'Schizophrenia' may not exist
Sep 10, 2005, 15:16, Reviewed by: Dr.
|"The idea that there is a clear division between 'mad' and 'sane' people, and that distinct psychiatric categories like 'schizophrenic' actually exist, is resulting in the mass-application of treatments which, will benefiting some, are very harmful to others. And because psychiatric patients are seen as having a biological brain illness which affects their rationality, they are not usually allowed a say in the matter."
Schizophrenia has been attributed to everything from genetic predisposition, brain chemistry, sufferers' home environment and even cat-borne viruses, but no consistent causal pattern has ever been identified. As a result, treatment outcomes for today's patients are not very different from those of patients treated 100 years ago.
According to Richard Bentall, Professor in Experimental Clinical Psychology at The University of Manchester, the problem is that the psychiatric category 'schizophrenia' falsely groups people with a wide range of problems together.
"Psychiatric diagnoses are based on a set of false assumptions stemming from the 19th century," says Professor Bentall, writer of the highly successful book 'Madness Explained'. "Although deep-seated, these assumptions have very little scientific value, and could actually be detrimental to patients and their treatment options.
"The idea that there is a clear division between 'mad' and 'sane' people, and that distinct psychiatric categories like 'schizophrenic' actually exist, is resulting in the mass-application of treatments which, will benefiting some, are very harmful to others. And because psychiatric patients are seen as having a biological brain illness which affects their rationality, they are not usually allowed a say in the matter."
Although psychiatric drugs and other traditional treatments can be helpful, they are not nearly as effective as is often thought and can have detrimental, even life-threatening side-effects. There is also a significant risk of relapse when treatment is stopped.
"Rather than diagnosing and treating people on the basis of psychiatric categories, which actually contain many people with no symptoms in common, we need to look at each sufferer's symptoms individually from a psychological perspective," says Professor Bentall. "It then becomes relatively easy to understand why they might be happening and how the sufferer can address and cope with them."
Together with colleagues at Manchester, Glasgow, Cambridge and Birmingham, Professor Bentall has recently received a £1.5m grant from the Medical Research Council to research this approach, in which the UK is acknowledged as a world leader. Although sufferers' responses have been very positive however, the availability of psychological treatments for psychiatric difficulties nowhere near matches the incidence of such problems.
"Identifying and addressing the problems the sufferer, rather than the psychiatrist, perceives creates an understanding of each person's condition which is far more scientific, humane and effective than a blanket diagnosis," Professor Bentall asserts. "It also allows us to identify people at risk of psychological breakdown earlier, and keep them out of the traditional cycle of diagnosis and treatment."
- The School of Psychological Sciences, University of Manchester
Professor Bentall will be discussed his ideas at one of the University's Café Scientifique discussion evenings on 5 September. The event is open to all (places must be booked) and will be held in Cafe Muse at The Manchester Museum on Oxford Road.
Richard Bentall (www.psych-sci.manchester.ac.uk/staff/RichardBentall) undertook a PhD in experimental psychology in Bangor before obtaining a qualification in clinical psychology at the University of Liverpool and an MA in philosophy applied to health care from University College Swansea. After a brief period as a National Health Service forensic clinical psychologist, he returned to the University of Liverpool, where he was ultimately appointed Professor of Clinical Psychology. In 1999 he moved to a Chair in Experimental Clinical Psychology at The University of Manchester.
In 1989 he received the British Psychological Society's May Davidson Award for his contribution to clinical psychology, and in 2005 received the BPS book award for his book Madness Explained: Psychosis and Human Nature.
The University of Manchester (www.manchester.ac.uk) was formed by the merger of The Victoria University of Manchester and UMIST in October 2004, and with over 36,000 students in 2005/6 is the largest higher education institution in the country. Its Faculty of Medical & Human Sciences (www.mhs.manchester.ac.uk) is one of the largest faculties of clinical and health sciences in Europe, with a research income of over £37 million.
The School of Psychological Sciences (www.psych-sci.manchester.ac.uk) was founded in 2004, and comprises the oldest Psychology department in the UK together with Human Communication and Deafness and Clinical Psychology divisions. All were rated 5/5 in the last higher education Research Assessment Exercise.
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