Wednesday 12 December 2012

What's In A Name?

Lots of interesting stuff coming out of the Inquiry into the Schizophrenia Label - see this link.

I don't inhabit the wilder shores of antipsychiatry but I do think there is quite a lot of hocus and dodgy science in psychiatric diagnosis - and schizophrenia is a case in point. It sounds (because it's Greek?) like a definitive diagnosis but in reality it depends on some rather arbitrary scoring of disparate symptoms which don't add up convincingly to a single, specific illness.

And yet... many of those who experience schizophrenia, their families, and those of us who work to support people with a serious mental illness know very well what schizophrenia is and it's obviously an illness even if we can't pin it down scientifically.

So I'm not sure I can agree with the Inquiry's view that "it is time to move away from psychiatric diagnoses and support people as fellow human beings rather than as people with a medical illness". This is in any case tendentious because of course you can give somebody a psychiatric diagnosis and also support them as a fellow human being. The serious question remains whether diagnosis makes sense and, on balance, I do think you have to give illnesses a name and indeed many patients draw comfort and understanding from knowing their illness is recognised, not unique to them, and that there are tried and tested treatments (however imperfect) and pathways to recovery. Of course the diagnosis of schizophrenia is very difficult to bear but calling it something else or nothing at all isn't going to make things better sadly.

What is needed is much greater honesty about the vagueness of the diagnosis and I certainly agree that attention needs to be placed on recognising and treating the specific symptoms of individual patients rather than focusing on the schizophrenia label - good psychiatrists do just that in our experience but there isn't consistent practice.

For an honest decription of the illness see Hafal's leaflet on schizophrenia here.


Many people will recognise this post's title from Romeo and Juliet (Act II Scene 2) -

What's in a name? that which we call a rose
By any other name would smell as sweet

Less well known is the immediately preceding half line -

O, be some other name!

So says Juliet wishing Romeo wasn't a Montague and some people would say the same about the schizophrenia label. But, as with the rose, name changes don't alter the reality