. I've also taken a few pharmacology classes. It's pretty clear that mental illnesses do indeed have a neurological basis, and in schizophrenia, it's readily apparent that it does. Of course, the enlarged ventricles and reductions in gray matter don't necessarily show up on the MRIs of all patients, but pretty much all patients with psychotic disorders respond to antipsychotic meds such as haloperidol, clozapine, etc., lending credence to the assertion that an excess of dopamine plays a very large role in the development of their positive symptoms (if you don't know what this means, read on).

If you're looking to do a research report on schizophrenia, there are two places you should probably look:
-the DSM (this is a draft of the 5th edition, but it's not officially out yet. It cites some good current papers that you should look up, though. The current criteria are in the DSM-IV-TR.)


Also, PubMed. Just type in schizophrenia into the search bar, and you should come up with tons of papers. If you want to find out about childhood schizophrenia (which is a bit more controversial as to whether it is actually a form of schizophrenia, though clearly something is wrong with the children that is causing them to hallucinate), just type that in instead. Google Scholar is also a good place to search for current papers, but I like the advanced search functions in PubMed better.

If you need help understanding something, you can VM or PM me, and I will be more than happy to answer your questions to the best of my ability :)

 

[ivar]

whatever lanturn, people with schizophrenia are just spiritually troubled. they need to unify their souls and find God--this neurowhatever mumbo jumbo is just non-sequitur liberal elite babble. you need to stop worshiping your false God science and find the real God

 

[mixmaster.mewthree]

Thanks for the information Lanturn I was hoping you'd post here!!

And sorry, I didn't mean to come off as ignorant or anything as I realize my OP probably sounded pretty stupid.

 

[wickdaggler]

whatever lanturn, people with schizophrenia are just spiritually troubled. they need to unify their souls and find God--this neurowhatever mumbo jumbo is just non-sequitur liberal elite babble. you need to stop worshiping your false God science and find the real God

hahaha yes

ivar I love you

 

[FlareBlitz]

It's relatively apparent that most mental illnesses have an empirically observable neurological basis (serotonin imbalances, issues with dopamine receptors, etc), which means psychiatry is certainly not a pseudoscience. However, there is an interesting issue in psychiatry right now revolving around the notion of "normalcy". Lanturn brought up the DSM; DSM-IV (soon to be DSM-V) has thousands of mental illnesses within its pages, and almost all of us have symptoms of at least one of these. There is discussion around whether the DSM is based around deviations from an idea of normalcy that doesn't exist in reality.

I tried to find good readings about this, but unfortunately a lot of them are from kooky anti-science websites...this one is pretty good, though. It's by one of the creators of the DSM-IV.

 

[Umbreon Dan]

schizophrenia is characterized by "some symptoms" and is caused by "some neurological anomalies". the symptoms are not the same in every patient, nor are the causes (and often the cause is totally unknown). this is way too imprecise to meet basic scientific standards, so yes, psychiatry is a soft science or pseudoscience.

psychiatrists prescribe drugs on the basis that "i think x is affecting you and i think y will stop it". compare this to "your foot hurts because you stepped on a nail, lemme pull it out and you'll be fine". medical doctors can do this because they know that every body works basically the same way. on the other hand, every mind works differently.

i really don't like calling schizophrenia a disease, either. in that video, they state that the girl was born sick because she has recurring hallucinations. it can't be that she's simply a weird kid, it has to be a disease. psychiatry tends to insist that there is some kind of "normal person" and everyone different is "sick". i much prefer to think that everyone is simply different.

have you ever seen the sixth sense? the doctor in that film is an example of doing psychiatry right. he never prescribes drugs - in fact he never "cures" the illness of seeing ghosts - but he turns the kid from perpetually scared and upset to very happy. making people happy is what psychiatry should be about - not forcing everyone to conform to the social norm of the day. very few psychiatrists actually attempt to do this because giving out drugs is faster and more profitable.

around the 50s and 60s, homosexuality was considered a mental illness because people considered it "not normal". they don't prescribe drugs to gays any more because being gay is now socially acceptable, but being hyper still isn't. i'm pretty sure that every person in the world could be diagnosed with some sort of mental illness by the right (wrong) psychiatrist.

