Posted by SLS on December 6, 2004, at 9:43:31
In reply to Re: Distinct Physiological entity, posted by ed_uk on December 6, 2004, at 8:52:50
Hi Ed.
> To me, it seems highly improbable that any diagnosis which is based on subjectively measured symptoms will ever be demonstrated to be a distinct physiological entity. Rather, a group of people who's symptoms are consistent with the same DSM diagnosis are likely to have numerous different pathologies- both biological and psychosocial in nature.
I respectfully disagree. I think whatever physiological heterogeneity there is within bipolar disorder, idiosycratic to the individual, is minor and due to the great plasticity of the human brain. There are enough phenotypic variables such that differential responses to medications for the same illness are inevitable. This is true of many other illnesses as well, including Parkinsons and Alzheimers, disorders with well known and identifiable physiological pathologies.
Clinical diagnosis of somatic illness very often relies upon signs and symptoms reported by the patient that are subjective and must be interpreted by the physician. There are so many idiopathic syndromes for which no etiology has been identified and few, if any physical tests exist. Medicine in these circumstances remains an art and relies on the subjective observations and clinical interpretations of the physician. Gulf War syndrome might be an example of this.
- Scott
poster:SLS
thread:422741
URL: http://www.dr-bob.org/babble/20041206/msgs/425199.html