Who says you're sick?
Illness should be a pretty straight forward proposition to my way of thinking. Either you have signs and symptoms of an illness or you don't. But when it comes to the world of psychiatry and psychology the lines become blurred, and it's even more so when the book used to make a determination of illness has authors who appear to have vested interests in proclaiming your illness. At least, that's what a recent article in The Washington Post indicated.
The standard guide for determining mental disorders is The Diagnostic and Statistical Manual (DSM or dizme, as most people say), and every few years it comes out with a newer version where some disorders may be added and some dropped. The interesting fact, however, is that, unlike physical illnesses where blood work or other biological tests or imaging techniques may be used, there is virtually nothing but conversation to act as the tool here. You can imagine how thorny an issue that can be, especially in cases of inexperienced personnel, or with patients who come from different cultures or who aren't sufficiently conversant in English.
A psychologist from the University of Boston, Lisa Cosgrove, decided to do an analysis to see just how many people involved in deciding what is a mental disorder and what gets into DSM had ties to pharmaceutical companies. Five of the six panel members assigned to look at PMS (premenstrual syndrome) had ties to a major drug company. In fact, of the 170 experts who worked on DSM, 50% had ties to these companies and 100% of the experts in the various work groups on mood and psychotic disorders had such ties.
While I understand that the connection between the decision-makers and the drug companies may appear eye opening, the reality of medical research is that it has to be funded by outside sources and those sources are primarily drug companies. The US does not have government funding for much medical research in the order of that found in such countries as Japan where they also allow drug companies to work together on research projects.
One expert suggested that these panels should be staffed by individuals without ties to the drug companies, but that flies in the face of reason. I believe, from personal experience, that it is very difficult to climb the ladder of professional success in medicine without outside research funding. Keeping the funding sources means keeping research alive, and that's a fact of life.
Related Topics: Americans Want More Medical Research, WebMD Mental Health Center
Technorati Tags: mental disorders, mental illness, DSM
The standard guide for determining mental disorders is The Diagnostic and Statistical Manual (DSM or dizme, as most people say), and every few years it comes out with a newer version where some disorders may be added and some dropped. The interesting fact, however, is that, unlike physical illnesses where blood work or other biological tests or imaging techniques may be used, there is virtually nothing but conversation to act as the tool here. You can imagine how thorny an issue that can be, especially in cases of inexperienced personnel, or with patients who come from different cultures or who aren't sufficiently conversant in English.
A psychologist from the University of Boston, Lisa Cosgrove, decided to do an analysis to see just how many people involved in deciding what is a mental disorder and what gets into DSM had ties to pharmaceutical companies. Five of the six panel members assigned to look at PMS (premenstrual syndrome) had ties to a major drug company. In fact, of the 170 experts who worked on DSM, 50% had ties to these companies and 100% of the experts in the various work groups on mood and psychotic disorders had such ties.
While I understand that the connection between the decision-makers and the drug companies may appear eye opening, the reality of medical research is that it has to be funded by outside sources and those sources are primarily drug companies. The US does not have government funding for much medical research in the order of that found in such countries as Japan where they also allow drug companies to work together on research projects.
One expert suggested that these panels should be staffed by individuals without ties to the drug companies, but that flies in the face of reason. I believe, from personal experience, that it is very difficult to climb the ladder of professional success in medicine without outside research funding. Keeping the funding sources means keeping research alive, and that's a fact of life.
Related Topics: Americans Want More Medical Research, WebMD Mental Health Center
Technorati Tags: mental disorders, mental illness, DSM
11 Comments:
I've used the DSM over the years to process medical insurance claims (I think I started when the DSM was on version II, so it's been a while!) and I think it's a wonderful tool. I've watched it grow to include social issues like homelessnes or lack of adequate housing and I'm glad to see things like that recognized.
I've also been a patient and have been interviewed by a psychiatric nurse, psychiatrists, and psychologists who each had their own interviwing techinique (verbal or written) and I'm sure had their own interpretations based on their experiences with patients and the contents of their particular interview or questionnaire, so I also think the DSM is a limited tool. The interview is a frightening experience as is putting down on paper the answers to questions. This is normally done at the first visit and that visit is so anxiety evoking it can be a complete blur when it is over.
Unfortunately, these days medication seems to be overwhelmingly the initial if not the only treatment offered or accepted, so maybe it's a good thing that so many of the experts have ties to drug companies.