psychiatry isn't in and of itself a bad thing. when it can make people happier, it's a beautiful thing. the problem is that it very rarely does, and in the meantime, it disgraces the notion of human rights in the developed world. institutionalizing people who haven't broken any laws because they're too weird is outrageous. taking away voting rights from people who are different makes an absolute farce of democracy.

the child in that video said the drugs aren't working, so why the fuck is she still taking them? presumably she doesn't have a choice; her parents are forcing her to. her parents may not be able to stop, either, because psychiatrists can call human rights groups and accuse them of endangering the child. this is blatant abuse of the system to keep people buying drugs.

in summary, schizophrenia may exist but is not a disease, and psychiatry is (at least partly) a scam for money. "normal people" do not exist.

 

[cookie]

whatever lanturn, people with schizophrenia are just spiritually troubled. they need to unify their souls and find God--this neurowhatever mumbo jumbo is just non-sequitur liberal elite babble. you need to stop worshiping your false God science and find the real God

time to bust out my trepanning drill

 

[His Eminence Lord Poppington II]

cookie is your new god it seems

 

[Morm]

schizophrenia is characterized by "some symptoms" and is caused by "some neurological anomalies". the symptoms are not the same in every patient, nor are the causes (and often the cause is totally unknown). this is way too imprecise to meet basic scientific standards, so yes, psychiatry is a soft science or pseudoscience.

I am not sure you know how the process works. Let me explain! There is a unifying body of symptoms that unite schizophrenia as there is for all the more rigidly defined metal disorders. So this very much so is a science that is flying a little blind because we don't know how personality manifests. Just because there isn't an answer right now doesn't mean there isn't one, however. I will agree that many of the softer diagnosis' such as Borderline Personality Disorder can trend towards fucking bullshit and many things can overlap, but as Lanturn said- the fact that they respond similarly to similar drugs indicates there is unity in the response area as well. This means there are two lines of evidence uniting certain disorders, meaning that there has to be something different about individuals that suffer from them.

psychiatrists prescribe drugs on the basis that "i think x is affecting you and i think y will stop it". compare this to "your foot hurts because you stepped on a nail, lemme pull it out and you'll be fine". medical doctors can do this because they know that every body works basically the same way. on the other hand, every mind works differently.

Every mind works in the same way on a physiological level. Just thing about it this way: A liver will work differently if there is something wrong with it. Again, personality manifestation and understanding it is something that isn't understood. I suspect being the subject of our own study complicates this matter.

i really don't like calling schizophrenia a disease, either. in that video, they state that the girl was born sick because she has recurring hallucinations. it can't be that she's simply a weird kid, it has to be a disease. psychiatry tends to insist that there is some kind of "normal person" and everyone different is "sick". i much prefer to think that everyone is simply different.

As someone who suffers from recurring hallucinations I can tell you that it's not a walk in the park. It's not like your recreational drug trips. "Normal" is basically the average of a functional group of people, which is society. Schizophrenics tend to be strong outliers on this group, trending almost entirely towards nonfunctionality. They don't even bathe themselves or change their underwear.

have you ever seen the sixth sense? the doctor in that film is an example of doing psychiatry right. he never prescribes drugs - in fact he never "cures" the illness of seeing ghosts - but he turns the kid from perpetually scared and upset to very happy. making people happy is what psychiatry should be about - not forcing everyone to conform to the social norm of the day. very few psychiatrists actually attempt to do this because giving out drugs is faster and more profitable.

So you're an advocate of talk therapy > drugs? One of my therapists tried that with me, tried to convince me that everyone was normal. Normal means average, which I am not! Well, talk therapy DOES work really well for some people and helps almost anyone suffering from mental illness. However, I can tell you I have been way more functional and happy in life when medicated...and it's not like I'm taking valium, just stuff that helps stunt the problematic issues I have. So clearly if we are talking analogy, I cancel out that movie!

around the 50s and 60s, homosexuality was considered a mental illness because people considered it "not normal". they don't prescribe drugs to gays any more because being gay is now socially acceptable, but being hyper still isn't. i'm pretty sure that every person in the world could be diagnosed with some sort of mental illness by the right (wrong) psychiatrist.

