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There is no schizophrenia? Distinguished psychiatrist questions diagnosis
Jim van Os, psychiatry professor in Utrecht, questions whether schizophrenia, as it is in psychiatric textbooks, even exists.
No split personality
According to van Os, the idea of schizophrenia as a divided personality in the sense of Dr. Jekyll and Mr. Hyde. Today, the disease still has this meaning in the general language, but not in science.
Schizophrenia is considered a chronic disorder of the brain. The psychiatrist van Os does not believe this to be tenable. According to him, diagnosis is not an independent disease. (Image: psdesign1 / fotolia.com) Scientific definition
Scientific psychiatry regards schizophrenia as a chronic brain disease. Symptoms are hallucinations and delusions, as well as disorganized thinking and loss of motivation.
Destructive diagnosis
Van Os says, "Schizophrenia is a devastating diagnosis that can lead to a" burned schizophrenic, "a patient who has no hope and gives himself up."
psychosis susceptibility
Van Os, however, calls these symptoms susceptibility to psychosis. He says, "Genetic and epidemiological research has identified hundreds, even thousands, of risk genes. The more someone has it, the greater the risk of the disorder. The decisive factor is often traumatic experiences or setbacks in life. But even something like immigration to another country can play a role. "
need for help
The crucial question in a psychosis is: "Does someone have a need for help? Is he or she no longer able to get out of mental health problems? Can the person still work and maintain relationships with others? "
Everyone is vulnerable
About 15% of all adolescents and young adults would at least hear voices or suffer from paranoia. In 80% of them these symptoms would disappear.
Few can not do it alone
We assume that in about 3.5% of people, the problems become so strong at least once in a lifetime that a need for help arises.
giving meaning
Van Os says, "Someone has to find new goals, reinvent themselves, write a new story of themselves. Your own strength is of central importance to this, how can he or she experience life as meaningful despite the susceptibility and limitations that may remain? That's what we call "meaning". "
Pastoral care instead of annihilation
For Van Os, the essential elements of healing mental problems are "connectedness, hope, optimism, identity as a person - not as a category of diagnosis - control over one's life, empowerment, and meaningfulness."
Chronic means forever
If someone diagnosed a chronic brain disease, suggest that it would never be better.
Only the extreme end
Schizophrenia sees van Os merely as an extreme susceptibility to psychosis.
No scientific basis
There is, according to van Os, no scientific basis for diagnosing a disease of its own "schizophrenia".
Do not break
Van Os says, "You must not break patients with such a bad diagnosis! Their point of view contradicts all evidences. "
Hope is justified
Hope is essential to healing, says Van Os: "Hope and optimism are justified. The way out of a psychosis can be very different, but even with a very severe form one can learn to live. "
Psychiatrist in Germany against the diagnosis schizophrenia
I've already asked psychiatrists at congresses whether we need to get rid of the diagnosis. Interestingly, the result in Europe, also in the Netherlands and in Germany, is 50:50. By contrast, 95% of them hold fast to this in the US.
A banal derivation not possible
According to van Os, brain research does not have the power to define mental problems: "Of course, the brain is necessary for our thinking, feeling and acting. But such a causal derivation for something like anxiety, sadness, or delusion, just as it does in paralysis in neurology, just does not work. "
Do not overpress the label
The psychiatrist advises: "Do not be hasty to put a label on a psychiatrist or a psychiatrist, but seek out contact with someone who has already gone through such problems and survived. There are also online networks for that. "
Tap into networks
Second and third is important: "Second, seek help from a mental health care network in your area that focuses on personal recovery and mental resilience. Third, involve your parents, family, and friends. You do not need to be ashamed or hide. "
Self-organizing
If you have medical help, you should do it as well as you can, says van Os.
psychotherapy
Psychotherapy can also help, especially in the third of patients where trauma is the cause of the problems.
Embrace the problem
Van Os advises: "Get to know your problem, do not crowd it out, hug it, accept it, ask yourself what you do with it. Take care that you do not fall into depression, that you do not lose your personal and social network. "
One in four suffers from mental disorder
Mental health care can treat around four to five percent of the population in most countries. However, around one quarter of the population suffers from a mental disorder each year. Above all, the problem at the moment is that medical service providers want to make a profit and that everything has to be measurable.
Minor disorders over-treated
Van Os says, "In practice, these services are picking out people with mild disabilities because their symptoms can be treated well. For such patients, we therefore have an over-treatment. "
Heavy disorders under treated
However, the severe cases remained under-treated. But they need help most urgently.
Public mental health care
The psychiatrist calls for a public mental health care for mild mental health problems.
Health model
Van Os wants to educate people better about mental health, to enable early prevention and to have more freedom for the serious cases.
Hard biology brings money
Van Os says, "The prestigious scientific journals reward biological research. These magazines have influence and influence brings money. You get influence mainly through hard biology. "
Industry wants to make money
The industry wants, according to Van Os, biological treatments, because it can earn money with it.
Patients want to die because of wrong treatment
Van Os says: "What we have to take very seriously is the number of suicides, especially in the Netherlands, especially among adolescents and young adults".
We need a new health care
Van Os says, "Much of science and the clinical world bypass the needs of patients and their families. We need new mental health care (...) We currently have a number of pilot studies in some neighborhoods with 20,000 people. "
In USA two different systems
There were two systems in the United States - biologically oriented academic psychiatry and a system of donations and volunteers to help people with problems.
Ten syndromes
Van Os calls the ten major groups of mental illness syndromes. However, these always include a personal diagnosis of the condition of the individual. (Dr. Utz Anhalt)