Although the percentage of experts with ties to the drug companies, I'm equally as glad that the U.S. government doesn't do the all medical research. But indirectly they affect it with other funding.
There should be regulations and guidelines concerning things like using input from experts who may have a personal and/or professional interest in the finished product. I think they should definitely be included with others without ties to the pharmaceutical industry. Those individuals might be difficult to find though...
~Tasker
I have a question for anyone out there who can answer it. My question is this: How does a person handle being Bipolar, and explain how you feel or what a person goes through to family? I have problems explaining things and I hide a lot of the things I go through in any given day.
A friend of mine was diagnosed as "slightly" Bi-Polar. For this "slight" problem, the local quacks put him on three strong medications. He got worse, so they doubled his does. He got even worse, so they increased it again. I noticed that he was having MAJOR muscle twitches so I checked his meds side effects. He was in toxic level in one. After that, he started to halucinate. They figured he was way worse than they thought and put him in the state institution.
After 6 months, and my repeatly telling them that he does not react to medication well, they finally took him off everything except 1 (reduced dose). Ten days later he was home He was still incapable of work, so 8 months later he stopped everything. One month later he was working. Since then he has had very little problem
Doctors do not take the time to properly treat people, are not capable of telling when a drug is causing a problem, what side-effects there are, and do not listen to their patients.
By the way, the number one side effect of one medication they put him on is halucinations (15% of patients). From depression web sites, the #1 way to treat this hallucination effect is to give another drug to stop it.
I have three other similar stories about the incompetance of doctors when it comes to this sort of treatment.
I am a psychiatriast,... in this day and age the "science" of medicine has reduced the condition of a person to the cookbook mentality of the DSM,... this is both sad and dangerous. The DSM can be a valuable tool, but as just one way of viewing an individual. There is so much more to someone's down mood, or their up & down mood then the label of "depression" or "bipolar".
That most psychiatrist use this limited perspsective is due to,... I believe, as I've not done "a scientific" study of such,.. is due to the fact that most of them have not experienced the power of the psyche, of the unconscious and of the spirit. My wish is that more psychiatrists do "their own work" (psychological work on themselves). Then they will have the potential to see their clients/patients in ways other then just "the medical/biological model". We all are so much more then just a collection of neurons and neurotransmitters, that need manipulation by an external force, namely the psychiatrist. There certainly is a role for medications and psychiatrist, however, clients/patients would be better served if it were by those with an increasing sense of awareness.
So,... may psychiatrists explore that which is beyond the purely biological,...and may the client/patient/family members seek out, +/- demand, those psychiatrists with an expanded awareness.
BRAVO!!! I say to this article and the information it conveys. Hospitalized for anorexia 4 times in the last 8 years, I have acquired new diagnosis as well as new medications (AND their adverse effects) with each treatment. Each new set of doctors saw me in a different place in treatment and somehow used that to label who/what I am.
The concern is that for some I believed. For some I became that diagnosis, and for most of them I was not that profile outside of the stressfull environment of gaining weight and working on anxiety.
This was a pleasure for me to read, and a reminder that I am not who THEY say I am, but who and what I feel.
i think people say that they need help because they say to me and go off on me.
Appreciate your blog,i have a victims support page against Eli Lilly for it's defective Zyprexa product causing my diabetes.--Daniel Haszard www.zyprexa-victims.com
My Dad had been put on duloxetine oral with 30 mg/day who within a weeek developed psychological problems such as hallucinations, lack of confidence to get up from bed,stand erect and walk a few steps,nightmares. I immediately asked to stop him taking the drug after six days.Is my decision correct?
My problem is simply this. I've been diagnosed bi polar but I've been on almost every combination of meds out there and they either don't work or I have terrible side effects from them. All I keep getting from my doctors is give the medicine more time and that line is beyond old and I'm sick of hearing it. What the hell am I suppost to do when it just seems I'm always in a lose lose situation no matter how hard I try?
This looks promising. I am 74 and am new to Bipolar, although I have had all the quirks for many years.A manic cousin, an ADD grand daughter.
I am on Depakote two months and my thinking is much straighter
I am also a RA in a chair and taking Remicade.
bwelton
done it already. Is poor concentration, tiredness, agression, anxiety, forgetfulness, family stress a need for (safe) medication, and what? How would you describe these symptoms in med. tgerms?
Post a Comment