This is a similar argument that I've heard creationists make, actually. "They weren't right the first time so they can't be right ever." It's progressive, deal with it. Yeah, you're right- most people do have some habits that can land them with symptoms of a disorder or two. This is most likely a relic of genetic drift as well as evolution not being caught up with our current lifestyle. Either that or psych is actually hard to put a pin in or both.

psychiatry isn't in and of itself a bad thing. when it can make people happier, it's a beautiful thing. the problem is that it very rarely does, and in the meantime, it disgraces the notion of human rights in the developed world. institutionalizing people who haven't broken any laws because they're too weird is outrageous. taking away voting rights from people who are different makes an absolute farce of democracy.

Its purpose isn't to make people happy. It's to make people able to cope and function which in turn opens the door for happiness. It has a high enough success rate to be continued, so I think that bumps it way out of the range of "rare." I don't think they take away the right to vote, but in patient mental health treatment is typically reserved for those that are an obvious and strong danger to themselves and others.

the child in that video said the drugs aren't working, so why the fuck is she still taking them?

Perhaps the kid is an ignorant idiot. It's likely the kid is on a loading dose or the wrong meds or that the kid is being a twat.

presumably she doesn't have a choice; her parents are forcing her to. her parents may not be able to stop, either, because psychiatrists can call human rights groups and accuse them of endangering the child. this is blatant abuse of the system to keep people buying drugs.

Umm unless taking the kid off the drugs makes it a danger to itself or others in a very obvious and strong way, the bolded would never happen. I'm assuming the parents keep the child on the drugs because it makes the child manageable. It's why I was on drugs as a child, I didn't have a choice but it allowed me to function and get through school, which was impossible without. Many times kids will say drugs aren't working if they don't FEEL an effect from them. Kids are quite prone to thinking they are 100% in control, even if they are not in control. It's a matter of the kid being an ignorant twat.

in summary, schizophrenia may exist but is not a disease, and psychiatry is (at least partly) a scam for money. "normal people" do not exist.

if it exists and is not a disease, what would you call it? Psych is just suffering more from being an art and a science. They need to whip that shit into shape, take the art shit out of the equation.

 

[Morm]

no TIK you got it wrong, he's an anarchist and a nihilist so basically nothing exists but his own selfish perspective (correct me if wrong, UD, but you have told me basically this in the past)

 

[THE_IRON_...KENYAN?]

Dude I think you might have schizophrenia because I didnt say anything

 

[Lanturn314]

No problem, mixmaster.mewthree! And it's ok-- there is a lot of bad info out on the internet... here's a hint: if something looks like a crazy conspiracy theory, it probably is one lol.

It's relatively apparent that most mental illnesses have an empirically observable neurological basis (serotonin imbalances, issues with dopamine receptors, etc), which means psychiatry is certainly not a pseudoscience. However, there is an interesting issue in psychiatry right now revolving around the notion of "normalcy". Lanturn brought up the DSM; DSM-IV (soon to be DSM-V) has thousands of mental illnesses within its pages, and almost all of us have symptoms of at least one of these. There is discussion around whether the DSM is based around deviations from an idea of normalcy that doesn't exist in reality.

I tried to find good readings about this, but unfortunately a lot of them are from kooky anti-science websites...this one is pretty good, though. It's by one of the creators of the DSM-IV.

It's true that ADD and ADHD are largely overdiagnosed, and this is a problem. There's a huge black market for aderall because college kids like to use it to focus better and stuff... As it stands, though, the DSM is one of the best tools around for diagnosing mental illness, and particularly for things like depression, anxiety disorders, bipolar, and psychotic disorders like schizophrenia, getting a correct diagnosis and then the proper medication and talk therapies can make a huge difference as to whether they can function.

