Talk:Psychiatry/Archive 2

message: Recent LA Times article by a psychiatrist covering several   criticisms of modern psychiatry.  Francesca Allan of MindFreedomBC 02:30, 3 January 2006 (UTC)
thread_title:  savodnik's article 

message: Francesca, stop deleting the reference to lab tests.  They are frequently used in the diagnosis of psychiatric disoders, the most frequent example is TSH levels to ensure that the patient isn't suffering from a disbalance of thyroid hormone which can cause depression or anxiety.  As for brain imaging, a CT scan in any first episode psychosis or new onset dementia is routine. djheart 05:16, 3 January 2006 (UTC)
replies: text: It's the wording, djheart.  The way it was worded suggested that mental illness could be diagnosed via lab test and that's patently false.  Ruling out thyroid dysfunction is a good idea but that's not diagnosing mental illness.  I don't know where in the world you are, djheart, but I can tell you that CT scans are the exception, not the norm, in psychiatric practice around here.  Furthermore, when they are used, they can't diagnose mental illness either.   Francesca Allan of MindFreedomBC 17:26, 3 January 2006 (UTC)
replies: text: Lab tests and CT scans are used in what is called the differential diagnosis in medicine including psychiatry.  Non-psychiatric medical conditions must be differentiated by purely psychiatric causes of the presenting symptoms.  For example, you cannot diagnose someone with Major Depressive Disorder without doing a TSH test, which is sometimes forgotten by the family and emergency docs who refer patients to psychiatry (also the test takes 48-72 h to give back results so patients are often under the care of psychiatry before the results are in).   As for the CT scans, ironically I  live in the same country as you Francesca, and I can tell you that in Ontario CT scans for a first episode psychosis or a new onset dementia are indeed routine and a standard of care.   djheart 21:33, 3 January 2006 (UTC)

text:  Just read some of the 'clarifications' that were made to the lab tests section.  Lab tests and medical imaging are useful to differentiate psychiatric illnesses from a long list of non-psychiatric conditions inluding: increased and decreased levels of cortisol, primary brain tumours, metastases to the brain from other cancers, epilepsy, drug intoxication, hepatic encephalophathy, stroke, normotensive hydrocephaly etc. etc. djheart 21:42, 3 January 2006 (UTC)

text:  In all areas of medicine ruling out is as important as ruling in when trying to diagnosis a patient.  For example, if a 50 year old man comes in when a painful, red and swollen leg it is important to rule out a deep vein thrombosis with a doppler ultrasound.  If that test is negative and the history is consistent than it will be treated as infectious cellulitis even though there is no lab or imaging test that can directly confirm the diagnosis.  Psychiatry may be presently lacking in 'ruling in' diagnostic tests but this does not change the fact that lab tests and imaging are crucial aspects of the diagnosis of psychiatric signs and symptoms and that too should be reflected in the article. The present wording I think is satisfactory in not misleading readers in either direction...  djheart 18:14, 4 January 2006 (UTC)
thread_title:  Lab tests in Psychiatry 

message: has littered the "pratice of psychiatry" section with several uses of the word "controversial". It is rather easy to label things such, but evidence is lacking. Also, this controversy is really just confined to the political opponents of psychiatry, and should be dealt with in the relevant section and not in the section that explains the practice of psychiatry as perceived by the field itself. I've allowed the exception of ECT, although I still think it is not correct to label it "controversial" just because Breggin and his lot make such a fuss. JFW | T@lk 17:41, 3 January 2006 (UTC)
replies: text: You'd have to have your eyes closed to believe that evidence is lacking for the controversy over psychiatry. You've "allowed" an exception.  How gracious of you. Francesca Allan of MindFreedomBC 18:13, 3 January 2006 (UTC)

text: Perhaps you could explain how my skepticism about psychiatry (which is based on years of psychiatric assault) could be considered an "outside attack."  Even better, please enlighten me as to what my political motivations are.  I agree with you that all of medicine encounters controversy.  However, psychiatry is in a class by itself when it comes to disregarding patients' views, blundering along without recourse to science and throwing civil liberties out the window.  Francesca Allan of MindFreedomBC 20:16, 3 January 2006 (UTC)

text: If you had just wanted to rearrange Cronian's contribution, fine, but that's never good enough.  You take every opportunity to belittle people's very valid criticism of psychiatry.  Psychiatry is a joke, more religion than medicine.  If mental illnesses were actual illnesses, they'd be treated by actual doctors such as neurologists.  I wonder if you will ever acknowledge all the lives destroyed.  There's something horribly sadistic about psychiatry.  I wonder if people become psychiatrists because of some deep-rooted insecurity that makes having authority over the defenceless seem attractive.  Francesca Allan of MindFreedomBC 20:24, 3 January 2006 (UTC)

text: You make several good points here.  I would just like to say that it's not just my own mistreatment that I am objecting to.  I really do think psychiatry causes more harm than good and that the field should be dismantled.  If I have disrupted the "flow" of articles, I believe that's probably a good thing because the overwhelming majority here seem wilfully blind to the harm that psychiatry causes.  Wiki-burnout is a good description.  I'm done here.  Francesca Allan of MindFreedomBC 17:08, 4 January 2006 (UTC)
thread_title:  "Controversial" 

message: The following paragraph:
"Another concern regarding the practice of psychiatry centers on the issue of involuntary treatment. Such concerns center on issues of civil liberties and personal freedoms. In the US there are many restrictions in place to attempt to maximize the desires of the patient with the need for treatment. Most states allow involuntary treatment only in the most severe cases where a person poses an immediate threat to themselves or others or if they are unable to provide for themselves basic needs such as food, clothing, or shelter (see Laura's Law). Furthermore, children are allowed to be placed into an institution at the will of their parents or legal guardians. "
was removed by User:FETuriousness with the comment Got rid of obvious bias. I wrote this paragraph in response to previous claims of bias (by both sides). While the language may not be perfect, the facts are all correct. If FETuriousness would care to elaborate here before making sweeping changes, or if they would care to fix what they percieve as bias, that would be a more appropriate course of action. Semiconscious • talk 07:46, 7 February 2006 (UTC)
thread_title: Claimed bias removal