Are We Looking at Psychiatric Disorders the Wrong Way?

McLean Hospital Guest Blogger Bruce M. Cohen, MD, PhD The first psychiatric patient I evaluated--42 years ago--presented with delusions and mood swings. Based on those symptoms, our attending physician diagnosed her with schizoaffective disorder. We medical clerks were confused by that assessment. Schizoaffective disorder encompasses a combination of symptoms of schizophrenic and mood disorders, and such a mixed diagnosis seemed like a violation of our education. We had been taught that illnesses are distinct, with specific causes, symptoms, and treatments. As I went on to study psychiatry and its diagnostic criteria further, strictly defined categories, a traditional medical model, continued to be the standard. Of course, some medical conditions are quite specific, but many are not. For nearly a century, proposals have been made for specific psychiatric disease categories, but clinical symptoms often do not fit these categories well. In fact, diagnostic complexity, even if it means assigning multiple diagnoses or mixed diagnoses to a single patient, is a practical clinical norm. As technology advanced, the search for distinct measures moved beyond symptoms to the exploration of potential biological causes. However, despite early hope that a particular chemical imbalance might explain major depression and a toxic metabolite might explain schizophrenia, psychiatric disorders don't seem to have simple explanations. Genes provide powerful lessons on why simple models failed...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news