Talk:Mental illness

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I'd have to be crazy to tackle a subject like this. --Ed Poor 15:52, 21 April 2007 (EDT)

Basis

Cut from article:

Psychiatric and psychological professionals draw a distinction between a mental disorder and a mental disease. While both are considered illnesses that are diagnosable and treatable, a disease is recognized as having an organic basis, while a disorder does not have a biologically underpinning. This broad distinction can be seen, for example, between schizophrenia -- recognized as having a biological basis, and a phobia which is considered an emotional disorder.

The question of organic vs. emotional basis is a crucial one, and also fraught with difficulty. What about depression? How about rational-emotive therapy vs. drug therapy?

I'm not saying you're wrong, Rob. I'm just asking for some back-up before we "go live" with the "facts". --Ed Poor 13:51, 30 April 2007 (EDT)

  • What makes a medical disorder mental rather than (exclusively) somatic or physical? Psychiatry to some extent depends for its existence as a medical specialty on the distinction between mental and somatic disorders, yet the history of this distinction presents a bewildering array of puzzling judgments, radical shifts, and seemingly arbitrary distinctions. The historical observation that putative mental disorders are often reclassified as physical disorders as soon as their physiologic basis is understood further confuses matters. Moreover, recent debates about such classifications often seem to reflect desires to protect professional turf or obtain optimal reimbursement for treatment more than they do the application of a coherent conceptual distinction. [1]
    • It turns out homosexuality was not eliminted by the APA as a mental illness in 1973, it was downgraded to "sexual orientation disturbance". [1]
  1. Mayes, R. & Horwitz, AV. (2005) DSM-III and the revolution in the classification of mental illness. J Hist Behav Sci 41(3):249-67.

There are problems here with international classifications. A disease in China or Japan, for instance, may only be regarded as a disorder in the US by the APA. It may help to put parameters on the discussion from the outset. Bascially, what is commonly refered to as "mental illness" has three classifications,

  • mental disease
  • mental disorder
  • mental disturbance

Depression is a good example. While it had been considered a disorder, since the mid 80s it is now considered organically based (bipolar). Some say this is part of the pharmacuetical industry conspiracy to bilk the public & government with high priced prescription meds, the psychiatrists are basically being paid off to write prescriptions for the rest of the patients life vs the old days where two years of therapy was considered enough. But that's a whole different debate. RobS 14:22, 30 April 2007 (EDT)

Basically anything that's listed in the DSM would be thought of as having some biological basis, in the sense that some people's biology makes them more vulnerable to certain mental health issues. Whether that vulnerability ultimately gets expressed is probably a matter of experience. For example, research shows that disorders like schizophrenia and depression are inherited biologically to an extent, but so are traits like impulsivity. Murray 14:45, 30 April 2007 (EDT)
I think it's safe to say that there's a lot of debate on that issue in the professional circles. --AKjeldsen 14:47, 30 April 2007 (EDT)
Depends on what you mean by professional circles, I suppose. The research is pretty clear, and while there isn't universal agreement, in my experience the vast majority of psychologists who do research would agree. However, as is true for many issues in the field, those who are strictly clinicians don't always agree. Murray 14:57, 30 April 2007 (EDT)

Please note that in the UK there is no legal definition of "insanity". Section 1 of the MHA 1983:

"1.-(1) The provisions of this Act shall have effect with respect to the reception, care and treatment of mentally disordered patients, the management of their property and other related matters.
(2) In this Act-
"mental disorder" means mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind and "mentally disordered" shall be construed accordingly;"
Nowhere in the MHA 1983 is the term "insane" or "insanity" used. However, the term *is* used in the Insanity (Fitness to Plead) Act, which is *significantly* older than the MHA 1983, but, once again, that Act doesn't describe what "insanity" or "insane" mean. The Insanity (Fitness to Plead) Act relates soley to the ability of the individual's capacity to understand the legal process and to instruct solicitors on their own behalf - it lays no charge with mental health professionals to diagnose, prove or disprove any form of mental disorder. And yes, I am a mental health nurse, and yes, I do know what I'm talking about. Spica 19:14, 5 May 2007 (EDT)
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