I have heard that very few psych patients ever get cured or are even curable. Is this true?
How Many Psych Patients are Actually Cured?
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C
ClinPsycMasters
Interesting question.
I'm not a psychiatrist but here's my opinion:
By "cure", you're presumably referring to restoring someone to a "healthy" state. I think psychiatry as a field is more concerned with making the dysfunctional, functional, and not so much about making the ill, healthy. The reason is that mental health is sort of fuzzy concept.
For instance, how anxious do you have to be to be considered mentally ill? What is more clear is that if you are terribly anxious and your work/personal life suffers, then the anxiety is dysfunctional. And the good news is that meds and therapy can ameliorate your anxiety significantly and make you all functional again. That applies to many common mental illnesses such as anxiety and mood disorders. Unfortunately, long-term results indicate that relapse is fairly common after therapies such as CBT for depression. Medications are somewhat less effective and need to be taken long-term. Of course, like an infection, depression can be targeted again and again. A major loss may send the patient back to the therapist.
There is a simplistic theory that claims depression is the result of "chemical imbalance" and that SSRI's restore that balance. This sounds like SSRI's are a cure, when in fact they are not.
Things get trickier with more severe illnesses, like schizophrenia. Even with antipsychotics, the patient's quality of life suffers tremendously. If you have serious fear of public speaking (which you need to do to move up the ladder in your job), therapy and/or meds can help you deal with the occasional speech, and get that promotion. If you are diagnosed with schizophrenia, however, some high stress situations are to be avoided all together, for the consequences can be truly overwhelming. Of course some patients with psychosis have fulfilled their potential beyond their doctor (and their own) wildest dreams. Others obtain some some benefit from meds (to control the positive symptoms) and therapy (to work on the relationship/social component). Generally speaking, however, the concept of "cure" may be applied to treatment for some neurotic disorders but rarely to any treatment for psychotic presentations.
I'm not a psychiatrist but here's my opinion:
By "cure", you're presumably referring to restoring someone to a "healthy" state. I think psychiatry as a field is more concerned with making the dysfunctional, functional, and not so much about making the ill, healthy. The reason is that mental health is sort of fuzzy concept.
For instance, how anxious do you have to be to be considered mentally ill? What is more clear is that if you are terribly anxious and your work/personal life suffers, then the anxiety is dysfunctional. And the good news is that meds and therapy can ameliorate your anxiety significantly and make you all functional again. That applies to many common mental illnesses such as anxiety and mood disorders. Unfortunately, long-term results indicate that relapse is fairly common after therapies such as CBT for depression. Medications are somewhat less effective and need to be taken long-term. Of course, like an infection, depression can be targeted again and again. A major loss may send the patient back to the therapist.
There is a simplistic theory that claims depression is the result of "chemical imbalance" and that SSRI's restore that balance. This sounds like SSRI's are a cure, when in fact they are not.
Things get trickier with more severe illnesses, like schizophrenia. Even with antipsychotics, the patient's quality of life suffers tremendously. If you have serious fear of public speaking (which you need to do to move up the ladder in your job), therapy and/or meds can help you deal with the occasional speech, and get that promotion. If you are diagnosed with schizophrenia, however, some high stress situations are to be avoided all together, for the consequences can be truly overwhelming. Of course some patients with psychosis have fulfilled their potential beyond their doctor (and their own) wildest dreams. Others obtain some some benefit from meds (to control the positive symptoms) and therapy (to work on the relationship/social component). Generally speaking, however, the concept of "cure" may be applied to treatment for some neurotic disorders but rarely to any treatment for psychotic presentations.
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I have heard that very few diabetic patients ever get cured or are even curable. Is this true?
(Consider your definition of "cured"...)
(Consider your definition of "cured"...)
Well stated OPD... The vast majority of patients with bread and butter anxiety/depression are well managed. I suspect Indya is referring to those patients with frank psychotic disorders.
Very few illness in all of medicine, aside from some infectious states, are ever curable. You are restoring functional state as another poster wrote. Just ask how many pts with DM, HTN, CA, CAD, SLE, RA, ARF etc if they feel they are cured.
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It is a naive view to expect to cure much of anything in medicine. The few exceptions might be certain bacterial infections, broken bones, and select surgical disease (eg, appendicitis). Everything else is about management and maximizing function.
good point. i would add therapy to maximize benefits.
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The word cure in relation to mental health is associated with a rather depressing, retrograde and unhelpful outlook. Just my opinion btw.
