Diagnosis By Design

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http://www.cchr.org/doctors/eng/page13.htm

 

DIAGNOSIS BY DESIGN

by Thomas Szasz, Professor of Psychiatry Emeritus

 

 

Dr. Thomas Szasz, Professor of Psychiatry Emeritus at the State

University of New York Health Science Center and author of more than

25 books, has been internationally acclaimed as " one of the most

important writers in present-day psychiatry. " He writes:

 

Using a poll surveying the nation's health, Parade magazine concluded

that depression is " the third most common `disease.' " Yet when the

respondents were asked, " What is your greatest personal health concern

for the future? " they did not even mention depression. They were

concerned about cancer and heart disease. Even though people have

accepted the categorization of depression as a disease, they are not

afraid of getting depression because they intuitively recognize that

it is a personal problem, not a disease. They are afraid of getting

cancer and heart disease because they know these are diseases—true

medical problems—not just names. Allen J. Frances, professor of

psychiatry at Duke University Medical Center and Chair of the DSM-IV

Task Force, writes: " DSM-IV is a manual of mental disorders, but it is

by no means clear just what is a mental disorder.... There could

arguably not be a worse term than mental disorder to describe the

conditions classified in DSM-IV. " Why, then, does the APA continue to

use this term? The primary function and goal of the DSMs is to lend

credibility to the claim that certain behaviors, or more correctly,

misbehaviors, are mental disorders and that such disorders are,

therefore, medical diseases. Thus, pathological gambling enjoys the

same status as myocardial infarction (blood clot in heart artery). In

effect, the APA maintains that betting is something the patient cannot

control; and that, generally, all psychiatric " symptoms " or

" disorders " are outside the patient's control. I reject that claim as

patently false. The ostensible validity of the DSM is reinforced by

psychiatry's claim that mental illnesses are brain diseases—a claim

supposedly based on recent discoveries in neuroscience, made possible

by imaging techniques for diagnosis and pharmacological agents for

treatment. This is not true. There are no objective diagnostic tests

to confirm or disconfirm the diagnosis of depression; the diagnosis

can and must be made solely on the basis of the patient's appearance

and behavior and the reports of others about his behavior. There is no

blood or other biological test to ascertain the presence or absence of

a mental illness, as there is for most bodily diseases. If such a test

were developed (for what, theretofore, had been considered a

psychiatric illness), then the condition would cease to be a mental

illness and would be classified, instead, as a symptom of a bodily

disease. If schizophrenia, for example, turns out to have a

biochemical cause and cure, schizophrenia would no longer be one of

the diseases for which a person would be involuntarily committed. In

fact, it would then be treated by neurologists, and psychiatrists then

have no more to do with it than they do with Glioblastoma [malignant

tumor], Parkinsonism, and other diseases of the brain.

 

Pharmacracy, (Praeger Publishers, Westport, CT 2001)