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Guesswork in Psychiatry
- Thread starter PublicHealth
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This is typical popular press info for the layperson with an apparent attempt to jumpstart medicine to "do something" for this suffering population. While there is a trial-and-error component to more difficult cases, and the need to switch medications after tachyphylaxis or receptor changes, one must remember how psychiatric hospitals looked as recently as the 1980s. When was the last time anyone saw a true catatonic schizophrenic, or one with waxy flexibility?
Genetic studies will play a large role in the management of psychiatric illness within our lifetimes. Psychiatrists' training in the future will likely entail heavy training in the clinical biology of genetics for this reason.
I've thought for some time that the real qualifiers for true major depression, for example have softened quite a bit. Studies have suggested that treatment of the so-called "depressed personality" is nearly impossible.
I know plenty of patients that have been stable on one medication for years - often a low dose neuroleptic or antidepressant or AD/benzo combination. They seem to not make it into studies.
We hear in residency to not think of psychiatric patients as "curable" per se, but rather along the lines of patients with chronic disease that require long-term management. Not unlike diabetes, CHF, HTN, etc. No one really faults medicine for this. I'm not sure why psychiatry gets singled out for having chronic patients.
Genetic studies will play a large role in the management of psychiatric illness within our lifetimes. Psychiatrists' training in the future will likely entail heavy training in the clinical biology of genetics for this reason.
I've thought for some time that the real qualifiers for true major depression, for example have softened quite a bit. Studies have suggested that treatment of the so-called "depressed personality" is nearly impossible.
I know plenty of patients that have been stable on one medication for years - often a low dose neuroleptic or antidepressant or AD/benzo combination. They seem to not make it into studies.
We hear in residency to not think of psychiatric patients as "curable" per se, but rather along the lines of patients with chronic disease that require long-term management. Not unlike diabetes, CHF, HTN, etc. No one really faults medicine for this. I'm not sure why psychiatry gets singled out for having chronic patients.
