4 ms·

Treating DSM categories as if they were a single disease is completely misguided. The DSM describes syndromes, and ignores pathophysiology because we still have

by pygy_ 7y ago

Treating DSM categories as if they were a single disease is completely misguided. The DSM describes syndromes, and ignores pathophysiology because we still have little to no idea of what happens in the brain (at least not enough to properly understand the relevant functional aspects). Genome-wide association studies have recently shown that schizophrenia was in fact several distinct diseases [0]. Their symptoms turn out to be mediated by the same drugs, to the extent that they makes the people who suffer from those ailments manageable. If your house suddenly becomes cold in the winter, putting on a jacket will help you feel better. You wouldn't infer from that that your furnace is down because of a clothing imbalance. [0] https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14040435 https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2...

thatoneuser 7y ago
This is why I think very highly of the transition in DSM V to diagnosing on spectrums. It's not perfect but it really helps get away from putting people into buckets they don't really belong in.
- lupire 7y ago
  At the expense of putting people on spectrums where two people with the same diagnose have wildly different symptoms and effective treatments, rendering the diagnosis moot. This is a crisis in "autism", where Asperger's and autism are different on such an extreme scale, yet the language, medical literature, and treatment plans and funding are muddling it up to the detriment of all involved, creating a culture war between people who say their mild Asperger's is a personality type not a disorder, and caregivers of people who cannot speak or provide basic self-care for themselves -- because DSM dumps them in the same diagnosis and society loses the language to disambiguate the scenarios.
JamesBarney 7y ago
That paper looks interesting but also seems very preliminary.

by pygy_ 7y ago

thatoneuser 7y ago

This is why I think very highly of the transition in DSM V to diagnosing on spectrums. It's not perfect but it really helps get away from putting people into buckets they don't really belong in.

lupire 7y ago
At the expense of putting people on spectrums where two people with the same diagnose have wildly different symptoms and effective treatments, rendering the diagnosis moot. This is a crisis in "autism", where Asperger's and autism are different on such an extreme scale, yet the language, medical literature, and treatment plans and funding are muddling it up to the detriment of all involved, creating a culture war between people who say their mild Asperger's is a personality type not a disorder, and caregivers of people who cannot speak or provide basic self-care for themselves -- because DSM dumps them in the same diagnosis and society loses the language to disambiguate the scenarios.

JamesBarney 7y ago

That paper looks interesting but also seems very preliminary.