Sunday, 14 February 2016

“Schizophrenia” does not exist #BMJ: Prof Stephen M Lawrie's "trite assertion" response & my reply

“Schizophrenia” does not exist: Prof Jim van Os, BMJ 2Feb16

12Feb16: the response from Prof Stephen Lawrie, Head of Psychiatry, University of Edinburgh Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF; @lawrie_s 

My response to Prof Lawrie's piece submitted on BMJ website 14 February 2015:

"Re: “Schizophrenia” does not exist and Prof Stephen M Lawrie's "trite assertion" response

As a mother who has survived, and made a full recovery from, 3 separate episodes of psychoses, two of them postpartum in 1978 and 1984, the other menopausal in 2002, and the subsequent coercive psychiatric drug treatment (for I resisted the antipsychotics, preferring talking therapy which wasn't available), I agree with Prof Jim van Os's Article and concluding paragraph:

"The best way to inform the public and provide patients with diagnoses, therefore, is to forget about “devastating” schizophrenia as the only category that matters and start doing justice to the broad and heterogeneous psychosis spectrum syndrome that really exists."

I was given the diagnosis of schizoaffective disorder in 2002 which, even after my recovery, remains in my notes like a label.  And I have family members who received the schizophrenia diagnosis/label.  Resulting in "family history of ..." being written in the notes of any of us who happened to be treated for psychosis in the same health board area of Scotland.   The schizophrenia and related diagnoses are very difficult to get erased from one's medical notes, regardless of recovery.  In my case I tapered the drug cocktail in 2003, of Risperidone, Venlafaxine and Lithium, under my own steam.   Stigma and discrimination, in my experience, are linked to the diagnoses and "family history of" assumptions. 

Dr Lawrie writes of genes and increased risks however it is my understanding that the gene research is not conclusive.  There are many ifs and buts.  Not least the fact that long-term psychoactive drug treatment can disable the person neurologically and systemically.  Parkinsonian side effects, problems with walking and balance, increased agitation and anxiety, loss of agency and ability to make decisions.  I know about these, in the short term, having experienced  the discomfort when having to take Chlorpromazine in the earlier treatment years and Risperidone later.  

I was only on antipsychotics for a year maximum, with all 3 psychosis episodes, as I did not feel that I had quality of life on the drugs, they made me feel zombie-like.  I know that other people may have different views and prefer medication.  However for those of us wanting alternative therapies for psychoses or altered mind states the psychiatric diagnoses can exclude us from receiving psychological interventions.  The psychiatrist may prefer using drugs, especially if they have links to pharmaceutical companies as consultants or "experts".  [And may receive payment from these drug companies, the amounts of which only their taxman will know, which is the phrase Prof Stephen Lawrie used at a conference on psychosis I attended where he was a speaker, in July 2014 Edinburgh .  I am wondering therefore if Dr Lawrie does have "competing interests"? edited out by BMJ]

I do not agree with Dr Stephen Lawrie's closing paragraph:

"Just because a word like schizophrenia is mis-used does not mean it should be abandoned; and replacing it with something else of unproven value is likely to do more harm than good.". 

Schizophrenia is more than a "word" to the people who bear the label and live with the stigma, also their family members.  It is a scapegoating term which has been used to separate some people from society, a form of alienation.  Why should it matter to Dr Lawrie that the term be changed?  Unless he has a lot invested in the matter.  For when it comes to "unproven value" then that could be said of all psychiatric diagnoses.  Which are only relevant at the time they are written down so as to "treat" a person/patient.  People recover from "schizophrenia" and in their recovery prove the diagnosis wrong.  What does cause "more harm than good" are the claims by psychiatry that the mind can be understood by science.  They are clutching at straws and in so doing demonstrate the bankruptcy of their claims and positioning."

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