Dr. Andy

Reflections on medicine and biology among other things

Thursday, June 16, 2005

What is mental illness

I thought I had already blogged on this, but apparently not. (Blame Blogger! ed.) More likely my screw up).

I think it is a good question what does and doesn't constitute a mental illness. See previous post for my own annoying problems.

In a report released last week, researchers estimated that more than half of Americans would develop mental disorders in their lives, raising questions about where mental health ends and illness begins.

In fact, psychiatrists have no good answer, and the boundary between mental illness and normal mental struggle has become a battle line dividing the profession into two viscerally opposed camps.

On one side are doctors who say that the definition of mental illness should be broad enough to include mild conditions, which can make people miserable and often lead to more severe problems later.

On the other are experts who say that the current definitions should be tightened to ensure that limited resources go to those who need them the most and to preserve the profession's credibility with a public that often scoffs at claims that large numbers of Americans have mental disorders.

I have scoffed myself at attempts to impose diagnostic categories on what I'd consider normal behavior, but this kind of logic is compelling
Dr. Robert Spitzer, a professor of psychiatry at Columbia University and the principal architect of the third edition of the diagnostic manual, wrote in a letter to The Archives of Psychiatry, "Many physical disorders are often transient and mild and may not require treatment (e.g. acute viral infections or low back syndrome). It would be absurd to recognize such conditions only when treatment was indicated."
I'm not sure what the answer is, but it does seem we should focus limited resources on those who are really suffering. But read the article and see what you think.


At 1:02 PM, Blogger John A said...

"But limiting the count to those who have taken action does not give an accurate picture of the extent of illness, argue other researchers, who have been sharply critical of efforts to drive down prevalence estimates."

Analogy: I have diabetes. Did I know it and seek treatment? Nope: I found out when I had blood tested for a very different problem, and the lab called me at home asking if they could have another sample as the results may have been skewed "because of your diabetes" - first I knew of it.


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