Another useful diagnostic manual is the ICD-10. It was developed by the World Health Organization, so you might want to read through it. Ctrl+F for schizophrenia. The overall criteria are relatively consistent between DSM and ICD, though ICD goes into a bit more detail. DSM is pretty much what's used in the US, though ICD definitions are often used in research.

And Morm, while a lot of the diagnostic criteria for Personality Disorders overlap, they should hardly be considered "soft diagnoses." Personality Disorders are considered severe mental illnesses; things like borderline personality disorder, schizoid personality disorder, and antisocial personality disorder are hardly things to scoff at.

 

[Morm]

things like borderline personality disorder, schizoid personality disorder, and antisocial personality disorder are hardly things to scoff at.

When they are actually diagnosed properly. Many personality disorders, like borderline, can be transient and can actually go away with treatment (particularly dialectical). Hence the scoffing! If I recall, antisocial is the most serious and the only one I've been told is fully nontransient.

Edit: You know, giving specific diagnosis' is so hard. In my experience, they are trending away from giving diagnosis and pidgeon holing and moving to treat symptoms that are present. The problem with this is that in many cases people have no idea what is wrong or abnormal, since they have no point of reference. Many are non communicative, like schizophrenics, and have no idea what the fuck is going on.

 

[StarmanXL]

Lanturn and Morm, lemme just say as a neuroscience major I fucking love you guys for saying what I wanna say. I get into this kinda argument with people all the time.

 

[ivar]

time to bust out my trepanning drill

 

[Lucchini]

Diagnoses tend to differ considerably depending on the specialist you consult however. Schizophrenia, or anything else, comprises certain symptoms and forms of behaviour, but apparently isn't as easily deduced as 2 + 2, otherwise there would be unanimity in this field.

The problem with mental illnesses and disorders is that you can never be sure. You are too likely to misinterpret somebody's behaviour, just as they are likely to misrepresent their problems verbally by choosing the wrong words or focusing their attention on the wrong aspects of their supposed problem.

 

[Improbability]

Dude I think you might have schizophrenia because I didnt say anything

Haha golden TIK. I'm interested to see what sparked that response from him.

But being constructive and all, there was this great article I read in a Wired magazine about the DSM and how one of the leading contributors was criticising what it has become; a series of 'illnesses' with symptons that almost anyone could have, and there was even talk about deals with pharmaceutical companies iirc.
Morm posted a link to something similar, but this one was greater in detail and perspective. When/If I find it, ill edit it in (it was in a hard magazine so may take a bit of searching).

 

[Brain]

From what I've been told by a friend studying in psychiatry, there is some evidence that schizophrenia essentially results from the brain being unable to properly filter stimuli. For instance, a normal brain will acknowledge ambient noise as being "unimportant" and will not process it. A schizophrenic brain might erroneously give importance to this noise (I think excess of dopamine might inhibit the brain's saliency analysis, but I am no expert) and feed it through, say, language processing. The brain will assume that if the noise got this far, that's because it's important and meaningful, and it will try to find a meaning to it. That will produce, essentially, garbage (whispers, etc.), but through the same pathways as real events. The brain then gets cluttered by a mix of real events and spurious ones that it all processes the same and can't really tell apart, and it will tie them together in whatever narrative best fits the nonsense they perceive. Hence hallucinations, delusions, paranoia, stress, etc.

Psychiatry might be a very difficult and inexact science, especially with diagnosis, but it is fairly clear that all brains share many structural properties and pathways, that these structures and pathways often have very standard purposes, and that they might sometimes be defective. Now, the word "defect" is loaded, and it is important to realize that even if a brain functions differently from the norm, that is not necessarily a "defect" - it might not impair someone, nor cause them any prejudice, and it could even be positive (like using a standard pathway in a novel way, so that you get to process information that normal brains overlook). Other conditions, on the other hand, seem to fall squarely in the category of "defect" because we can identify basic functions that are being done wrong, and those affected feel distressed or are non-functional. Some of these problems I don't think the brain can overcome without medication (of course, in practice, medication can be given out without good reason, and I am certain there is sometimes abuse). The brain can correct itself to some extent, but it does not do miracles.

