Attenuated psychosis syndrome, alternately called psychosis risk syndrome, pre-psychosis and prodromal disorder is going into section 3 of the DSM-5. This is the section for disorder labels that need more review, and which will not be reimbursable. The bad news is that it is in the DSM at all, and being in the DSM, it’s going to be considered as a disorder. The good news is that it is not an “official” disorder label, insurance companies are under no obligation to pay for it, and so its not likely to explode into an epidemic next year.
Researchers, it seems, much less fastidious than DSM revisers, are intent in studying people afflicted with this fictitious and elusive label. The latest rage in pseudo-scientific discoveries concerns this nebulous early stage in the development of psychosis. An article in the Detroit Free Press, Schizophrenia may give early warning signs, is typical.
Researchers in Chapel Hill looked at brain scans of 42 children, some as young as 9, who had close relatives with schizophrenia. They saw that many of the children already had areas of the brain that were “hyper-activated” in response to emotional stimulation and tasks that required decision-making, said Aysenil Belger, associate professor of psychiatry at the UNC School of Medicine and lead author of the study.
Now whether psychiatrized families actually think differently from non-psychiatrized families is anyone’s guess, and it could always be the topic for additional research should anybody choose to go there.
People who have a parent or sibling with schizophrenia are about 10 times more likely to develop the disease than those who do not. Signs of the illness typically begin in the late teens to mid-20s. These include declines in memory, intelligence and other brain functions that indicate a weakening in the brain’s processing abilities. More advanced symptoms may include paranoid beliefs and hallucinations.
Perhaps this sounds like an astonishing figure until you realize that it actually means 1 in 10 people rather than 1 in 100 people. This is to say that among the 1 in 100 people that get described as psychotic, 1 in 10 of their closest relatives could also be so described. Unlike in the rest of the world where the rate stays more or less at 1 %. 1 in 10 means that chances are, if you are in a family haunted by the phenomenon of psychosis in one of its members, 9 out of 10 of it’s members most probably wouldn’t be described as psychotic anyway.
“Of all the people who seem to have compromised circuitry in their brain, if we come back and image them in later years, some may be moving toward the cluster of symptoms for schizophrenia while others may have other types of deficits,” such as bipolar disorder or attention deficit disorder, Belger said.
The article goes on to add, “Still others may avoid serious disorders altogether”, but the damage has been done. If you were an agent of the inquisition, let’s say, looking for witches, you are not going to be questioning the existence of witches. If you want to find fault in anyone, or anything, no problem. Just conduct a fault finding mission. If you are out to praise those people, well, hunting for future “mental illnesses” is just not the way to do so.
I think these researchers have better things to be doing with their time. We really have a problem when the DSM starts predicting disorders in people. Ignoring any fork in the pathway that may lead to dysfunction, from functionality, is a major shortcoming, I would imagine. Ditto, in the case of paths that lead to folly from reason and wisdom. You are postulating that mental and emotional disturbances are a matter of predestination, and I imagine such leaps of faith belong in the realm of superstition rather than in the realm of scientific inquiry and skepticism.
This doesn’t mean that pre-psychosis isn’t going to make it’s way as a reimbursable disorder in a future edition of the DSM. I imagine, if things continue going the way they are going, it will. There is a lot of nonsense in the DSM. I would say maybe 100 % of the DSM is sheer nonsense. All the same, quite literally, even a listing as a category for diagnosis won’t make future psychosis a real disorder in present time.
Filed under: ADHD, Alternatives, Biological Psychiatry, Children and Adolescents, DSM, Media, Mental Health Care, Mental Health Screening, Misdiagnosis, Polypharmacy, Research | Tagged: dsm 5, early warning signs, mental-health, science | 4 Comments »