Belief and Mental Health

[Snoopy]

Originally Posted by dauer

Can't watch the iPlayer outside of the UK.

I know, don't know if it's technical or copyright or what...

s.

[Tao_Equus]

Originally Posted by Snoopy

I know, don't know if it's technical or copyright or what...

s.

Copyright and product protection. Much of BBC output is sold abroad and the programs they do not show are often bought in. So its a two fold protectionism.

tao

[Snoopy]

Originally Posted by Tao_Equus

Copyright and product protection. Much of BBC output is sold abroad and the programs they do not show are often bought in. So its a two fold protectionism.

oh ok...............................

s.

[Francis king]

re: how mad are you?

yes, I'm watching this programme myself- I laughed last week when the psychiatrists only got one out of two right...

for those of you who don't know, of the ten volunteers, we're looking for-
1 someone with OCD (obsessive-compulsive disorder),
2 a person with bi-polar disorder,
3 someone with a diagnosis of schizophrenia,
4 a depressive,
5 a person with social anxiety, and
6 an anorexic...

I've diagnosed them as follows...

1) it was pretty obvious that the OCD guy was the OCD guy- or maybe that was just me... they stuck him in a cow shed cleaning up ****e... he wanted to go home and wash properly... he didn't feel clean, and was uncomfortable with it more than the others... as one of the most usual features of OCD is obsession with germs and cleanliness, it was obviously going to effect this person more than the rest... I think this task was unfair. Far too obvious...

2) the person who they thought was sane (and they got it wrong), a spanish looking woman with short-ish hair, I have scored as bi-polar... as we know the doctors got this one very wrong, so it's "pick a diagnosis from the ones you have left", but this was my belief before the reveal, and I'm sticking with it... I am basing my diagnosis here soley on appearance- I have met a lot of ppl with bi-polar, and she reminded me of most of them...

3) the person I would diagnose as schizophrenic is the big-eyed white blonde haired guy (not the travelling kid)... I base this diagnosis again, soley on appearance... he reminds me of other schizophrenics I have met...

4) the person I would say had been diagnosed as suffering with depression is the short black/asian looking guy... this is not based on appearance, just a guess... if he is not the depressive, which he may not be, then I think the person with social anxiety is also the depressive- see 5) below...

5) the person with socal anxiety is the older, long dark haired woman... I base this on the fact that she was late to arrive at the meeting, which I read as a sign she was anxious about arriving... she may also have depression- I base this on the facts- namely, both disorders go hand in hand, and knowing that, originally, the experiment was to place "5 non-diagnosed with 5 diagnosed in the past" people... if there is 6 disorders, then there must be one person who has two... if this is the case, then this woman has depression and social anxiety, and the black guy has no dignosis.

6) I think the sweet looking ginger girl- the teacher- is the past anorexic...the doctors seem convinced she's a depressive, but I think they've got it wrong... she says she failed university, and it's about the right time for an anorexic to need treatment, at that time in history (anorexics are getting younger today, of course)...

this was my scores after the first episode... will be interesting to see if I want to change my mind as the show goes on... next episode is... tuesday...I will report back then...

my reasoning, I should add, is based soley on... snap descisions, the physical appearance of others, and a few small snippets of wisdom based on what's known about various disorders...

I am here making the assumption that, like the doctors, I will get half of my diagnoses wrong...

anyone else watching the show? It would be interesting to see if you too, like me, have made some snap decisions about who has what...

[Snoopy]

Originally Posted by Francis king

1) it was pretty obvious that the OCD guy was the OCD guy- or maybe that was just me... they stuck him in a cow shed cleaning up ****e... he wanted to go home and wash properly... he didn't feel clean, and was uncomfortable with it more than the others... as one of the most usual features of OCD is obsession with germs and cleanliness, it was obviously going to effect this person more than the rest... I think this task was unfair. Far too obvious...

I think I may have refused the task, then barfed

And I do not have OCD!

2) the person who they thought was sane (and they got it wrong), a spanish looking woman with short-ish hair, I have scored as bi-polar... as we know the doctors got this one very wrong, so it's "pick a diagnosis from the ones you have left", but this was my belief before the reveal, and I'm sticking with it... I am basing my diagnosis here soley on appearance- I have met a lot of ppl with bi-polar, and she reminded me of most of them...

