What if AIDS had been labeled psychiatric?..

I found this a few days ago and thought I would share it here. It is a segment from Cytokines and Depression by Ronald S. Smith, who has written some facinating articles on the connection between the immune system and human feeling/behaviour and The immune model of mental illness.
(http://www.cytokines-and-depression.com/)


Mental Classification as a Barrier to Progress

The poor progress of mental illness research stands in glaring contrast to the swift progress in understanding the causes and methods to prevent and/or cure many physical diseases. The acquired immune deficiency syndrome (AIDS) is a good example to illustrate the rapid advances in understanding the causes of physical diseases. AIDS was first reported in the medical literature in 1981. It was given the name AIDS in 1982. By 1984 the infective agent causing AIDS was discovered ( i.e. HIV-human immunodificiency virus). In 1985 a successful blood test to detect HIV was developed, which made it possible to positively diagnose AIDS. These remarkable advances have made it possible to prevent AIDS. The proven methods for prevention (safe sex, sterile needles, carefully screened blood) when implemented have sharply reduced the rate of HIV infection and demonstrate that AIDS is a preventable disease. Pharmaceutical companies have developed treatments for AIDS and are working on vaccines to prevent AIDS. The treatments are becoming so effective that some researchers are talking about being able to cure AIDS in the not too distant future.

Why have advances in understanding causes and implementing methods for preventing and curing physical diseases been so rapid while progress is almost non existent in understanding the causes or devising methods to prevent or cure mental diseases? Of course no one knows the whole answer, but a good part of the answer may have to do with classifying diseases as mental. If, for example, AIDS had been classified as a mental disease (and it is very possible it could have been because psychiatric symptoms usually occur with AIDS), then researchers would have been looking for mental (i.e.. psychological, emotional) causes of AIDS. Stressful lifestyles, abusive parents, emotional stressors, intense psychological stresses and various psychosocial stressors would have been searched and researched and then embellished with statistical significance and sophisticated mind-body jargon. Statements like "studies have shown that emotional stressors along with intense psychological stresses have conspired in these patients to cause their minds to suppress their immune systems" could have become commonplace buzzwords. A great deal of research, speculative concepts and confusing debate would have been produced. Nothing medically useful for preventing or treating AIDS would have resulted. The only general consensus would have been that more money was needed for research.

Peptic ulcer is a textbook example of a disease with physical and emotional symptoms that was assumed to have a mental cause (i.e. emotional and psychological stress). Mental stressors were believed to be causing excess stomach acid secretion. The excess stomach acid was thought to be the cause of the ulcers. The standard treatment for many years was a life of reduced mental and emotional stress along with a bland diet and copious amounts of antacids. In the 1970's medicines were discovered (Zantac, Pepcid) which blocked the secretion of stomach acid (acid blockers). These medications are very effective treatments for peptic ulcers but they are not cures. Peptic ulcer patients were told they would be taking acid blockers for the rest of their lives.

In 1982, Dr. Barry Marshall discovered an important link between the bacteria Helicobacter pylori and peptic ulcers. He proposed that peptic ulcers were caused by Helicobacter pylori infecting the lining of the stomach rather than mental stress. His work was met with ridicule because everyone already 'knew' that ulcers were caused by worry, anger and mental stress. Furthermore, everyone 'knew' that bacteria could not grow in the lining of the stomach and if they could, they would have been discovered already. Thus, for another 10 years the medical establishment rejected the growing mountain of evidence on Helicobacter pylori as the cause ulcers. Finally, in 1994 the evidence became so massive and convincing that the medical establishment agreed with Dr. Marshall. Indeed, over 90% of all peptic ulcers are caused by Helicobacter pylori. Peptic ulcers are now being cured using antibiotics.

Peptic ulcer is a classic modern case of psychiatric dogma (i.e. diseases have mental causes) interfering with the discovery of the physical cause of a disease. Physicians, especially psychiatrists, were so sure that worry and mental stress caused ulcers that it was thought foolish and unnecessary to look for physical causes. Over 25 million Americans suffered with peptic ulcers, yet for nearly 50 years almost all the studies investigating the cause of peptic ulcers looked at mental factors. Except for research on the blockade of stomach acid, there were few if any studies on physical causes of ulcers. For half a century no one believed ulcers were caused by an infection, so no one looked for an infective agent. Thanks to the unorthodox work of Dr. Barry Marshall, we now know that the bacteria Helicobacter pylori is the cause of ulcers rather than worry or mental stress. Ulcers can now be cured with one intensive course of antibiotics instead of being treated for a lifetime with acid blockers, antacids, a bland diet and a variety of emotional, psychological and psychiatric treatments.

Compare the rapid progress on AIDS and peptic ulcer (after the dogma of mental cause was overcome) with the situation for a 'mental' disease like depression. After a century of research on depression, the basic cause or causes are unknown. In the face of legions of psychotherapists applying the results of a century of research, we actually have increased incidence of depression every year. Incidence rates for depression are ten times higher now than at the turn of the century and they keep going up. Many medical researchers characterize this as an ongoing and escalating epidemic of depression. Furthermore, depression strikes at younger ages than ever before. For example, childhood depression was almost unknown at the turn of the century, whereas now it is a common disorder. The highest rates of depression for females used to be after menopause, but depression now occurs in women most often between ages 18 and 44. Clearly, the billions of dollars spent on research and the vast number of papers, books, and theories published on depression have not led to anything remotely resembling useful methods for prevention or any understanding of the cause of depression. The high rates of recurrence of depression demonstrates that we don't have a cure for depression either.
(http://www.cytokines-and-depression.com/)



About the author:
Ronald Stephen Smith was the author of numerous biomedical papers on the immune→brain connection, cytokines, depression, schizophrenia, psychosocial disease and headache. He was Professor of Chemistry and Nutrition at Gavilan College for many years and was also a Research Chemist at Shell Development's Biological Sciences Research Center. For the last two decades of his life, he researched the biomedical literature on immunology, neuroscience, nutrition and cardiovascular disease while lecturing nationwide in continuing education seminars for health care professionals.