PhD/PsyD Is schizophrenia neurological or more psychosocial?

[smalltownpsych]

Thanks. It is difficult to succinctly capture some of my thought processes on such complex phenomena as what we refer to as mental illness. I can spend hours lecturing on it. In fact, next fall that will be precisely what I will be doing as I will be teaching abnormal psych. Just realized how much I hate that course title.

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[Peacemaker36]

There is not really a normal range of psychotic thought processes that is more extreme in certain individuals.

FYI, the idea that psychosis exists on a continuum with normality is perhaps the central idea of CBT for psychosis. This perspective is not intuitive but it's invaluable because it normalizes psychosis and allows patients to talk about their experiences with less self-stigma. It also facilitates less defensive guided discovery and hypothesis testing in my experience. I like everything else you said!

 

[hamstergang]

Some claim, such as psychiatrists for example that it is a "brain disease" with an organic basis and therefore believe that antipsychotics are the best form of treatment.

Others, usually psychologists and social workers believe that even though there are neural correlates involved like with any human emotion or behavior, that it is less of an organic "disease" and more of a psychosocial issue, that no lesions or chemical inbalance theory has been proven and therefore it's better to treat it with psychotherapy and possible a small dose of medication... as opposed to "medicalizing" it and treating it only with pharmacology.

As a psychiatrist, I disagree with this premise. We use medications or therapy because they work, not because we believe they get to the root cause of the problem.

As for why schizophrenia is treated by psychiatrists instead of neurologists, it's because schizophrenia was classified as a psychiatric condition. Psychiatrists are trained to treat schizophrenia and so have this experience, and neurologists don't.

 

[Justanothergrad]

As a psychiatrist, I disagree with this premise. We use medications or therapy because they work, not because we believe they get to the root cause of the problem.

As for why schizophrenia is treated by psychiatrists instead of neurologists, it's because schizophrenia was classified as a psychiatric condition. Psychiatrists are trained to treat schizophrenia and so have this experience, and neurologists don't.

I can respect that and think that's true of many psychiatrists, but I've also known plenty of psychiatrists that argue that psychiatric conditions function of the infectious disease model (e.g., lets treat X in order to cure the cause). I was talking to a Menninger psychiatrist about that just this week and he was commenting about the way in which medical training continues to emphasize that model. It's not all, and its not the most contemporary, but I see it pretty regularly.