Saturday, December 28, 2013

Schizophrenia

You know how rare it is for me to link to an op-ed.  I thought well of this.  The part about short stays in hospitals for schizophrenics being driven by insurance companies is most, but not all of the reason.  It is my experience that many psychiatrists who specialise in acute cases rapidly get bored with a case once they have finished adjusting the medications and making sure there are not side effects which would require discontinuation.

Our Failed Approach To Schizophrenia.

6 comments:

james said...

When I think of hospital, I usually think of acute care. Are psychiatric hospitals also charged with long-term care which is less acute, or does some other institution (or none, per the op-ed) handle that? There doesn't seem to be anything like an outpatient mental clinic, at least around here--more like "call the doc to get an appointment to get your meds changed" plus some specialized therapy providers. And the suicide hotline people, I guess.

Assistant Village Idiot said...

My hospital, the state psychiatric institution, has a few people who are there long-term. Most of those are Not Guilty by Reason of Insanity and require court release, or are so chronically dangerous/helpless that they cannot be out. These number about 50 in a population of 1.4 million. The developmental and criminal justice sides have about another 50 in permanent lockup.

That leaves less than 100 beds for the acutely dangerous mentally ill. We have to turn those over pretty quickly. And it's horrible.

staffanspersonalityblog said...

I don't suppose you have any state-level prevalence data on this? I thought it would be interesting to compare with correlating personality traits, at least in states that are the most White; from what I've heard Black people get this diagnose too often.

Assistant Village Idiot said...

I don't have that data. Blacks are diagnosed with schizophrenia 3 times as often. There is an automatic pushback against that which says "oh, that can't be right. The diagnosers must be biased," followed by an anecdote or two about an obvious misdiagnosis of a black person. But it seems to be true nonetheless.

james said...

I wonder how they do the comparisons between countries with such widely varying mental health systems:
http://en.wikipedia.org/wiki/Epidemiology_of_schizophrenia

What is the shape of the current theories about cause: x% genetic, y% environment, z% infectious/trigger?

staffanspersonalityblog said...

It is odd because everytime you hear about someone who believes that reptilians secretely rule the world or something like that, its always a White person. And Openness seems to be a premorbid trait. Not that I have any data on it but the typical correlates like vegetarianism, spiritualism, tolerance of outgroups like for instance gay people, it all seems like White traits.