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> Best to seek the help of a real medical professional https://en.wikipedia.org/wiki/Psychiatrist https://en.wikipedia.org/wiki/Psychiatrist Psychiatrists are

> Best to seek the help of a real medical professional https://en.wikipedia.org/wiki/Psychiatrist https://en.wikipedia.org/wiki/Psychiatrist Psychiatrists are medical doctors.

wu-ikkyu 9y ago
And yet they are not bound to the same medical code of ethics or the same degree of objective science that all other medical doctors are.
- phren0logy 9y ago
  I'm a psychiatrist, and yes, we are. Psychiatrists are the same kind of medical doctor as every other medical doctor.
  - wu-ikkyu 9y ago
    1. Psychiatry is not bound to the medical ethic of patient autonomy. Medical doctors cannot lock someone in a cell and forcibly drug them because they have an STI. 2. Psychiatric illnesses are defined based on "fallible subjective judgments". Medical illnesses (pathologies) are defined based on objective biological tests.
    - mcguire 9y ago
      See also quarantine.
      - wu-ikkyu 9y ago
        Quarantine is much rarer than psychiatric commitment, and is based on objective science.
    - 2309kdujj 9y ago
      1. Because an STI doesn't cause you to go murder your spouse. 2. A behavioral record is no less objective than a biological one. Facebook and Google make a ton of money this way; if you want to offer a biological alternative, no one is stopping you.
      - wu-ikkyu 9y ago
        1. You can murder your spouse with an STI. Mental illness do not necessitate murder. 2. It is the opinion on the behavior as being good or bad that is subjective
        refill_request 9y ago
        1) Yep, and you'll be locked up if you murder someone. Someone with dementia or frontal syndrome after a stroke or tertiary syphilis may become paranoid enough to cause/contribute to violence, but we don't lock people up based on diagnosis. Nobody is locked up simply because they are diagnosed with a "mental illness" which is what you apparently want people to believe - you edited your parent comment, where you claimed that a diagnosis of schizophrenia was grounds for 5150. It's not. 2) No, there is no opinion about "good or bad" in diagnosing mental illness. The almost ubiquitous criteria is significant impairment - which almost always is an impairment the patient themselves identify (not someone else) and are seeking help for.
        wu-ikkyu 9y ago
        Is a mental illness diagnosis (i.e. schizophrenia) + a subjective pre-crime judgement + some signatures not the prerequisites for a 5150?
        refill_request 9y ago
        Oh. You want to swab someone's throat to see if they should be detained to protect themselves or others. Please let's you and I spend some time together in the emergency department. Last week we had a patient there who'd been brought in against his will by the police, and who claimed that the chip implanted in their brain was telling him to remove his eyes and everyone else's eyes with the spoon he carried in his back pocket. He'd already removed his left eye, with the spoon he carried in his back pocket. Please tell us your plan. I'm sorry that I can't find a throat swab to assist us. Or perhaps we could have lunch down at the dementia care facility, where the neurologists would love you to tell them they're not legitimate medical doctors because they don't have a throat swab for dementia yet, and because they "lock up" dementia sufferers with a few signatures at the request of dementia-sufferer families so they, the dementia patients, don't walk onto the freeway. They actually lock people up protectively before "the crime" of actually walking onto the freeway. Imagine that. Aren't a few signatures (even sans diagnosis) all that's needed to place children in what in effect is protective custody?
    - phren0logy 9y ago
      1. Just as in treatment of tuberculosis, there are times when autonomy is overridden by danger to self or others. This is no different to other fields of medicine. 2. Many aspects of diagnosis are subjective, even when tied to objective measurements. For example, cutoffs for high blood pressure, diabetes, and hyperlipidemia.
