Post by Admin on Sept 10, 2023 23:27:41 GMT
PETITION UPDATE
Some reasons why we should drop the term "schizophrenia"
www.change.org/p/american-psychiatric-association-apa-who-drop-and-replace-the-stigmatizing-term-schizophrenia/u/31896787
10 SEP 2023 —
Some reasons why we should drop the term "schizophrenia"
Below is a list of outdated terms for diseases and conditions, along with their more current names. Similar to what happened to "mental retardation," and "manic-depression," "schizophrenia" should also be retired to the annals of history. It is a term hopelessly encumbered with too many beliefs/myths which are highly stigmatizing and scientifically inaccurate. It is time for our field to have the courage to move on and stop clinging to familiar but traducing and anachronistic terms.
Brian Koehler PhD, MS
New York University
Ablepsy: blindness
Ague: flu-like symptoms likely caused by malaria
Apoplexy: stroke
Biliousness: jaundice
Black dog: depression
Blood poisoning: sepsis or septicemia
Breakbone: dengue fever
Camp fever: typhus
Chalkstones: swelling with pain that probably was caused by rheumatoid arthritis or gout
Consumption: tuberculosis
Dropsy: swelling caused by fluid retention
Dropsy of the brain: encephalitis
Drug Addiction: Substance Use Disorder
Falling sickness: epilepsy
French pox: syphilis
Green sickness or green fever: anemia
Grip, gripe or grippe: flu
Leprosy: Hansen's disease
Mad cow: Creutzfeldt-Jakob disease
Nervous Breakdown or Neurasthenia: Anxiety or Mood Disorder
Palsy: problems with muscle control, such as tremors or paralysis
Manic Depression: Bipolar Disorder
Mentally Retarded: developmentally or cognitively delayed
St Vitus dance: involuntary jerking movements now referred to as chorea. Huntington's disease is an example
Swine flu: H1N1 virus
Two pernicious myths in particular seem to be hard-wired into the term “schizophrenia”: dangerousness and non-recoverability.
First, research has repeatedly demonstrated that most of the violent crime committed in the US is not by persons given a diagnosis of “schizophrenia” a significant majority of those persons do not committ a violent crime. The Epidemiological Catchment Area Study (Swanson et al., 1990) found that only 3% of the total violence reported was done by persons given a diagnosis of “schizophrenia.” Other studies showed a range from 3-5%. In addition, violence may be explained better by the following factors: male gender, young adulthood, level of education, misuse of substances, homelessness, having been exposed to violence, sense of powerlessness, helplessness, stigma, etc.
Second, on the issue of non-recoverabilty, traditionally, many clinicians who saw people recover (a multi-dimensional construct to be derived with the significant input of people with lived experience) after being diagnosed with “schizophrenia,” based on the never proven concept of Kraepelin’s “prognosis confirms diagnosis,” would begin to think the person was misdiagnosed. This fatalistic perspective had a corrosive effect on a person’s sense of hope for her or his life to get better. Yale Professor Courtnay Harding, in her review of 10 world outcome studies, including the WHO studies, observed that people had a very good chance of significant improvement and recovery, even after being institutionalized for long periods of time. Some of the socioenvironmental factors that may and do impede recovery: institutionalization, socialization into the patient role, lack of good therapeutic programs, reduced economic opportunities, social exclusion as opposed to social inclusion (social isolation), racism, poverty, migration especially from a non-white to a white neighborhood, urban birth/living, side effects of some medications and/or dosages, lack of clinician expectations for recovery and improvement, survivor’s guilt, restricted access to good medical care, stigma, loss of hope and a sense of autonomy and agency.
In a remarkably little discussed paper published in the American Journal of Psychiatry “Identification of Distinct Psychosis Biotypes Using Brain-Based Biomarkers” Brett Clementz and colleagues (2015) noted:
“Multivariate taxometric analyses identified three neurobiologically distinct psychosis biotypes that did not respect clinical diagnosis boundaries” (p. 1). A concept of a single severity continuum using DSM diagnostic criteria did not map onto the distinct biotypes demonstrated in this research. The authors implicitly criticized the use of clinical categorization as opposed to the potential advantages of neurobiological indices.
I propose that we need to go much further in refinement of indices, particularly including salient social and psychological factors already identified in research as relevant to the inception, continuation and outcome of what we call “psychotic disorders.”
