The much-awaited arrival of DSM-5 (the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders) should ensure that every human being is classed as insane. At this point we might be able to start again and consider what psychiatry is for. Genomics is keen to help in the effort by finding the loci that are associated with all sorts of mental disorders. Enter a huge population based study funded by the National Institute of Mental Health: “Our findings show that specific SNPs are associated with a range of psychiatric disorders of childhood onset or adult onset. In particular, variation in calcium-channel activity genes seems to have pleiotropic effects on psychopathology. These results provide evidence relevant to the goal of moving beyond descriptive syndromes in psychiatry, and towards a nosology informed by disease cause.” Hmm. I think that when authors have to use words like “pleiotropic” and “nosology” there is a high chance that they do not know what they are talking about. So before welcoming the marriage of genomics and psychiatry, let us remember that there is a strong history of madness on both sides.
Richard Lehman, “Richard Lehman’s journal review—22 April 2013”, BMJ Group blogs, 2013-04-22
April 24, 2013
QotD: Welcoming the DSM-V appropriately
March 29, 2013
Demonizing smokers hasn’t forced them to quit … let’s start sending them to psychiatric care instead
When the all the persuasion, “nudging”, shaming, harassment, and legal shenanigans haven’t worked, try taking a leaf out of the old Soviet Union playbook for dealing with dissidents:
Smoking may be a sign of psychiatric illness, experts say. Doctors should routinely consider referring people who smoke to mental health services, in case they need treatment, they add.
The controversial recommendation from the British Lung Foundation, a charity, comes in response to a major report, Smoking and Mental Health, published this week by the Royal College of Physicians and the Royal College of Psychiatrists with the Faculty of Public Health. It says that almost one in three cigarettes smoked in Britain today is smoked by someone with a mental disorder. When people with drug and alcohol problems are included the proportion is even higher.
The reason is that smoking rates have more than halved over the past 50 years, but the decline has not happened equally in all parts of society.
“Smoking is increasingly becoming the domain of the most disadvantaged: the poor, homeless, imprisoned and those with mental disorder. This is a damning indictment of UK public health policy and clinical service provision,” the report says.
December 16, 2012
The domestic terror: “I live with a son who is mentally ill. I love my son. But he terrifies me.”
Anarchist Soccer Mom has a story to tell. It’s neither pleasant nor uplifting, but it needs to be told:
I live with a son who is mentally ill. I love my son. But he terrifies me.
A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7 and 9 year old siblings knew the safety plan — they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me.
That conflict ended with three burly police officers and a paramedic wrestling my son onto a gurney for an expensive ambulance ride to the local emergency room. The mental hospital didn’t have any beds that day, and Michael calmed down nicely in the ER, so they sent us home with a prescription for Zyprexa and a follow-up visit with a local pediatric psychiatrist.
We still don’t know what’s wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He’s been on a slew of antipsychotic and mood altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work.
[. . .]
When I asked my son’s social worker about my options, he said that the only thing I could do was to get Michael charged with a crime. “If he’s back in the system, they’ll create a paper trail,” he said. “That’s the only way you’re ever going to get anything done. No one will pay attention to you unless you’ve got charges.”
[. . .]
No one wants to send a 13-year old genius who loves Harry Potter and his snuggle animal collection to jail. But our society, with its stigma on mental illness and its broken healthcare system, does not provide us with other options. Then another tortured soul shoots up a fast food restaurant. A mall. A kindergarten classroom. And we wring our hands and say, “Something must be done.”
I agree that something must be done. It’s time for a meaningful, nation-wide conversation about mental health. That’s the only way our nation can ever truly heal.
God help me. God help Michael. God help us all.
H/T to Drew M. for the link.
February 18, 2012
March 1, 2010
Miami considers new ways to marginalize the homeless
Miami has a problem with the homeless, so it has come up with a new and innovative way to address it: making it even more difficult for people to (legally) help feed them.
Miami residents may have to think twice before giving up their leftovers to the homeless.
The Miami City Commission is set to consider a proposal next month that would prohibit unauthorized people and groups from feeding the homeless downtown, an ordinance proponents say will cut down on litter and ensure the safety of the food the homeless do eat.
The Miami Downtown Development Authority recently approved the measure, sending it up to the commission.
Though the change could draw objections, David Karsh, spokesman for Development Authority Chairman Marc Sarnoff, said the rule isn’t a blanket ban. He said that anybody would be able to feed the homeless, but they would have to go through formal training first — amateurs couldn’t just give up part of their lunch to help someone they meet on the street.
I’m sure there are problems . . . few people are homeless voluntarily unless they have other issues (commonly mental health problems). But this proposal appears to be moving in the wrong direction, by discouraging individual efforts to help. Give a homeless man a sandwich and face a $300 fine? Two predictable results 1) fewer ad hoc efforts to help the homeless, and 2) fewer meals for the homeless.
November 24, 2009
Friendly reminder to UK readers: you do not have a right to remain silent
A fascinating story about a case in Britain where the government’s shiny new powers under Regulation of Investigatory Powers Act (RIPA) have been used to jail a schizophrenic man for refusing to divulge the passwords to access his files:
The first person jailed under draconian UK police powers that Ministers said were vital to battle terrorism and serious crime has been identified by The Register as a schizophrenic science hobbyist with no previous criminal record.
His crime was a persistent refusal to give counter-terrorism police the keys to decrypt his computer files.
The 33-year-old man, originally from London, is currently held at a secure mental health unit after being sectioned while serving his sentence at Winchester Prison.
In June the man, JFL, who spoke on condition we do not publish his full name, was sentenced to nine months imprisonment under Part III of the Regulation of Investigatory Powers Act (RIPA). The powers came into force at the beginning of October 2007.
[. . .]
Throughout several hours of questioning, JFL maintained silence. With a deep-seated wariness of authorities, he did not trust his interviewers. He also claims a belief in the right to silence — a belief which would later allow him to be prosecuted under RIPA Part III.
