5+ Year Member
- Jul 9, 2009
- Reaction score
Manic sleep - My posting was to convey that most advances in health generally and the global lessoning in the burden of disease in the last 150 years are due to better sanitation and better nutrition. With respect that point is beyond all doubt. Technology has played a minor role by comparison.
I hope Im not the only one that finds these posts nauseating, particularly the last one...classic argumentum ad hominem.
Frankly, it's frightening that a mental health professional would attempt to undermine an argument by attacking the speaker instead of addressing the argument, and evermore so when doing so by questioning the speaker's mental health.
Ibid's post is absurd. He feels that most medical treatment is only due to sanitation and an improved diet? By that absurd logic, if your child gets diabetes or cancer or any number of genetic diseases that have nothing to do with diet or sanitation, you will clean them and give them fruits and vegetables?
Do you even remember what was routinely available for scanning the brain in 1990? How many people got MRIs in 1990? Even CT technology has advanced greatly. Can you imagine a world without spiral CT?
You will be saying the same thing in 20 years about gene therapy, nanomachines and organ transplant/cell transplant. Schizophrenia may be a syndrome, a lot of diseases that present similarly or perhaps a lot of disease states that cause similar damage to the brain. You can treat the underlying cause or the damage but hiding in the corner and closing your eyes wont do anyone any good. It is very likely that the mind is that last thing to be treated but before that we will see real cures for the body, then the brain and then the mind.
The idea that imaging is ONLY for predicting outcomes is not true. It will be for targeting. Gene therapy is progressing at an amazing rate. They are already growing cells, organs and nanomachines. Gene therapy has been use to "cure" mice of diabetes. These things are still in their infancy but give it a decade or 2.
After that slight diversion what is really at the heart of the difference between us is a difference of emphasis. I am positing that the biology of human distress needs to understood with in its social context and a persons biographical history. Of course you will say this has always been the case but to me its the matter of emphasis that is critical. Above you just say so what? That I believe misses the point because as I have said I believe it is critical.
I appreciate your clarification. Thank you.
I agree that there needs to be integration and in todays world attention should be given to biological, psychological and social. As psychiatrists that is our job and it is what we are trained to do better than anyone else. But the final goal is only the cure and nothing more.
Forgive me but psychiatrists are educated and absorb an abstract body of knowledge. Training is what plumbers do.
The analogy you present I accept as far as it goes but I am suggesting that all of what is described as mental illness is best understood as human distress which takes place in a social and biographical context,not as a disease. This being the critical difference between psychiatry and the rest of medicine.
Lets say a blood test for diagnosing schizophrenia is developed with excellent sensitivity and specificity. With it a 100% effective cure is developed as well. Are you really going to sit around and try to incorporate psychosocial aspects of treatment in someone who has not had symptom onset yet or would you cure them and let them go on their merry way?
Ill indulge the prospect as this is about the future. To answer with an illustration. What if the person who took the test is a forth generation shaman living in central Africa, who has a valued role in their community because of their perceived ability to communicate with the spirit world. Are you going to take that away from them? Granted an extreme example but so is yours.
Why a blood test? Why not posit a genetic test? What will you do now, especially with all the people you identify as homozygous recessive? Are you going to cure them as well? Would this notional blood test work for say post natal depression?
The difference between us is that I am hopeful that ways of ameliorating human distress will continue to be refined and I am suggesting that the best way to do that is to disinvest in the lanquage of pathology and the fruitless quest for biological markers that don't exist. You are suggesting the equivalent of searching for a safe way to eliminate people with the autosomal recessive trait that leads to hitchhikers thumb when you dont yet and can not yet know, what the future utility of that trait might be.
Sure, science can set you free but it can also bind you in ways you didnt expect.
With all your 'classical education' you failed to understand my simple words. I will ask again.
Ibid. Are you a physician?
In this case and in every case it is up to the hypothesiser to demonstrate the worthiness of their case. In this instance you need to find the biological marker for schizophrenia. Its no good getting upset because you cant find it. Thats your problem. I dont think it exists and so far all the evidence is on my side sunshine, not yours. Forgotten Carl Popper so fast have we? How convenient for you.
Why are you trying to make this personal and about me?
I would remind you that this is a student network, not the Nobel Prize winners after party.
I think I will go with :troll:
I will just ignore him and would ask others to do the same. (If you think I am the troll, don't respond to me).
The future of psychiatry is going to be modulated by several factors. Here are a few that I can think of.
Ever increasing stressors due to greater population density and paradoxical concomitant isolation that humans suffer.
Increased awareness of mental illness as well as fluctuating stigma.
i) I think overall the stigma is decreasing even with the scientologists and other fringe groups.
ii) there is going to be an upswing in the forensic aspect I think. It has already happened to a degree and if more events like VT happen, it will get worse for the severely mentally ill. The pendulum is starting to swing the other way.
The new health care system. Who knows what that will bring but it will be a game changer. This can be bad in the short run but ultimately I think it will be good for the patients and psychiatrists.
and scientific advances. Psychiatry and Neurology are both primed for major breakthroughs and I think we are going to come full circle where the two specialties start to merge again. The countdown has begun, its time for liftoff.
I'm very excited about the possibilities of utilizing technology and scientific advances in psychiatry, especially as we learn more about the brain and mind. However, I have a hard time seeing the benefit of merging neurology and psychiatry. Although we both are treating the same organ, the skills and training are so different. How would that look with things like therapy training?