    - refill_request 9y ago
      You're exhibiting either a woeful lack of knowledge about medicine, or you have a particular axe you want to sharpen repeatedly here. 1) Medical doctors (including psychiatrists), police, social workers, judges, and other trained personnel all can lock someone up for a brief time (and with all sorts of legal protections and due process) if: a) They are a danger to themselves or others. b) They are unable to care for themselves. Please tell us your alternative plan for dealing with those issues. 2) I'd love to be drill a hole in your well-protected cranium and stick a needle in your brain to obtain a sample to diagnose major depression, schizophrenia, or PTSD. Just a small sample, ok?. Let me know if you're ok with that. And if you think there are "objective biological tests" for most common illnesses that are diagnosed and treated, day in and day out, by physicians, I'd invite you to accompany me to clinic where, off the top of my head" we'll see tons of upper respiratory infections, real chronic pain without any demonstrable pathology, "ear infections", etc. This is the bread-and-butter of primary care physicians, and we don't order "objective biological tests" in order to diagnose and treat "medical illnesses" - in many cases because the tests simply don't exist, or are too expensive or too invasive. But perhaps you'd care to explain to the sufferers and their families that we can do nothing for them without your "objective biological tests".
      - wu-ikkyu 9y ago
        >I'd love to be drill a hole in your well-protected cranium and stick a needle in your brain to obtain a sample to diagnose major depression, schizophrenia, or PTSD. Just a small sample, ok?. Let me know if you're ok with that Sure it's okay, post mortem. Many scientists have tried this. Unfortuntely, you would not be able to make a conclusive diagnosis, because the science isn't there.
        refill_request 9y ago
        Post-mortem doesn't do much for your current debilitating panic disorder that makes it impossible to leave your home, now does it? Please. Give us your plan for relief of suffering while we sit around twiddling our thumbs waiting because "the science isn't there." The history of the entire field of medicine (including psychiatry, which is as much science and medicine as any other medical specialty) is a march from partial understanding based on classification of symptoms to other measures. The brain, hidden away behind bone and blood-brain barrier, has been called the most complex object in the known universe. That machine and it's foibles is a little more complicated than finding a buffer overrun or swabbing your throat for strep.
    - neuromantik8086 9y ago
      2. Psychiatric illnesses are based on whether or not a patient meets certain criteria. Major depression, for instance: https://www.ncbi.nlm.nih.gov/books/NBK64063/ https://www.ncbi.nlm.nih.gov/books/NBK64063/ These criteria are, to some degree, subjective and also easily gamed since in many cases doctors are relying upon noisy / potentially flawed input from patients (i.e., it's possible to game the system to get adderall, etc). However, the DSM, in providing these criteria and the number that need to be expressed to constitute a disorder, are establishing some measure of objectivity. While it is certainly imperfect, it's far from the state of affairs in the 40s/50s and definitely not purely subjective. More objective / less noisy and biased criteria would certainly be welcome, but they don't really exist and that's been a major goal of NIMH as late. Some people have attempted to predict the presence of mental illness using fMRI scans, with limited success: http://fcon_1000.projects.nitrc.org/indi/adhd200/results.html http://fcon_1000.projects.nitrc.org/indi/adhd200/results.htm... However, even without reliable diagnosis via fMRI, I've noticed some psychiatrists using tasks from psychophysics to aid in diagnosis. Unfortunately they aren't always as savvy as scientists with respect to test-retest reliability, but it's a start.

