Rethinking Madness: Towards a Paradigm Shift In Our Understanding and Treatment of Psychosis (Sky's Edge Publishing, 2012) is a book by the psychologist Paris Williams which explores creative ways of dealing with madness (psychosis). Williams says that psychotic experiences, which cause significant distress, typically occur deep within the mind. Given suitable conditions, this process can often result in a positive outcome, but Williams avoids the romantic notion that psychosis is always beneficial. Much of what Williams says is in close accord with a recovery approach. [1] [2]
Williams says that the term "psychosis" has many meanings, and the definitions that have been put forward are controversial. Even the DSM-IV-TR, says that "the term psychosis has historically received a number of definitions, none of which has achieved universal acceptance". [3]
Williams says that the diagnosis of schizophrenia is also the subject of much debate:
Despite over a century of intensive research, no biological markers or physiological tests that can be used to diagnose schizophrenia have been found, its etiology continues to be uncertain, and we don’t even have clear evidence that the concept of schizophrenia is a valid construct. However, diagnosis and treatment based upon the diagnosis continues unhindered by these serious problems. [3]
William's definition does not match the dominant psychiatric viewpoint on psychosis, which characterizes it as primarily resulting from brain pathology. [4] Neuroscience research has found that dopamine, serotonin, glutamate, and GABA all tend to functionally abnormally in those with schizophrenia. [5] A 2020 survey of clinical psychologists in the United Kingdom found that some practitioners have found success incorporating the idea of transformative psychosis into care. The paper concluded that the care models used by clinicians represented an extension of practices recommended by professional organizations such as the American Psychiatric Association and not a qualitatively distinct approach. [4]
Catatonia is a complex neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal. The onset of catatonia can be acute or subtle and symptoms can wax, wane, or change during episodes. It has historically been related to schizophrenia, but catatonia is most often seen in mood disorders. It is now known that catatonic symptoms are nonspecific and may be observed in other mental, neurological, and medical conditions. Catatonia is now a stand-alone diagnosis, and the term is used to describe a feature of the underlying disorder.
Dementia praecox is a disused psychiatric diagnosis that originally designated a chronic, deteriorating psychotic disorder characterized by rapid cognitive disintegration, usually beginning in the late teens or early adulthood. Over the years, the term dementia praecox was gradually replaced by the term schizophrenia, which initially had a meaning that included what is today considered the autism spectrum.
Psychosis is a condition of the mind or psyche that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
Schizophrenia is a mental disorder characterized by reoccurring episodes of psychosis that are correlated with a general misperception of reality. Other common signs include hallucinations, delusions, disorganized thinking and behavior, social withdrawal, and flat or inappropriate affect. Symptoms develop gradually and typically begin during young adulthood and are never resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months or one month. Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.
Anti-psychiatry, sometimes spelled antipsychiatry, is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionable effectiveness and harm associated with psychiatric medications, the failure of psychiatry to demonstrate any disease treatment mechanism for psychiatric medication effects, and legal concerns about equal human rights and civil freedom being nullified by the presence of diagnosis. Historical critiques of psychiatry came to light after focus on the extreme harms associated with electroconvulsive therapy or insulin shock therapy. The term "anti-psychiatry" is in dispute and often used to dismiss all critics of psychiatry, many of whom agree that a specialized role of helper for people in emotional distress may at times be appropriate, and allow for individual choice around treatment decisions.
A psychiatric or psychotropic medication is a psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat mental illnesses. These medications are typically made of synthetic chemical compounds and are usually prescribed in psychiatric settings, potentially involuntarily during commitment. Since the mid-20th century, such medications have been leading treatments for a broad range of mental disorders and have decreased the need for long-term hospitalization, thereby lowering the cost of mental health care. The recidivism or rehospitalization of the mentally ill is at a high rate in many countries, and the reasons for the relapses are under research.
Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia (psychosis) and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses. many people with schizoaffective disorder have other mental disorder including anxiety disorders
Richard Bentall is a Professor of Clinical Psychology at the University of Sheffield in the UK.
The Soteria model is a milieu-therapeutic approach developed to treat acute schizophrenia, usually implemented in Soteria houses.
The biopsychiatry controversy is a dispute over which viewpoint should predominate and form a basis of psychiatric theory and practice. The debate is a criticism of a claimed strict biological view of psychiatric thinking. Its critics include disparate groups such as the antipsychiatry movement and some academics.
The following outline is provided as an overview of and topical guide to abnormal psychology:
Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of deleterious mental conditions. These include various matters related to mood, behaviour, cognition, perceptions, and emotions.
This is a timeline of the modern development of psychiatry. Related information can be found in the Timeline of psychology and Timeline of psychotherapy articles.
The Critical Psychiatry Network (CPN) is a psychiatric organization based in the United Kingdom. It was created by a group of British psychiatrists who met in Bradford, England in January 1999 in response to proposals by the British government to amend the Mental Health Act 1983. They expressed concern about the implications of the proposed changes for human rights and the civil liberties of people with mental health illness. Most people associated with the group are practicing consultant psychiatrists in the United Kingdom's National Health Service (NHS), among them Dr Joanna Moncrieff. A number of non-consultant grade and trainee psychiatrists are also involved in the network.
The National Psychosis Unit is a national treatment centre for patients with schizophrenia and other psychotic disorders, in the United Kingdom. The unit is a tertiary referral centre in the National Health Service. It is located at the Bethlem Royal Hospital, part of the South London and Maudsley NHS Foundation Trust. It is closely affiliated to the Institute of Psychiatry, King's College London, and forms part of the Psychosis Clinical Academic Group of King's Health Partners.
Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.
The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States.
John Read is a psychologist and mental health researcher from England. He is professor of clinical psychology in the University of East London's School of Psychology.
Doctoring the Mind: Why psychiatric treatments fail is a 2009 book by Richard Bentall, his thesis is critical of contemporary Western psychiatry. Bentall, a professor of clinical psychology, argues that recent scientific research shows that the medical approach to mental illness is fatally flawed. According to Bentall, it seems there is no "evidence that psychiatry has made a positive impact on human welfare" and "patients are doing no better today than they did a hundred years ago".
Psychiatry is, and has historically been, viewed as controversial by those under its care, as well as sociologists and psychiatrists themselves. There are a variety of reasons cited for this controversy, including the subjectivity of diagnosis, the use of diagnosis and treatment for social and political control including detaining citizens and treating them without consent, the side effects of treatments such as electroconvulsive therapy, antipsychotics and historical procedures like the lobotomy and other forms of psychosurgery or insulin shock therapy, and the history of racism within the profession in the United States.