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>There are guidelines for determining if someone has depression and/or other mental health diseases, just like any other disease. Psychiatric diagnoses are not

>There are guidelines for determining if someone has depression and/or other mental health diseases, just like any other disease. Psychiatric diagnoses are not "just like any other disease". Medical pathology is objective science, psychiatry is subjective postulation. >In 2013, Frances said that "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests". https://en.wikipedia.org/wiki/Allen_Frances https://en.wikipedia.org/wiki/Allen_Frances

pmyteh 9y ago
Pain management, optometry, and many other non-psychiatric disciplines also rely on self-report. There's no bright line between the 'objective' and the 'postulation'.
- Arizhel 9y ago
  >Pain management, optometry, and many other non-psychiatric disciplines also rely on self-report. That's just plain wrong on the optometry part. While there is a lot of self-reporting used in optometry because it's faster and easier, it's entirely possible to remove it, because you can't fake not being able to read stuff when your vision is too blurry. How do you think the DMV tests your vision? It's not self-reporting; they show you something that you don't know beforehand and you have to read it. Optometrists also use vision tests to gauge your vision as they try different lenses. If they really wanted to, they could move from static tests that you can memorize to dynamic ones to prevent "cheating", but why would anyone cheat on an optometry exam (like they really would for the DMV)?
  - TylerE 9y ago
    Sure you can. There are only so many eye charts in use. It's possible to memorize them. Just being left in the exam room for 30 seconds unobserved would be enough.
    - cowboysauce 9y ago
      How do you propose fooling a retinoscope?
    - Arizhel 9y ago
      >Sure you can. There are only so many eye charts in use. It's possible to memorize them. No, you can't. Sure, you can memorize the optometrists' eye charts now, but that's because they're not expecting anyone to try to cheat, and just use some printed charts. Why would they expect someone with ill intentions? You're paying them to help you see optimally. However, at the DMV, they absolutely can test you properly, because their machines (at least the last one I used a couple years ago) can change all the letters around however they want, and presumably every test is different (within the maximum number of combinations, which is surely too high to memorize). They're actually expecting people to try to cheat there, so they don't just use a single printed wall chart, they have a special device you stick your head in.
- omginternets 9y ago
  Self-report for pain management relies on ontological subjectivity, not epistemic subjectivity.
tptacek 9y ago
Crohns, ALS, Celiac, and early Parkinsons are also diagnosed based on "fallible subjective judgements", but don't have cheering sections on message boards suggesting that they're not grounded in science.
- omginternets 9y ago
  They're also diagnoses of exclusion with a looooooong list of prior pathologies that are tested with objective measures. The point being: it's a much higher standard of diagnosis than the catch-all term "depression".
- Fuzzwah 9y ago
  re: celiac "The Tissue Transglutaminase Antibodies blood test will be positive in about 98% of patients with celiac disease who are on a gluten-containing diet." https://celiac.org/celiac-disease/understanding-celiac-disease-2/diagnosing-celiac-disease/screening/ https://celiac.org/celiac-disease/understanding-celiac-disea...
- wu-ikkyu 9y ago
  >Crohns, ALS, Celiac, and early Parkinsons There are biological tests/indicators that are conducted for all of these pathologies.
pw 9y ago
There's an undercurrent here that I find troubling, and I think it's the belief that, because psychiatric diagnoses rely on something other than "objective biological tests", mental illness is somehow less "real" than other illnesses. That's a conceit that only someone who has neither experienced nor been exposed to severe mental illness can hold. One cannot interact with someone that is floridly psychotic and not come to the conclusion that, while the specific diagnostic criteria may be subjective, there is something objectively wrong with that individual's biological functioning.
- wu-ikkyu 9y ago
  >One cannot interact with someone that is floridly psychotic and not come to the conclusion that, while the specific diagnostic criteria may be subjective, there is something objectively wrong with that individual's biological functioning Without any objective scientific proof, this is at best theoretical, and at worst mythological. Such an arrogant assumption has led to horrible conclusions: https://www.ncbi.nlm.nih.gov/pubmed/23511221 https://www.ncbi.nlm.nih.gov/pubmed/23511221

pmyteh 9y ago

Pain management, optometry, and many other non-psychiatric disciplines also rely on self-report. There's no bright line between the 'objective' and the 'postulation'.

