A Behavioral Approach to Mental Disorders

Last month the British Psychological Society’s Division of Clinical Psychology published a very important document. It’s called Understanding Psychosis and Schizophrenia, and was edited by Anne Cooke, Principal Lecturer in the Department of Applied Psychology, Canterbury Christ Church University. Here are some quotes: "It is often assumed that there is a straightforward dividing line between ‘mental health’ and ‘mental illness’ (normality and abnormality) and that discrete, identified disease processes (for example ‘schizophrenia’) are responsible for experiences such as hearing voices. However, recent research suggests that this is not the case." ...

On November 28, Psychiatric Times published an article titled Psychiatric Diagnosis and Treatment of Somatizing Neuropsychiatric Disorders. The authors are Daniel T. Williams, MD, and Alla Landa PhD, both from Columbia University Psychiatry Department. The article’s lead-in states: "Although the somatizing disorders cover a vast array of symptomatic domains across many medical specialties, this article addresses the broad topic conceptually." The so-called somatizing disorders have an interesting history in psychiatry. DSM-III-R (1987) states: "The essential features of this group of disorders are physical symptoms suggesting physical disorder (hence, Somatoform) for which there are no demonstrable organic findings or known physiologic mechanisms, and for which there is positive evidence, or a strong presumption, that the symptoms are linked to psychological factors or conflicts." (p 255) ...

On August 11, Pediatrics, the official journal of the American Academy of Pediatrics, published an article by Amy Houtrow, MD, et al. The article is titled Changing trends of childhood disability, 2001-2011 Here are the authors’ conclusions: "Over the past decade, parent-reported childhood disability steadily increased. As childhood disability due to physical conditions declined, there was a large increase in disabilities due to neurodevelopmental or mental health problems. For the first time since the NHIS began tracking childhood disability in 1957, the rise in reported prevalence is disproportionately occurring among socially advantaged families. This unexpected finding highlights the need to better understand the social, medical, and environmental factors influencing parent reports of childhood disability." ...

Vivak Datta, MD, is a second year psychiatry resident at the University of Washington, Seattle. He has a website called Medicine and Society, and on November 14, he published a lengthy article titled Science and Pseudoscience in Psychiatric Training: What Psychiatrists Don’t Learn and What Psychiatrists Should Learn. On November 20, the article was published on Mad in America. Here are some quotes: "…what is currently emphasized [in psychiatric training] is tantamount to pseudoscience." ...

On November 17, Scientific American published on its MIND blog website Why We Need to Abandon the Disease-Model of Mental Health Care, by Peter Kinderman, PhD. Here are some quotes: "The idea that our more distressing emotions such as grief and anger can best be understood as symptoms of physical illnesses is pervasive and seductive. But in my view it is also a myth, and a harmful one. Our present approach to helping vulnerable people in acute emotional distress is severely hampered by old-fashioned, inhumane and fundamentally unscientific ideas about the nature and origins of mental health problems. We need wholesale and radical change, not only in how we understand mental health problems, but also in how we design and commission mental health services." ...

On October 15, psychiatrist Allan Tasman, MD, published an article in Psychiatric Times. The title of the article is The Most Exciting Time in the History of Psychiatry. Psychiatric Times describes itself: “Our Focus: News, special Reports, and clinical content related to psychiatry. Our Audience: Psychiatrists and allied mental health professionals who treat mental disorders.” According to Wikipedia: “Psychiatric Times is a medical trade publication written for an audience involved in the profession of psychiatry.” It is published by UBM Medica and is distributed to about 50,000 psychiatrists monthly. ...

On October 23, Simon Wessely, MD, a British psychiatrist, published an article, The real crisis in psychiatry is that there isn’t enough of it, at the online site The Conversation. Dr. Wessely is the Professor of Psychological Medicine at King’s College, London, and is also the President of the Royal College of Psychiatrists. The Conversation is an independent non-profit online media outlet that delivers “…news and views from the academic and research community…” directly to the public. Their aim is “…to promote better understanding of current affairs and complex issues.” ...

On September 9, 2014, the BMJ published an article by Sophie Billioti de Gage et al. The article was titled Benzodiazepine use and risk of Alzheimer’s disease: case-control study, and concluded: “Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.” [Emphasis added] ...

I’ve recently received the following video link (3 minutes) from two readers who lost their only child, whom they believe could have been saved but for “a draconian mental health system.” One Step At A Time Please take a look.

On September 9, 2014, the BMJ published an article by Sophie Billioti de Gage et al. The article is titled Benzodiazepine use and risk of Alzheimer’s disease: case-control study. The research was a study based on data from the Quebec health insurance program database. Here are the authors’ conclusion: "Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern." ...