Posted by Jim on December 3, 2000, at 10:14:05
In reply to Re: negative symptoms, posted by JohnL on December 2, 2000, at 9:29:25
> Nice try Scott, but I don't buy it. :-)
>
> We'll have to agree to disagree.
>
> Have you read the book called "Dysthymia, the Spectrum of Chronic Depression", by Hagop Akiskal? Good book. Highly esteemed author. He makes the case for the opinions I have concerning 'diagnosis'. That is, different psychiatric conditions have considerable overlap; they are in constant evolving change; and they don't breed true from generation to generation. I read this book a few years ago and its influence still sticks. That's because I haven't seen realworld evidence to prove otherwise.
>
> Certainly I think an attempt at an accurate diagnosis is a crucial starting point for narrowing down initial drug choices. But after that, might as well toss a coin. Heck, I had four different diagnosis from four different pdocs. Who was right? Did any of them matter? I still think it's an exercise in futility. Better suited to the world of academic study than in the real world of suffering people. Just because some doctors do it everyday doesn't make it accurate, valid, or even useful. It's a starting point, that's all. If anything, I think it actually prolongs suffering instead. Someone diagnosed with anxiety as an example may go through years and years of SSRIs, benzodiazepines, eventually antipsychotics, with no success, yet may never consider Lithium. A diagnosis of anxiety does not warrant Lithium. But 22% of anxiety patients in one doctor's office found total cure with Lithium. So what good was an accurate diagnosis in the first place? And what about the majority of the population of this board? How has their supposed diagnosis helped them? Obviously not enough. Like I said, there are just too many gray areas. It's not as black and white as textbooks make it seem.
>
> JohnI guess (?) my point of targeting symptoms then rather looking for
a quick Dx is what I have found most valuable in
getting some effective relief. That is also part of
my belief that GP's should not be prescribing
psych meds, but also everyone has a right to
an affordable and good psych doc. I think all meds,
from benzos, antipsychotics can play a role in the
wide variety of conditions. But, the pdoc has to
be extremely knowledgeable and confident with every med.
Sadly, many aren't, and are often only 'comfortable'
with a small range of medications. We should not be used as
human test rats, but denying a good Rx can be just
as inhumane.
poster:Jim
thread:49706
URL: http://www.dr-bob.org/babble/20001130/msgs/49844.html