by Guest » Wed Mar 30, 2005 5:39 am
Mental Health: A Report of the Surgeon General (1999) is explicit about the absence of any findings of specific pathophysiology:
p. 44: "The diagnosis of mental disorders is often believed to be more difficult than diagnosis of somatic, or general medical, disorders, since there is no definitive lesion, laboratory test, or abnormality in brain tissue that can identify the illness."
p. 48: "It is not always easy to establish a threshold for a mental disorder, particularly in light of how common symptoms of mental distress are and the lack of objective, physical symptoms."
p. 49: "The precise causes (etiology) of mental disorders are not known."
p. 51: "All too frequently a biological change in the brain (a lesion) is purported to be the 'cause' of a mental disorder ... [but] The fact is that any simple association -- or correlation -- cannot and does not, by itself, mean causation."
p. 102: "Few lesions or physiologic abnormalities define the mental disorders, and for the most part their causes remain unknown."
In the third edition of Textbook of Clinical Psychiatry (1999), we find similar statements:
p. 43: "Although reliable criteria have been constructed for many psychiatric disorders, validation of the diagnostic categories as specific entities has not been established."
p. 51: Most of these [genetic studies] examine candidate genes in the serotonergic pathways, and have not found convincing evidence of an association."
In Andreasen and Black's (2001) Introductory Textbook of Psychiatry, we find, in the chapter on schizophrenia:
p. 23. "In the areas of pathophysiology and etiology, psychiatry has more uncharted territory than the rest of medicine...Much of the current investigative research in psychiatry is directed toward the goal of identifying the pathophysiology and etiology of major mental illnesses, but this goal has been achieved for only a few disorders (Alzheimer's disease, multi-infarct dementia, Huntington's disease, and substance-induced syndromes such as amphetamine-related psychosis or Wernicke-Korsakoff syndrome)."
p. 231: "In the absence of visible lesions and known pathogens, investigators have turned to the exploration of models that could explain the diversity of symptoms through a single cognitive mechanism."
p. 450: "Many candidate regions [of the brain] have been explored [for schizophrenia] but none have been confirmed."