What an appalling basis for your diagnosis! I thought the same too.

3) the person I would diagnose as schizophrenic is the big-eyed white blonde haired guy (not the travelling kid)... I base this diagnosis again, soley on appearance... he reminds me of other schizophrenics I have met...

Same again.

I was expecting the programme to be rubbish (I think the title is) because these days programmes like Horizon seem to spin out 5 minutes of "meat" into 60 minutes of visuals, music, summaries, conjecture, waffle, theorising over theories that are then discounted, only for the programme which was called "The Real Reason Why Continents Drift" to end with "so after all this research we still aren't sure of the real reasons why continents drift".

This however was informative and dealt with the issues well I thought, in a neutral, non-sensationalist manner. (Great location too)

Glad I'm not the only one watching it Francis. See you after Tuesday.

s.

[Tao_Equus]

I been watching too.

I think the "Spanish looking" woman to be the schizophrenic, pure hunch mostly based on the strength of her relief at not being spotted last week and the occasional look she had.

I think the anorexic to be the "late" one from Edinburgh. Arriving late on a scheduled flight from Edinburgh is a very valid excuse as I can attest. But her physical appearance shows the ravage many years of anorexia caused malnutrition can cause.

The others Im not sure about.

Will be interesting to see it when I get back.


tao

[Paladin]

Originally Posted by Snoopy

And I do not have OCD!



s.

I have CDO, it's alot like OCD except it's in alphabetical order as it should be.

[Tao_Equus]

Originally Posted by Paladin

I have CDO, it's alot like OCD except it's in alphabetical order as it should be.

Loving it

[Snoopy]

tonight (Tues) BBC2, 9 PM .....

s.

[Snoopy]

well Francis!

and humbling for the professionals too.


10 volunteers, 5 with "mental health problems."

Identified by the professionals correctly: 2.

Lots to read here:

BBC - Headroom

s.

[Francis king]

Identified correctly by Francis King, 2... just like the professionals...

today I have been reading a book called, madness explained, by richard bentall, penguin 2004... he's a reputable psychologist/psychiatrist in the UK...

he states in this book that this lack of certainty in diagnosis is based on several factors- the most importance of which is... we diagnose purely by chance... we jump to conclusions based on our "expert opinions". When a psych diagnoses a patient, he does not "test" them. He does not read brain scans or ask you to sort cards... there is usually no questionnaire to fill in, no exam to sit. He looks at you, listens to you, asks you questions which he feels are relevant, ignores what he doesn't feel is relevant, and jumps to a certain conclusion so he can prescribe something which might work.

Bentall says another factor in this "lack of certainty" is often centered on the accuracy of the scales we use to determine symptoms. In the beginning, schizophrenia was a designation given to ppl who probably suffered not just from schizophrenia, but from encephalitis lethargica or autism, or mania... today, the same thing applies- what one psych sees as schizophrenia another thinks is a bi-polar, or a histrionic attention seeker...

psychiatrists cannot quite decide what the features of the specific disorders are- which suggests that instead of looking for a label and then deciding on treatment we should forget labels and instead focus on symptoms, and treat the most troubling symptoms first...

bentall reckons that globally, psychs cannot decide who has what... in 1974, kappa measures computed for six studies - adapted from R.L. Spitzer and J.L. Fliess (1974)" a reanalysis of the reliability of psychiatric diagnosis" (BJ PSYCH, (123) pp341-7) found inter-rater reliability of the various diagnostic subscales to be only .38. A kappa of 1 would be spot on, perfect agreement, and 0 would indicate agreement at chance level (p>0.05)... to get .38 then means that the results you get from scales are even worse than chance... statistically, they are completely irrelevant...

ian brockington from Birmingham university applied the various definitions of schizophrenia to a number of patients (1992). Using these different scales ... american criteria- 163 patients had schizophrenia, but using the icd definition, of these 163 only 65 had schizophrenia. this number fell to 55 when schneiders first rank symptoms scale was used, when the RDC was used this number of patients became 28, and when DSM was used, this number fell to... 19...

162, or 19 schizophrenics? It depends who you ask.

Studies before and since these all find similiar results- that we cannot agree what mental illness is, and even when we do, different people have different criteria as to what it is, even if it is. The usual agreement or concordance of diagnoses is 0.38. Worse than just guessing...

