Some Statistics and Patterns prevalence, course, prognosis Statistical Prevalence of Schizophrenia Schizophrenia is not a terribly common disease but it can be a serious and chronic one. Worldwide about 1 percent of the population is diagnosed with schizophrenia, and approximately 1.
Models of mental disorder, as they are now called, continue to be hotly contested between different stakeholder groups in mental health right up to the present day Fulford et al.
Running through these differences and disputes, as outlined later in this entry, is a tension between what may be called moral and scientific models. Mental illness, understood in terms of this tension, is poised between the everyday moral world of free agency, subjectivity and reasons, and a scientific world of determinism, objectivity and causal laws.
How the tension between moral and medical models of mental illness is resolved in a period of unprecedented advances in the neurosciences—in behavioral genetics, in functional brain imaging, and in psychopharmacology—is critical to a range of ethical issues in psychiatry: This entry explores the meaning of the concept of mental illness, not directly, by way of a critique of the very large number of competing definitions available in the literature, but indirectly, by way of the use made of the concept in practice.
This approach—examining the use of concepts as a guide to their meanings—is exemplified by the work of the English philosopher J. Austin — and others working mainly in Oxford in the middle years of the twentieth century Warnock, — The approach, called linguistic analysis or ordinary language philosophy, although relatively neglected by subsequent generations of philosophers Williams, —and certainly very far from being a philosophical panacea Fannprovides a conduit or bridge between philosophical theory and medical practice Fulford, In psychiatry, linguistic analysis offers a number of helpful insights into: Many Definitions Difficulties in the use of the concept of mental illness have traditionally been assumed to reflect difficulties of definition.
This assumption, of a genetic link between difficulties of use and difficulties of definition, was not unreasonable given the successes of psychiatry in the second half of the twentieth century in improving the reliability of its diagnostic categories by clarifying the definitions of many of its key diagnostic terms: There are, furthermore, as this entry shall explore, many examples of continuing difficulties both in the use of the concept of mental illness and in its definition.
These examples, however, understood linguistic analytically, point, not to the traditional assumption of a genetic link between use and definition, but rather to the need for a reformulation of the problem as one of difficulty in the use of the concept of mental illness rather than a difficulty of definition.
Simon, a forty-year-old African-American lawyer, was threatened with a malpractice action, which he believed to be racially motivated, by a group of colleagues. Although he had never been a particularly religious man, he responded to this situation by setting up a makeshift altar in his front room and praying all night.
In the morning he found that wax had run down from a candle on to his bible, marking out certain words and phrases. This is how he described his experience: I think the beauty of it was the specificity by which the sun burned through.
It was … in my mind, a clever play on words. His seals meant nothing to anyone else. But for Simon they were direct communications from God, showing that he was "…the living son of David…and captain of the guard of Israel. Simon's story, which is based on a real person's experiences, comes from a study of the differences between delusion and spiritual experience carried out by a British psychologist Mike Jackson, at the time working as a doctoral student with Gordon Claridge at Magdalen College, Oxford Jackson, ; Jackson and Fulford.
The study included blind ratings using one of the first carefully standardized instruments for assessing a person's mental state, the Present State Examination PSE. Developed by John Wing, John Cooper and Norman Sartorius at the Institute of Psychiatry in London, the PSE includes a glossary of carefully crafted definitions that, together with a standardized interview schedule, allow the identification of over one hundred symptoms and signs of mental disorder with high degrees of reliability Wing, Cooper, and Sartorius.
PSE ratings of Simon's story identified his experience as a delusional perception, a form of primary delusion. The PSE defines this as a delusion which is "based upon sensory experiences delusional perceptions in which a patient suddenly becomes convinced that a particular set of events has a special meaning" Wing, Cooper and Sartorius, p.
What then does this delusional perception mean diagnostically? In particular both are descriptive in orientation.
That is to say, both seek to define mental disorders as far as possible descriptively, by reference to the presence of specific symptoms, like delusional perception, of known reliability.
In ICD delusional perception as defined in the PSE is one of a number of symptoms that, if present, are sufficient for a diagnosis of schizophrenia or of some other psychotic illness—affective, organic, or other—depending on associated features.
According to ICD, then, Simon had schizophrenia or some related psychotic disorder. He was empowered and guided by his experiences, idiosyncratic as they were; he won his court case; and his career consequently went from strength to strength. By the lights of ICD, then, Simon had a psychotic illness albeit one with, in this instance, a benign course ; but by the lights of DSM-IV, he had a positive albeit idiosyncratic spiritual experience.
On first inspection, it is somewhat disconcerting, at least from psychiatry's point of view, to find that its two major classifications, although closely similar in their scientific orientations, should yield radically different ways of understanding Simon's story.
This is the more surprising given that those responsible for the two classifications worked hard to make them compatible. Simon's case, furthermore, is not marginal in these classifications: Karl Jaspersthe founder of modern descriptive psychopathology, placed delusion among the central symptoms of mental disorder Jaspers, a ; and the case for a medical model of mental disorder is regarded by many as being strongest for the psychoses.
It was for this reason that Thomas Szasz, notorious for the slogan mental illness is a myth Szasz,called schizophrenia, in the title of a later paper, the "sacred symbol of psychiatry" Szasz, The Mental Health Country Profile is a tool for formative evaluation of the mental health situation in a country, and was generated by the International Mental Health Policy and Services Project to inform key stakeholders about important issues which need to be considered in mental health policy development.
The concept of a Mental Health.
The diagnostic concept of schizophrenia: its history, evolution, and future prospects requirement, however, is that an endophenotype should be a represented by a quantitatively measurable trait. In schizophrenia research, an increasing number of endophenotypes Jacobsen B, Ingraham LJ, Jansson L, Faber B.
Mental illness in the biological. Key words: schizophrenia, family, behavior, expressed emotion, mental illness Purpose Symptoms of the condition diagnosed as schizophrenia usually first appear . Wiersma D, Professor in clinical epidemiology of psychiatric disorders, University Medical Center Groningen, Department of Psychiatry, PO Box , RB Groningen, The Netherlands.
Objective: This study reviews conceptual and methodological issues of needs for care among people with severe. In its analysis of the schizophrenia team and of those experiencing the disorder, this book will reveal to mental health professionals many of the unspoken assumptions of their role.
It will also confirm to social scientists and clinicians the power of the ethnographic approach in psychiatric attheheels.com: Robert J.
The concept of schizophrenia is dying. Harried for decades by psychology, it now appears to have been fatally wounded by psychiatry, the very profession that once sustained it. Its passing will not be mourned. Today, having a diagnosis of schizophrenia is associated with a life-expectancy reduction of nearly two decades. produce schizophrenia, but all the tools of modern biomedical research are being used to search for genes, critical moments in brain development, and other factors that may lead to the illness. The Mental Health Country Profile is a tool for formative evaluation of the mental health situation in a country, and was generated by the International Mental Health Policy and Services Project to inform key stakeholders about important issues which need to be considered in mental health policy development. The concept of a Mental Health.
Barrett. Cluster analysis of the original data reproduced closely Kraepelin's dichotomous classification of the psychoses but suggested that DP was a narrower concept than schizophrenia today, while MDI.