Re: MD The Definition of "Insanity"

From: Ian J Greely (ian@tirnanog.org)
Date: Fri Apr 28 2000 - 04:59:42 BST


For Info.

I've clipped a small section of DSM IV so that people can see what we
are talking about. This is the schizophrenia section.

To make myself clear on this. People suffer great problems with the
symptoms diagnosed with this illness. *I* believe that disturbances
can cause us to be non-functional in society. My point is that it is
*in* society. In a non-social context I do not believe that this would
make all that much difference.

The concept of what is "bizarre" I've never seen well explained.

As to what a delusion is I would hope that it is more closely defined
than the dictionary definition.

On the basis of this I'd probably have diagnosed John Major as
schizophrenic during the last election. Good job it's not my job eh?

DSM-IV diagnostic criteria for schizophrenia7

                   A
                        Characteristic symptoms: Two or more of the
following, each present for a significant portion of time during
                        a one-month period:

                             delusions
                             hallucinations
                             disorganised speech (eg, frequent
derailment or incoherence)
                             grossly disorganised or catatonic
behaviour
                             negative symptoms (ie, affective
flattening, alogia, or avolition).
                   Note
                        Only one Criterion A symptom is required if
delusions are bizarre or hallucinations consist of a voice keeping
                        up a running commentary on the person's
behaviour or thoughts, or two or more voices conversing with each
                        other.
                   B
                        Social/occupational dysfunction: Since the
onset of the disturbance, one or more major areas of functioning,
                        such as work, interpersonal relations, or
self-care, are markedly below the level previously achieved.
                   C
                        Duration: Continuous signs of the disturbance
persist for at least six months. This six-month period must
                        include at least one month of symptoms (or
less if successfully treated) that meet Criterion A.
                   D
                        Exclusion of schizoaffective disorder and mood
disorder with psychotic features.
                   E
                        Substance/general medical condition exclusion:
the disturbance is not due to the direct physiological
                        effects of a substance (eg, a drug of abuse, a
medication) or a general medical condition.
                   F
                        Relationship to a pervasive developmental
disorder: If there is a history of autistic disorder or another
                        pervasive development disorder, the diagnosis
of schizophrenia is made only if prominent delusions or
                        hallucinations are also present for at least a
month (or less if successfully treated).

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