Thursday, March 11, 2010
NHS Psychiatry: Ban Some Diagnosis.
Can we as psychiatrists hide behind some diagnosis and pretend that we have done everything “proper” even if the result is that the patient committed suicide. It is simply against everything that we as doctors were brought up to do: save lives.
Antipsychotic drugs can reduce the suspiciousness of cluster A personality disorders (paranoid, schizoid and schizotypal). They can also help with borderline personality disorder if people feel paranoid, or are hearing noises or voices.
Antidepressants can help with the mood and emotional difficulties of people with cluster B personality disorders. Some selective serotonin reuptake inhibitor antidepressants can also reduce anxiety in cluster C personality disorders.
Mood stabilisers such as lithium, carbamazepine, and sodium valproate may also reduce impulsiveness and aggression.
She did not know what was happening, but an NHS consultant psychiatrist believed he did. He told her she was suffering from borderline personality disorder, a diagnosis that angered her with its misleading implication that there was something wrong with her character and no hope of recovery. "I had not heard that term before but I was indignant. I was, in my view, distressed beyond anything I imagined it possible for a human being to be and remain alive. I replied firmly: "I beg your pardon, but speak for yourself." She feels passionately that we need to rethink the language we use to discuss mental illness.
Perhaps we really should ban some diagnosis in psychiatry. Perhaps then a few more lives would be saved.