Arizhel 9y ago
>Pain management, optometry, and many other non-psychiatric disciplines also rely on self-report. That's just plain wrong on the optometry part. While there is a lot of self-reporting used in optometry because it's faster and easier, it's entirely possible to remove it, because you can't fake not being able to read stuff when your vision is too blurry. How do you think the DMV tests your vision? It's not self-reporting; they show you something that you don't know beforehand and you have to read it. Optometrists also use vision tests to gauge your vision as they try different lenses. If they really wanted to, they could move from static tests that you can memorize to dynamic ones to prevent "cheating", but why would anyone cheat on an optometry exam (like they really would for the DMV)?
- TylerE 9y ago
  Sure you can. There are only so many eye charts in use. It's possible to memorize them. Just being left in the exam room for 30 seconds unobserved would be enough.
  - cowboysauce 9y ago
    How do you propose fooling a retinoscope?
  - Arizhel 9y ago
    >Sure you can. There are only so many eye charts in use. It's possible to memorize them. No, you can't. Sure, you can memorize the optometrists' eye charts now, but that's because they're not expecting anyone to try to cheat, and just use some printed charts. Why would they expect someone with ill intentions? You're paying them to help you see optimally. However, at the DMV, they absolutely can test you properly, because their machines (at least the last one I used a couple years ago) can change all the letters around however they want, and presumably every test is different (within the maximum number of combinations, which is surely too high to memorize). They're actually expecting people to try to cheat there, so they don't just use a single printed wall chart, they have a special device you stick your head in.
omginternets 9y ago
Self-report for pain management relies on ontological subjectivity, not epistemic subjectivity.

tptacek 9y ago

Crohns, ALS, Celiac, and early Parkinsons are also diagnosed based on "fallible subjective judgements", but don't have cheering sections on message boards suggesting that they're not grounded in science.

omginternets 9y ago
They're also diagnoses of exclusion with a looooooong list of prior pathologies that are tested with objective measures. The point being: it's a much higher standard of diagnosis than the catch-all term "depression".
Fuzzwah 9y ago
re: celiac "The Tissue Transglutaminase Antibodies blood test will be positive in about 98% of patients with celiac disease who are on a gluten-containing diet." https://celiac.org/celiac-disease/understanding-celiac-disease-2/diagnosing-celiac-disease/screening/ https://celiac.org/celiac-disease/understanding-celiac-disea...
wu-ikkyu 9y ago
>Crohns, ALS, Celiac, and early Parkinsons There are biological tests/indicators that are conducted for all of these pathologies.

pw 9y ago

There's an undercurrent here that I find troubling, and I think it's the belief that, because psychiatric diagnoses rely on something other than "objective biological tests", mental illness is somehow less "real" than other illnesses. That's a conceit that only someone who has neither experienced nor been exposed to severe mental illness can hold. One cannot interact with someone that is floridly psychotic and not come to the conclusion that, while the specific diagnostic criteria may be subjective, there is something objectively wrong with that individual's biological functioning.

wu-ikkyu 9y ago
>One cannot interact with someone that is floridly psychotic and not come to the conclusion that, while the specific diagnostic criteria may be subjective, there is something objectively wrong with that individual's biological functioning Without any objective scientific proof, this is at best theoretical, and at worst mythological. Such an arrogant assumption has led to horrible conclusions: https://www.ncbi.nlm.nih.gov/pubmed/23511221 https://www.ncbi.nlm.nih.gov/pubmed/23511221