Brian Koehler PhD, MS
New York University
Some reasons why we should drop the term "schizophrenia"
www.change.org/p/american-psychiatric-association-apa-who-drop-and-replace-the-stigmatizing-term-schizophrenia/u/31896787
10 SEP 2023 —
Some reasons why we should drop the term "schizophrenia"
Below is a list of outdated terms for diseases and conditions, along with their more current names. Similar to what happened to "mental retardation," and "manic-depression," "schizophrenia" should also be retired to the annals of history. It is a term hopelessly encumbered with too many beliefs/myths which are highly stigmatizing and scientifically inaccurate. It is time for our field to have the courage to move on and stop clinging to familiar but traducing and anachronistic terms.
Brian Koehler PhD, MS
New York University
Ablepsy: blindness
Ague: flu-like symptoms likely caused by malaria
Apoplexy: stroke
Biliousness: jaundice
Black dog: depression
Blood poisoning: sepsis or septicemia
Breakbone: dengue fever
Camp fever: typhus
Chalkstones: swelling with pain that probably was caused by rheumatoid arthritis or gout
Consumption: tuberculosis
Dropsy: swelling caused by fluid retention
Dropsy of the brain: encephalitis
Drug Addiction: Substance Use Disorder
Falling sickness: epilepsy
French pox: syphilis
Green sickness or green fever: anemia
Grip, gripe or grippe: flu
Leprosy: Hansen's disease
Mad cow: Creutzfeldt-Jakob disease
Nervous Breakdown or Neurasthenia: Anxiety or Mood Disorder
Palsy: problems with muscle control, such as tremors or paralysis
Manic Depression: Bipolar Disorder
Mentally Retarded: developmentally or cognitively delayed
St Vitus dance: involuntary jerking movements now referred to as chorea. Huntington's disease is an example
Swine flu: H1N1 virus
Two pernicious myths in particular seem to be hard-wired into the term “schizophrenia”: dangerousness and non-recoverability.
First, research has repeatedly demonstrated that most of the violent crime committed in the US is not by persons given a diagnosis of “schizophrenia” a significant majority of those persons do not committ a violent crime. The Epidemiological Catchment Area Study (Swanson et al., 1990) found that only 3% of the total violence reported was done by persons given a diagnosis of “schizophrenia.” Other studies showed a range from 3-5%. In addition, violence may be explained better by the following factors: male gender, young adulthood, level of education, misuse of substances, homelessness, having been exposed to violence, sense of powerlessness, helplessness, stigma, etc.
Second, on the issue of non-recoverabilty, traditionally, many clinicians who saw people recover (a multi-dimensional construct to be derived with the significant input of people with lived experience) after being diagnosed with “schizophrenia,” based on the never proven concept of Kraepelin’s “prognosis confirms diagnosis,” would begin to think the person was misdiagnosed. This fatalistic perspective had a corrosive effect on a person’s sense of hope for her or his life to get better. Yale Professor Courtnay Harding, in her review of 10 world outcome studies, including the WHO studies, observed that people had a very good chance of significant improvement and recovery, even after being institutionalized for long periods of time. Some of the socioenvironmental factors that may and do impede recovery: institutionalization, socialization into the patient role, lack of good therapeutic programs, reduced economic opportunities, social exclusion as opposed to social inclusion (social isolation), racism, poverty, migration especially from a non-white to a white neighborhood, urban birth/living, side effects of some medications and/or dosages, lack of clinician expectations for recovery and improvement, survivor’s guilt, restricted access to good medical care, stigma, loss of hope and a sense of autonomy and agency.
In a remarkably little discussed paper published in the American Journal of Psychiatry “Identification of Distinct Psychosis Biotypes Using Brain-Based Biomarkers” Brett Clementz and colleagues (2015) noted:
“Multivariate taxometric analyses identified three neurobiologically distinct psychosis biotypes that did not respect clinical diagnosis boundaries” (p. 1). A concept of a single severity continuum using DSM diagnostic criteria did not map onto the distinct biotypes demonstrated in this research. The authors implicitly criticized the use of clinical categorization as opposed to the potential advantages of neurobiological indices.
I propose that we need to go much further in refinement of indices, particularly including salient social and psychological factors already identified in research as relevant to the inception, continuation and outcome of what we call “psychotic disorders.”
Brian Koehler PhD, MS
New York University