The Myth of Schizophrenia as a Progressive Brain Disease

Kermit Cole
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Researchers from Canada and the U.K. review, in Schizophrenia Bulletin, the evidence of clinical outcomes, brain volume, and cognitive functioning from longitudinal studies and find that although 25% of people with schizophrenia diagnoses have poor long-term outcome, few show the characteristics of neurodegenerative illness. Rather, decreases in brain tissue volumes are attributable to antipsychotic medication, substance abuse, and other secondary factors. The authors conclude that the majority of people with schizophrenia diagnoses have the potential to achieve long-term recovery.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

7 COMMENTS

  1. The concept of “schizophrenia” as a disease itself is a myth.

    Schizophrenia is nothing more than an unscientific and stigmatizing descriptive label placed on a person through the “Chinese Menu” approach of the DSM. (Which the APA and psychiatrists admit is the case.)

    A person with a head injury could end up labeled schizophrenic or bipolar just as easily as a person with an encephalopic condition could.

    The labels of schizophrenia and bipolar disorder do not address the root causes of psychotic or manic symptoms.

    Recovery from symptoms classified as “schizophrenia” and “bipolar disorder” would be a hell of a lot easier if those using the Diagnostic Manual learned how to use it to rule out:

    1) Medical Conditions
    2) Substance-Induced
    3) Medication-Induced psychosis/mania

    This is not rocket science, and it does not require any research. The codes are right in the DSM.

    293.81 Psychotic Disorder Due to Medical Condition, with Delusions

    293.82 Psychotic Disorder Due to Medical Condition, with Hallucinations

    293.83 Mood Disorder Due to Medical Condition

    293.89 Anxiety Disorder Due to Medical Condition

    298.8 Brief psychotic disorder

    289 Anxiety Disorder Due to Medical Condition

    298.8 Brief psychotic disorder

    291.3 Alcohol-Induced Psychotic Disorder With Hallucinations

    There are many cases medical conditions that have been misdiagnosed as mental illness. It is cruel to allow the suffering to continue.

    Hashimoto encephalopathy presenting as schizophrenia-like disorder.

    Cogn Behav Neurol. 2009 Sep;22(3):197-201.

    Lin YT, Liao SC.

    Source

    Department of Psychiatry, National Taiwan University Hospital and Medical College, Taiwan.

    Abstract

    OBJECTIVE:

    Hashimoto encephalopathy (HE) is associated with numerous neuropsychiatric symptoms and responds well to steroid therapy. In the past, only a few cases were reported to present with pure psychiatric syndromes. We describe a case of HE with presenting symptoms like that of schizophrenic patients.

    METHODS:

    We describe a 73-year-old woman with a history of autoimmune thyroiditis. She had psychotic symptoms for 3 years that responded poorly to antipsychotic agents, and she was thus admitted in 2007.

    RESULTS:

    The diagnosis of HE was made, although the patient presented neurologic symptoms and signs including abnormal electroencephalography, recent memory impairment, and executive function declination. The psychotic symptoms subsided completely in a few days after high-dose intravenous steroid therapy.

    CONCLUSIONS:

    The neuropsychiatric manifestation of HE can be similar to typical schizophrenia. Considering the effectiveness of steroid therapy for HE, we suggested HE as an important differential diagnosis for psychotic disorders, particularly for those patients of late onset, with abnormal electroencephalography, history of autoimmune thyroiditis, or poor response to conventional psychiatric treatment, so as to provide prompt and effective treatment for these patients.

    Psychosomatics. 2009 Sep-Oct;50(5):543-7.

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

    Alao AO, Chlebowski S, Chung C.

    Source

    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    Abstract

    BACKGROUND:

    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:

    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:

    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:

    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:

    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

    • Seems to me that ANY “disorder” / “disease” is actually created at the very moment of trauma. Impact. Like a car wreck.

      And without precise care and “treatment”, any so-called disease or disorder logically WOULD progress into something much, much worse. Monstrosities.