Maybe you could argue that a patient, even though he or she cannot discriminate notable events from background noise, is nonetheless happy in his or her fantasy world. That could be the case, and I'm not sure what is ethically right to do in such a situation. I do think that if the brain of someone can be made to function in a "normal" way without causing them huge prejudice that they would not normally get, that person deserves to be able to choose whether they prefer this to their previous condition.

 

[CaptKirby]

Technically it is a science no matter how you feel about it, observing and trying to deal with observations would classify it as such. It may not be as thorough as the deeper aspects behind it (neuroscience and whatever), but it is a science. Of course a lot of people who receive psychiatric help for weak reasons are jokes though...

 

[Morm]

Technically it is a science no matter how you feel about it, observing and trying to deal with observations would classify it as such. It may not be as thorough as the deeper aspects behind it (neuroscience and whatever), but it is a science. Of course a lot of people who receive psychiatric help for weak reasons are jokes though...

I'd like to add that science isn't just about observing and dealing with observation, but it must use the scientific process. In the case of pretty much all medicine it's a mix of trial and error and statistics. The only reasons why pretty much every other branch of medicine are so far ahead of psych is because less discrete physical medicine is observable without a filter or bias and as such as, which is actually the second reason it's ahead, is because it's been practiced for centuries to effect rather than the few centuries of vagina fumigation and lobotomies here and there.

You're right though, CK, god there are A LOT of retired old men unsure of what to do now and old menopausal women. Also you see a LOT of teens and pre teens looking for things like Xanax because they can't deal with being a teen or preteen.

Maybe you could argue that a patient, even though he or she cannot discriminate notable events from background noise, is nonetheless happy in his or her fantasy world. That could be the case, and I'm not sure what is ethically right to do in such a situation.

If they are not a harm to themselves or others then they are just fine. Harm can include threats, infringing on the rights of others, assaults, rape, self mutilation, inability to work/clean so they become ill (extreme hoarding, for example) and whatnot. It's a case by case basis, really it's a matter of safety to the person and people around them. That's how it would be handled and that is the ethical thing to do.

 

[Brain]

If they are not a harm to themselves or others then they are just fine. Harm can include threats, infringing on the rights of others, assaults, rape, self mutilation, inability to work/clean so they become ill (extreme hoarding, for example) and whatnot. It's a case by case basis, really it's a matter of safety to the person and people around them. That's how it would be handled and that is the ethical thing to do.

Yeah, I was thinking about someone who might not be a threat to anyone and might be happy, but is definitely not functional. Treatment might make them functional while keeping them happy, which would be a win and would lower the pressure on their family. But you don't necessarily want to force treatment in a bid that the outcome would be positive, when status quo is tolerable. Just food for thoughts, I guess.

 

[Morm]

Then again Brain, how many people are happy compared to how many simply functional? Functionality > happiness, kind of a law of survival. I guess the goal is get as much functionality out of someone as you can, since happiness isn't the most common of attributes in people who can feed themselves. Sometimes I feel that in cases like this, happiness is viewed as an entitlement rather than a sideshow to being able to feed ones self and live independently.

 

[FlareBlitz]

It's true that ADD and ADHD are largely overdiagnosed, and this is a problem. There's a huge black market for aderall because college kids like to use it to focus better and stuff... As it stands, though, the DSM is one of the best tools around for diagnosing mental illness, and particularly for things like depression, anxiety disorders, bipolar, and psychotic disorders like schizophrenia, getting a correct diagnosis and then the proper medication and talk therapies can make a huge difference as to whether they can function.

The issue is not that the DSM (or any diagnostic tool) is bad or should be discarded, the issue is that as time goes on, behaviors that we would now consider normative would be increasingly and unnecessarily classified as mental illnesses. This a social issue more than anything - with the advent of internet self-diagnoses and all the media hype over autism spectrum disorders, eating disorders, etc. we're all getting a little tense with respect to mental illness. We should probably step back a bit and restructure diagnoses such that drugs are prescribed only when there is a clear biological trigger that has been identified, in my opinion.