> Best to seek the help of a real medical professional https://en.wikipedia.org/wiki/Psychiatrist https://en.wikipedia.org/wiki/Psychiatrist Psychiatrists are medical doctors.

wu-ikkyu 9y ago

And yet they are not bound to the same medical code of ethics or the same degree of objective science that all other medical doctors are.

phren0logy 9y ago
I'm a psychiatrist, and yes, we are. Psychiatrists are the same kind of medical doctor as every other medical doctor.
- wu-ikkyu 9y ago
  1. Psychiatry is not bound to the medical ethic of patient autonomy. Medical doctors cannot lock someone in a cell and forcibly drug them because they have an STI. 2. Psychiatric illnesses are defined based on "fallible subjective judgments". Medical illnesses (pathologies) are defined based on objective biological tests.
  - mcguire 9y ago
    See also quarantine.
    - wu-ikkyu 9y ago
      Quarantine is much rarer than psychiatric commitment, and is based on objective science.
  - 2309kdujj 9y ago
    1. Because an STI doesn't cause you to go murder your spouse. 2. A behavioral record is no less objective than a biological one. Facebook and Google make a ton of money this way; if you want to offer a biological alternative, no one is stopping you.
    - wu-ikkyu 9y ago
      1. You can murder your spouse with an STI. Mental illness do not necessitate murder. 2. It is the opinion on the behavior as being good or bad that is subjective
      - refill_request 9y ago
        1) Yep, and you'll be locked up if you murder someone. Someone with dementia or frontal syndrome after a stroke or tertiary syphilis may become paranoid enough to cause/contribute to violence, but we don't lock people up based on diagnosis. Nobody is locked up simply because they are diagnosed with a "mental illness" which is what you apparently want people to believe - you edited your parent comment, where you claimed that a diagnosis of schizophrenia was grounds for 5150. It's not. 2) No, there is no opinion about "good or bad" in diagnosing mental illness. The almost ubiquitous criteria is significant impairment - which almost always is an impairment the patient themselves identify (not someone else) and are seeking help for.
        wu-ikkyu 9y ago
        Is a mental illness diagnosis (i.e. schizophrenia) + a subjective pre-crime judgement + some signatures not the prerequisites for a 5150?
        refill_request 9y ago
        Oh. You want to swab someone's throat to see if they should be detained to protect themselves or others. Please let's you and I spend some time together in the emergency department. Last week we had a patient there who'd been brought in against his will by the police, and who claimed that the chip implanted in their brain was telling him to remove his eyes and everyone else's eyes with the spoon he carried in his back pocket. He'd already removed his left eye, with the spoon he carried in his back pocket. Please tell us your plan. I'm sorry that I can't find a throat swab to assist us. Or perhaps we could have lunch down at the dementia care facility, where the neurologists would love you to tell them they're not legitimate medical doctors because they don't have a throat swab for dementia yet, and because they "lock up" dementia sufferers with a few signatures at the request of dementia-sufferer families so they, the dementia patients, don't walk onto the freeway. They actually lock people up protectively before "the crime" of actually walking onto the freeway. Imagine that. Aren't a few signatures (even sans diagnosis) all that's needed to place children in what in effect is protective custody?
  - phren0logy 9y ago
    1. Just as in treatment of tuberculosis, there are times when autonomy is overridden by danger to self or others. This is no different to other fields of medicine. 2. Many aspects of diagnosis are subjective, even when tied to objective measurements. For example, cutoffs for high blood pressure, diabetes, and hyperlipidemia.
  - refill_request 9y ago
    You're exhibiting either a woeful lack of knowledge about medicine, or you have a particular axe you want to sharpen repeatedly here. 1) Medical doctors (including psychiatrists), police, social workers, judges, and other trained personnel all can lock someone up for a brief time (and with all sorts of legal protections and due process) if: a) They are a danger to themselves or others. b) They are unable to care for themselves. Please tell us your alternative plan for dealing with those issues. 2) I'd love to be drill a hole in your well-protected cranium and stick a needle in your brain to obtain a sample to diagnose major depression, schizophrenia, or PTSD. Just a small sample, ok?. Let me know if you're ok with that. And if you think there are "objective biological tests" for most common illnesses that are diagnosed and treated, day in and day out, by physicians, I'd invite you to accompany me to clinic where, off the top of my head" we'll see tons of upper respiratory infections, real chronic pain without any demonstrable pathology, "ear infections", etc. This is the bread-and-butter of primary care physicians, and we don't order "objective biological tests" in order to diagnose and treat "medical illnesses" - in many cases because the tests simply don't exist, or are too expensive or too invasive. But perhaps you'd care to explain to the sufferers and their families that we can do nothing for them without your "objective biological tests".
    - wu-ikkyu 9y ago
      >I'd love to be drill a hole in your well-protected cranium and stick a needle in your brain to obtain a sample to diagnose major depression, schizophrenia, or PTSD. Just a small sample, ok?. Let me know if you're ok with that Sure it's okay, post mortem. Many scientists have tried this. Unfortuntely, you would not be able to make a conclusive diagnosis, because the science isn't there.
      - refill_request 9y ago
        Post-mortem doesn't do much for your current debilitating panic disorder that makes it impossible to leave your home, now does it? Please. Give us your plan for relief of suffering while we sit around twiddling our thumbs waiting because "the science isn't there." The history of the entire field of medicine (including psychiatry, which is as much science and medicine as any other medical specialty) is a march from partial understanding based on classification of symptoms to other measures. The brain, hidden away behind bone and blood-brain barrier, has been called the most complex object in the known universe. That machine and it's foibles is a little more complicated than finding a buffer overrun or swabbing your throat for strep.
  - neuromantik8086 9y ago
    2. Psychiatric illnesses are based on whether or not a patient meets certain criteria. Major depression, for instance: https://www.ncbi.nlm.nih.gov/books/NBK64063/ https://www.ncbi.nlm.nih.gov/books/NBK64063/ These criteria are, to some degree, subjective and also easily gamed since in many cases doctors are relying upon noisy / potentially flawed input from patients (i.e., it's possible to game the system to get adderall, etc). However, the DSM, in providing these criteria and the number that need to be expressed to constitute a disorder, are establishing some measure of objectivity. While it is certainly imperfect, it's far from the state of affairs in the 40s/50s and definitely not purely subjective. More objective / less noisy and biased criteria would certainly be welcome, but they don't really exist and that's been a major goal of NIMH as late. Some people have attempted to predict the presence of mental illness using fMRI scans, with limited success: http://fcon_1000.projects.nitrc.org/indi/adhd200/results.html http://fcon_1000.projects.nitrc.org/indi/adhd200/results.htm... However, even without reliable diagnosis via fMRI, I've noticed some psychiatrists using tasks from psychophysics to aid in diagnosis. Unfortunately they aren't always as savvy as scientists with respect to test-retest reliability, but it's a start.