IS Psychiatry mostly non-scientific?

[Jenny TipsforME]

psychiatric disease might turn out to be physical disease that affects the brains.

Are you inclined to think all diseases have biological cause then? I actually think there's something in the biopsychosocial model, it's just been twisted beyond recognition for political reasons. I think all disease involves elements of biological dysfunction, thought processes and influence from wider society.

However, these elements aren't equal. I think you can get a sense of which element is primary if you imagine being improved by one level on its own. ME I think is mainly biological and deserves mainly biological research. For example, Rituximab can lead to complete remission on its own. There will be psychosocial factors in taking Rituximab such as recognition by a social institution that you deserve serious, expensive treatments and various expectancy effects, but if placebos don't have the same effect it can be safe to conclude it was the biological level of explanation that was important. If we're able to provide full employment and eradicate child abuse you could imagine that far fewer people would suffer from depression. I can't imagine a societal change which on its own would alleviate ME.

When I looked at the Action for ME report on funding it looks like over 70% of UK funding was for psychosocial research. As I mentioned above only 3% of mental illness research here is psychological. This means they should find biological factors in mental illness if they exist (and I believe they do) but it doesn't mean that psychological processes aren't important they just ignore the potential to research that. Similarly publicly funded research in the UK is unlikely to find biological causes of ME because they're not looking there.

Not a bad summing up

Unlike the rest of medicine, mental disorders are arrived at by a political, not medical process.

This is naive about the rest of medicine. Nothing is in an objective vacuum. All Illness is to some extent socially constructed, as well as having measurable scientific basis. For example, how we decide our bodily sensations are illness and we should respond by going to a doctor is not universal. This construction of illness is particularly obvious with ME. Our illness status in society is highly political despite evidence of biological abnormalities.

Everything placed under the MUS umbrella is political. If you don't value finding answers, you don't invest in the research, and then the symptoms are unexplained, and then you can dismiss the patients as malingerers or mentally unwell.

 

[Solstice]

Are you inclined to think all diseases have biological cause then? I actually think there's something in the biopsychosocial model, it's just been twisted beyond recognition for political reasons. I think all disease involves elements of biological dysfunction, thought processes and influence from wider society.

However, these elements aren't equal. ME I think is mainly biological and deserves mainly biological research. When I looked at the Action for ME report on funding it looks like over 70% of UK funding was for psychosocial research. As I mentioned above only 3% of mental illness research here is psychological. This means they should find biological factors in mental illness if they exist (and I believe they do) but it doesn't mean that psychological processes aren't important they just ignore the potential to research that. Similarly publicly funded research in the UK is unlikely to find biological causes of ME because they're not looking there.


This is naive about the rest of medicine. Nothing is in an objective vacuum. Most illness is to some extent socially constructed, as well as having measurable scientific basis. This is particularly obvious with ME. Our illness status in society is highly political despite evidence of biological abnormalities.

Everything placed under the MUS umbrella is political. If you don't value finding answers, you don't invest in the research, and then the symptoms are unexplained, and then you can dismiss the patients as malingerers or mentally unwell.

Let me start by saying i'm way out of my depth here and am purely philosophizing as a layman. But I see the brain as a biological part of the body, as probably do you. So in "braindisease" where you can actually see something gone wrong in the brain I have to assume there's a biological cause. I'm not saying anything revolutionary so far I reckon.

For other braindisease or psychiatric disease we just might not have found out enough about the body to accuretaly diagnose where in the brain things go wrong. But seeing as how so much that once was viewed as psychological disease is now recognized as biological I can imagine large chunks of the DSM actually turn out to have biological roots. As opposed to other stuff that's just made up bullshit.

 

[Snowdrop]

Not a bad summing up.

Yes it is. I read also in one of the pieces that it was likened to horse trading. The 'I'll support your illness if you support mine'.

 

[Snowdrop]

Let me start by saying i'm way out of my depth here and am purely philosophizing as a layman. But I see the brain as a biological part of the body, as probably do you. So in "braindisease" where you can actually see something gone wrong in the brain I have to assume there's a biological cause. I'm not saying anything revolutionary so far I reckon.

For other braindisease or psychiatric disease we just might not have found out enough about the body to accuretaly diagnose where in the brain things go wrong. But seeing as how so much that once was viewed as psychological disease is now recognized as biological I can imagine large chunks of the DSM actually turn out to have biological roots. As opposed to other stuff that's just made up bullshit.

I think so far, psychiatry has not been capable of distinguishing the difference between physical disease that manifests in the brain as opposed to pathological adaptations of the mind that stems from human* self-awareness/consciousness.

As regards @Jenny TipsforME I would say that for depression as an example it can be either a biological illness or one of social/personal mal-adaption/other issues or a combination of the two.
Mental Health research has a long way to go in understanding that depression is not the same thing among everyone who is diagnosed.

Technology has begun to open the opportunity to discover the difference but we are as yet a long way off and there is still much research bias toward thinking the two are the same-- this is how we get the mind-body paradigm which I believe is flawed because our mind arises not just from our body but from our environment and experience.

Although I'll add that I too am way out of my depth.
* the asterisks is for the possibility that it's not just humans that have self-awareness. Although I'm not looking to open up a discussion on that.

 

[Snowdrop]

A diagnosis such as major depressive disorder is about as telling as fever.

and. . . Psychiatry may be on the verge of such a breakthrough, one that could shake the foundations of the diagnostic system. A growing number of specialists, with a Canadian team at the forefront, are joining forces with researchers who study genetics, the hormonal, metabolic and immune systems, and how the brain works. They’re putting aside a century’s worth of theories, and delving into the biology of mental disorders on a scale never before seen. The aim is not just to broaden our understanding of mental illness, but to overhaul how we diagnose and treat it.

Another perspecctive, this from the Globe & Mail (Canada): http://www.theglobeandmail.com/life/in-pursuit-of-mental-healths-holy-grail/article24705010/

Bringing good science to light in mental health research would do a lot of good for so many including those with MUS.