Even “experts” have really dumb ideas sometimes

“Schizophrenia” should be dropped, say experts
Mon Oct 9, 2006
By Patricia Reaney

LONDON (Reuters) – Mental health experts called on Monday for the term schizophrenia to be dropped, saying it has no scientific validity, is imprecise and stigmatizing.

“It is a harmful concept,” said Professor Marius Romme, a visiting professor of social psychiatry at the University of Central England in Birmingham.

He added that symptoms such as delusions, hearing voices and hallucinations are not the results of the illness but may be reactions to traumatic and troubling events in life.

Speaking at a news conference, Richard Bentall, a professor of clinical psychology at the University of Manchester, said the concept of schizophrenia is scientifically meaningless.

“It groups together a whole range of different problems under one label — the assumption is that all of these people with all of these different problems have the same brain disease,” he added.

Schizophrenia affects about 1 percent of people in the United States and Britain. Treatments such as atypical antipsychotic drugs focus on eliminating the symptoms. But the drugs can cause side effects such as weight gain, an increased risk of diabetes and sexual dysfunction.

Paul Hammersley of the University of Manchester who recently helped launch The Campaign for the Abolition of the Schizophrenia Label (CASL), said there is no agreement on the cause of the illness or its treatment.

CASL argues that the term schizophrenia is extremely damaging to those to whom it is applied and implies unpredictability, being dangerous, unable to cope and someone in need of life-long treatment.

“It is like canceling someone’s life,” said Hammersley. “We generally believe this word has to go.”

Other psychiatrists agree that schizophrenia is an unsatisfactory term that conveys bizarreness but they are concerned that discarding the term could lead to problems classifying patients with psychosis.

“If we don’t have some way of distinguishing between patients, then those with bipolar disorder or obsessional disorder would be mixed up with those currently diagnosed as having schizophrenia and might receive treatments wholly inappropriate for them,” said Robin Murray, a professor of psychiatry at the Institute of Psychiatry in London.

He suggested replacing the term schizophrenia with the label dopamine dysregulation disorder, which he said more accurately reflects what is happening in the brain of someone who is psychotic.

My reactions to this story:
  1. we all pretty much know what schizophrenia is, even if Hollywood still mostly gets it wrong – we know what the diagnosis implies in terms of symptoms as well as treatment and prognosis
  2. calling it “dopamine dysregulation disorder” wouldn’t be any less stigmatizing – only more difficult to say
  3. calling it “dopamine dysregulation disorder” implies (a) that we know what the cause(s) of schizophrenia are and (b) that we know the cause to be a problem with dopamine regulation – neither of those is true

Put simply, I think the notion proposed by these so-called “experts” is simplistic, misguided, and just poorly thought out. It reminds me of some of the simple-minded ideas previously put out by so-called social psychiatry, notably the idea that there is no such thing as psychosis and that psychotic illnesses are simply the result of society failing to accept people who are different.

Absolute and total nonsense!


schizophrenia, psychiatry, psychology, mental disorders, mental illness, bad science

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