Ten people then, with the same diagnoses would then be perceived and diagnosed and labelled by ten psychiatrists with ten seperate conditions and they would only agree three times between three of them them about 3 patients.

This begs the question- if these mental illness are in fact, illnesses, then why do they appear so different to so many different professionals?

In dermatology, there are, say... 35 different types of skin lesion. Of these, 5 have two forms each (for example). Of these 40 lesions, 15 are malignant and potentially fatal. We have looked at 3 million lesions, and we know what a basal cell carcinoma looks like. We can differentiate between a basal cell carcinoma and a squamous cell carcinoma quite easily. One might kill you, one will not. If in a dermatology clinic we only got this right .38 of the time, then out of a hundred people all of them but one would be dead, and he would be dying...

This kind of inaccuracy would not be tolerated in general medicine, so why should we tolerate it in psychiatric medicine?

In reality, there's probably only four mental health problems- 1) being hyper, 2) being on a downer, 3) being deluded, and 4) being a person not liked by other people, aka, having a personality disorder... Of each of these four, some ppl will be at the mild end, and some at the severe end of the spectrum, and some in the middle.

In my line of work I often come across ppl who have had several different mental health diagnoses over a period of years. Each new consultant can feasibly give you another one, your treatment is changed accordingly, and a person has schizophrenia one year, bi-polar disorder the next, the year after the diagnosis can change again and suddenly- you're just a benefits scrounger with nothing much wrong with you. You don't have any say in these decisions. The models we use mean... we don't just deal with the symptoms, dampen down the mania, lift up the depressive, level out the deluded one... that would be far too simple...

of course, we have scales and assessment tools with good validity... it's just that nobody knows what they are... even well known scales like "becks depression inventory", "hare's psychopathy scale", are flawed, and do not measure what they say they measure... we, the professionals, say we do not use scales because we think that "people are beyond boxes", but in truth, we don't use them as they are rubbish, and we know it...

[Tao_Equus]

So what is the future of psychiatry? Seems to me that there is less and less faith in the quackery of the psychiatric mainstream. The only therapies that seem effective are those time intensive one to one counter-strategies. And even they are fragile. The drugs, in most cases, do not work. To me it seems there is not a lot that can be done. It has to be a reactive system that responds to individual need and loose definitions of spurious accuracy need replacing with something that does not stigmatise by label and make recovery harder. But it is this slave society that really needs changed. We are forced to work far to many hours, our families are divided by corporate strategies to sell more product, we are left alone and isolated and only valued as machine parts. What little time off we do get we are alone and told we will find solace in consumerism, that shopping will make us happy. I think the so called explosion of mental health problems is the direct result of a society that does not value social relationships enough. This TV experiment showed that when given a natural environment for social cooperation to flourish we see little evidence of individual problems. I think most people with problems are just lonely and isolated.

tao

[greymare]

Originally Posted by Paladin

I have CDO, it's alot like OCD except it's in alphabetical order as it should be.

is that like the agnostic dyslexic insomniac who used to lay awake at night wondering if there really was a Dog?

[Paladin]

Yep

here's one I know you have seen before:
Welcome to the Psychiatric Hotline
If you are obsessive-compulsive: Please press 1 repeatedly.
If you are co-dependant: Please ask someone to press 2.
If you have multiple personalities: Please press 3, 4, 5, and 6.
If you are paranoid-delusional: We know who you are and what you want. Just stay on the line so we can trace your call.
If you are schizophrenic: Listen carefully, a little voice will tell you which number to press.
If you are a manic depressive: It doesn't matter which number you press, no one will answer

[Snoopy]

Originally Posted by Paladin

Yep

here's one I know you have seen before:
Welcome to the Psychiatric Hotline
If you are obsessive-compulsive: Please press 1 repeatedly.
If you are co-dependant: Please ask someone to press 2.
If you have multiple personalities: Please press 3, 4, 5, and 6.
If you are paranoid-delusional: We know who you are and what you want. Just stay on the line so we can trace your call.
If you are schizophrenic: Listen carefully, a little voice will tell you which number to press.
If you are a manic depressive: It doesn't matter which number you press, no one will answer

There's a part of me that says I shouldn't laugh at this.

But I try to ignore that little voice in my head.....

s.