[maybelsyrup]

> but it is a biological disease

I want to be charitable because I think I know the point you're trying to make in your comment, and what I want to say is mostly to the side of that. But I think that this statement at best glosses over what's been a long, expensive, and heated (though sincere) scientific conversation about schizophrenia over the past century and change. It's one that not only includes a substantively fruitless search for any underlying pathophysiology, but a spirited conversation about the validity, reliability, and plain-English usefulness of the concept itself! Further, this conversation is far from the stomping grounds of cranks and scammers; it has taken place inside what you might call the most orthodox psychiatric and psychological institutions: the APA, the major high-impact journals, fancy universities etc etc.

So when an eminence like Robin Murray, knighthood and all, can go into Schizophrenia Bulletin (2017) and write something like ...

"I expect to see the end of the concept of schizophrenia soon. Already the evidence that it is a discrete entity rather than just the severe end of psychosis has been fatally undermined. Furthermore, the syndrome is already beginning to breakdown, for example, into those cases caused by copy number variations, drug abuse, social adversity, etc. Presumably this process will accelerate, and the term schizophrenia will be confined to history, like 'dropsy.'" [1]

... saying that we know it's a biological disease as part of broader claims about treatment effectiveness doesn't tell the whole story. (I encourage everyone to read Murray's reflections in the linked article, as it's a fascinating retrospective on an illustrious career in psychosis research and psychiatry.)

[1] https://academic.oup.com/schizophreniabulletin/article-abstr...

[sudoshred]

Excellent comment. A “symptom” of schizophrenia is thinking that one does not have schizophrenia. A “heads I win tails you lose” situation where the single doctor is solely and individually responsible for diagnostics and treatment, but not liable. Criminals are given more rights and protection from abuse, and the legal systems has known and documented failures. For those who are labeled mentally ill there have not been established effective safeguards to protect and support those who might speak out, and by definition of competency their perspectives are not valid. Those who are economically incentivized to argue in favor of a biological explanation can be expected to do so, despite no personal expertise in the matter, and regardless of reproducible evidence.

[throw18376]

i think we would agree a lot about the brutality and incompetence of the current system of psychiatric institutions.

however, the reality is, psychosis frequently prevents people from recognizing their own impairment. it's just true that this is very common, and maybe shouldn't be so surprising, since in many other cases (alcohol, drugs, dementia, brain injury) people also are prone to underestimate how impaired they are.

[slibhb]

As I read it, the parent comment is making a point about the classification of schizophrenia. It is not disputing that the condition (psychosis) is real, or claiming that people are frequently misdiagnosed with some form of psychosis.

[throw18376]

well, okay, then we can say that a lot of people diagnosed with schizophrenia now, even if the concept of schizophrenia is not viable, do have biological disease(s) that cause psychosis alongside what we now call the negative symptoms of schizophrenia. I'm fine with that claim.

it's very different than the common anti-psychiatry claim that the schizophrenia diagnosis is a social construction that gets applied to healthy people who violate social norms.