People with psychosis are considered hopeless cases. And that’s baloney.”
I must admit, the baloney in the article, “Let’s Forget the Diagnosis of Schizophrenia,”1 caught my eye. So did the opening sentences: “Schizophrenia does not exist. Yes, you read that right.” The certainty of the authors, a group of six Dutch psychiatrists and researchers, reaches to their website named ‘schizophreniadoesnotexist.’ Quack medicine? Read on and decide for yourself.
You’ll find the article posted on an Australian mental health website by an organization that works with the Ministry of Health. The opening proclamation, shocking as it sounds, sets the tone to a hopeful outlook about psychosis and schizophrenia. Jim van Os, a professor of psychiatry in Holland who worked on the DSM-5, translated the findings into English. How did he and the other five authors reach their conclusions?
they begin by stating that over 15% of teens and young adults suffer from psychosis and most of them, 80%, recover naturally. A small percentage, 3.5%, needs help and with help they will bounce back. A fifth of that small group might have a serious life long struggle.
in their opinion, individuals diagnosed with schizophrenia actually have a psychosis sensitivity syndrome (PSS) along with other symptoms. They believe PSS is its own treatable condition no matter what other symptoms are present. It is treatable because it is not an organic disease of the brain. In their words, “The dominant view that psychosis is a manifestation of an underlying biomedical brain disease (schizophrenia) is scientifically incorrect.”1
they believe their revised understanding of psychosis will open the door to efficient treatment: the vital ingredient to treatment of PSS is psychotherapy. If there is a rush to medicate and only medicate, the psychotic condition goes untreated. The authors are not opposed to using antipsychotics but they are clear about the limitations: “An antipsychotic does not heal.”1
Why Do Hopeless Prognoses Exist?
Because of their research, the authors Aartjan Beekman, Wilma Boevink, Rutger Engels, Rutger Jan van der Gaag, Jim van Os, and Robert Vermeiren, are hopeful about recovery. In their original article, “Schizophrenia Does Not Exist”2 (translated by Davy de Geeter), they point to a main reason why many professionals have a hopeless view about the traditional diagnosis of schizophrenia.
Since the majority of people with psychosis heal naturally, as presented in their article, the patients who do reach out for treatment are those in the minority who have a severe struggle. As a result physicians don’t see the people who heal naturally. The authors write:
“It’s logical then that super specialists of academic hospitals think that ‘mild’ cases of schizophrenia don’t exist, simply because they never see these patients. This is known as the Berkson bias, a distortion in the perceived severity of diseases. This bias is also present in modern psychiatry (Maric et al., 2004, Regeer et al.,2009).”2
When swayed by the Berkson bias “the most negative prediction is in control of the image of the whole spectrum of a certain disease.” The dismal predictions prevent a hopeful outlook.
The authors also included an expanded definition of recovery, one they believe gives hope to every person diagnosed with schizophrenia or psychosis, no matter how stubborn the symptoms:
“From the recovery oriented movement, we know that when medical recovery isn’t possible, there is a possibility to change someone’s perspective on it. In such a way that people despite having their constant severe limitations, have a way to experience their life in a meaningful way. This is called personal recovery.”
In a medical recovery there is a reduction of symptoms and in a personal recovery there is the addition of an understanding and way of life that can lead to a meaningful experience.
Is This For Real?
These psychiatrists want to offer a more hopeful picture of a dire prognosis but are they being realistic about an illness long considered incurable? In the past few years the Hearing Voices Network has challenged the long-standing outlook about psychosis, and in psychiatry overall the old attitudes about schizophrenia are changing also.
According to Dr. Yedishtra Naidoo, writing for Psychiatric Times, “Schizophrenia is now viewed as a spectrum with multiple parts to be examined by researchers . . . a collection of different parts, each with its own etiology and treatment.” 3
If true, says Dr. Yedishtra, we will all have to be open to a set of remedies. Perhaps most are available now, though not easily pieced together in the chaos and expense of turbulent lives.
Where do viewpoints like Yedishtra’s and the five psychiatrists leave you in your search for a remedy? The views presented aren’t meant to muddy the waters of anyone’s struggle. Uncertainty unsettles us, yet in the case of a serious mental health diagnosis and the rush to prescribe powerful medications, uncertainty might be a benefit.
Make your medical uncertainty work for you. Include other options. Hopefully you can find a medical provider who will work with you. I think you have discovered by now you’re in a tough battle to find your set of remedies, recovery, or complete restoration. You are your own best advocate.
If you believe schizophrenia exists and someone else doesn’t, don’t get upset. The label exists for a set of symptoms that has eluded a definitive cure. The Dutch doctors think they have a key to unlock one symptom. May the insight and perseverance of compassionate health professionals like them reduce your fears and the fears of those around you. Hope exists.
1 “Let’s Forget the Diagnosis of Schizophrenia” by Aartjan Beekman, Wilma Boevink, Rutger Engels, Rutger Jan van der Gaag, Jim van Os, and Robert Vermeiren. Mental Health Carers Arafmi NSW Inc. online, March 7, 2015 http://www.arafmi.org/2015/03/dutch-experts-say-schizophrenia-does-not-exist-but-psychosis-does-and-is-very-treatable/
(Mental Health Carers Arafmi NSW Inc. is an organization in Australia which works with the Ministry of Health)
2 “Schizophrenia Does Not Exist,” by Aartjan Beekman, Wilma Boevink, Rutger Engels, Rutger Jan van der Gaag, Jim van Os, and Robert Vermeiren. Posted online June 8, 2015, https://kenyattayamel.wordpress.com/2015/06/08/does-schizophrenia-exist/
3 “Schizophrenic Disorders: Is There an Elephant?” by Yedishtra Naidoo, M.D., Psychiatric Times, June 01, 2015. http://www.psychiatrictimes.com/apa-2015-Schizophrenia/schizophrenic-disorders-there-elephant?GUID=4EDD48DC-EB6E-4A5B-A452-B31972C1220B&rememberme=1&ts=18062015