The unfortunate influence of psychiatry on medical diagnosisHOW MUCH have physicians been influenced by psychiatric explanations for disease origins? In 1966, it was reported that general practitioners in London were asked what case proportion of 14 conditions was caused by psychogenic(1) factors. They chose either "all cases," "most cases," "some cases," or "no cases," and their responses were weighted and scored. As the chart shows, not one of the 14 conditions was thought in every case to always have a biological cause. Those at the top of the chart were rated as being psychogenic in almost every instance. By the end of the 20th Century it was generally accepted that not a single one of these conditions was psychogenic (and, of course, "liability to accidents" never was a medical condition). Psychiatric explanations for their causes had been thoroughly discredited. But by that time other conditions had replaced those 14, such as irritable bowel syndrome, colitis, allergies, and headaches.
Source: Psychiatric Illness in General Practice, Shepherd, A person who had one of the 13 medical conditions would have been misdiagnosed and mistreated if he was said to have a psychogenic disorder. Research into the genuine causes of the 13 diseases may have been retarded by acceptance of psychiatric explanations for their causation. It took almost 30 years after this survey for doctors to widely accept that most peptic ulcers were caused by a bacterium, and even after the bacterial cause was established many physicians were not properly treating it with curative antibiotics. In decades prior to this survey, many diseases were misdiagnosed as psychogenic, often with dire consequences for persons so diagnosed. For instance, prevailing medical opinion prior to the 1960s held that epilepsy was evidence of pathological criminality. Epileptics were isolated in "colonies," and many of them were involuntarily sterilized.(2) Given that psychiatric diagnoses are increasingly popular in Western countries, it is reasonable to ask whether physicians are repeating the diagnostic errors reflected in this survey. Are physicians continuing to ignore genuine physical causes of illnesses, assuming they are psychogenic? It is undeniably the case that the some diseases are idiopathic(3). Instead of admitting "the cause is unknown," why do physicians habitually claim that idiopathic diseases are psychogenic? Why is there the need to fabricate a mythical explanation where no scientific one yet exists? It seems inconceivable, almost laughable, that many of the 13 diseases could have been considered psychiatric disorders, yet they were, both in England and the United States. Is the repeated diagnosis of physical diseases as psychiatric disorders a form of quackery that will continue to negatively impact medical care? 1. A "psychogenic" illness is defined as one that is mental or emotional rather than physiological in origin. 2. The Epilepsy Foundation of America mentions nothing on its website about the appalling abuses suffered by epileptics. Since the abuses were primarily inflicted by physicians, perhaps the foundation considers discussion of the issue to be in bad taste, possibly causing a loss of support, grants, and donations. Or perhaps the foundation is controlled by physicians who wish the suppress the history of epilepsy. 3. An "idiopathic" disease is one whose cause is unknown. Cerebral arteriosclerosis. Psychiatric quackery, 1948 The following quotes are taken from the book, Synopsis of Psychosomatic Diagnosis and Treatment, published in 1948. It reveals the extent to which psychiatry has historically accepted and promoted health quackery. It is no different today: a disease whose cause is unknown is reflexively assumed to by psychosomatic until the real cause is found. MANY ULCER patients show in their overt behavior aggressive, ambitious, and independent attitudes. They do not accept help and tend to burden themselves with all kinds of responsibility...Deeply hidden, however, is the person's unconscious longing for the sheltered existence of the little child...This constantly increasing repressed longing is the unconscious psychological factor directly connected with the organic processes which may lead to the ulceration of the stomach or favor the development of ulcer when other factors are brought into play. This explains in part the dramatic therapeutic success often reported as a result of rest cures, during which the patient is able to throw off responsibility and acquire, in a way that seems legitimate, the care and attention which he craves. THE PICTURE was more complex in the diabetic group, but the evidence NO DOUBT, further investigation will uncover other means by which Spreading breast cancer fear, 2002 Stressful life experiences and risk of relapse of breast cancer: observational cohort study American Iatrogenic Association |
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Why is it that doctors take it as axiomatic that when you've lost your health you've also lost your mind? > Dennis Potter, "The Singing Detective"
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