A much more helpful notion is the idea of recovery. The benefits to this way of thinking are that, the answer to the question "When is one recovered" is set by the patient and is therefore highly specific to each person. For some people it will be about a return to social, cultural, economic or family life or anything else they define. It is not all about treatment.
Even people with strict ideas about the nature of mental health problems can live with and find it useful so it has a lot going for it.
Recovery is more to do with having a meaningful life than functionalism on its own and that is why it is helpful. Social and cultural factors clearly play a large part in recovery.
This link has some simple stats in it.
http://www.rcpsych.ac.uk/pdf/Fair Deal Manifesto - Recovery and Rehabilitationx.pdf
c&p below. says it in another way using some words I wouldn't use, nevertheless.......
‘Recovery' has been used in two ways in mental health.1,2 First, recovery is the intended consequence of the skilful application of medicine, nursing and social care on a specific illness. Second, recovery is where individuals actively build a meaningful life for themselves while either continuing to experience mental health problems, or following a period of poor mental health.
A recovery-based approach is not primarily about returning to a pre-illness state, but is a process where the individuals and professional collaboratively work towards a meaningful and satisfying life. It is one where people with mental health problems regain active control of their lives, and where services support this through negotiated decisions about the best ways of meeting a person's medical, social and personal needs.1,3
Social inclusion is the goal we all share for people with mental health problems. A recovery- based approach is fundamental for this to be achieved.
A much more helpful notion is the idea of recovery. The benefits to this way of thinking are that, the answer to the question "When is one recovered" is set by the patient and is therefore highly specific to each person. For some people it will be about a return to social, cultural, economic or family life or anything else they define. It is not all about treatment.
Even people with strict ideas about the nature of mental health problems can live with and find it useful so it has a lot going for it.
Recovery is more to do with having a meaningful life than functionalism on its own and that is why it is helpful. Social and cultural factors clearly play a large part in recovery.
This link has some simple stats in it.
http://www.rcpsych.ac.uk/pdf/Fair Deal Manifesto - Recovery and Rehabilitationx.pdf
c&p below. says it in another way using some words I wouldn't use, nevertheless.......
‘Recovery' has been used in two ways in mental health.1,2 First, recovery is the intended consequence of the skilful application of medicine, nursing and social care on a specific illness. Second, recovery is where individuals actively build a meaningful life for themselves while either continuing to experience mental health problems, or following a period of poor mental health.
A recovery-based approach is not primarily about returning to a pre-illness state, but is a process where the individuals and professional collaboratively work towards a meaningful and satisfying life. It is one where people with mental health problems regain active control of their lives, and where services support this through negotiated decisions about the best ways of meeting a person's medical, social and personal needs.1,3
Social inclusion is the goal we all share for people with mental health problems. A recovery- based approach is fundamental for this to be achieved.
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although even with a broken bone, the body is what actually heals it, rather than an outside cure provided by a physician, right? i know screws and plates can be added to help the process, but what else is done that would really count as a cure? i've never broken anything so i'm not familiar with all that. and i'm not sure removing an appendix is a cure either, as the appendix isn't ever restored to the original state. so can anything really be cured, ever (other than the bacterial infections you mentioned)? because it sounds to me like the bones and appendicitis would fall into your category of management and maximizing function.
ps i havent started school yet, so i apologize if i sound so stupid that it makes your head spin 😀.
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Psychiatry rarely cures but cures are available. Most diagnoses are treated and the recovery usually depends on the severity of the illness and the amount of resources available to fully implement the bio-psycho-social model.
The biological aspect or neuropsychiatry has been growing lately and is anticipated to have a banner decade using stem cell research, high resolution imaging etc.
Cures are available now but for very limited diagnoses, usually short term adjustment reactions, mental status changes caused by things such as substances, medications or other medical illness.
The biological aspect or neuropsychiatry has been growing lately and is anticipated to have a banner decade using stem cell research, high resolution imaging etc.
Cures are available now but for very limited diagnoses, usually short term adjustment reactions, mental status changes caused by things such as substances, medications or other medical illness.
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I would say a healed fracture that restores functionality is a cure.
Bacteria infections can leave scars and damage that are not curable even after the infection is defeated.
C
ClinPsycMasters
Interestingly, loss and trauma can leave deep psychic wounds in its wake but these "wounded people" can reorganize their lives around these wounds, and meanings associated with them, and be whole again, in a different plane of psychic existence and reality, aided by philosophical and spiritual concepts but also psychological reframing.
Physical reality is less malleable, and physical wounds less amenable to this kind of reframing.
