An Important New Psychiatric Diagnosis
Yet politically incorrect for not conforming to “biological psychiatry”
Norman Jay Gersabeck, M.D.
There is an important (but unofficial) new diagnosis of “Substance Dependency-Induced Psychosis” (SDIP), which is currently usually diagnosed as schizophrenia. It would have been established many years ago if it weren’t for its being (unscientifically) regarded as “politically incorrect,” by the worldwide psychiatric establishment (PE).
The PE has totally bought into “biological theorizing.” The result of this is that those ideas or findings, that don’t fit well with its “scientific-appearing world view,” are automatically dismissed as being simply “unscientific and incorrect.”
The essence of political incorrectness regarding the PE is that of any clashing with the reductionist or “biological psychiatric theorizing.” There is probably no better example than the SDIP diagnosis threatening the “biological integrity” of the diagnosis of schizophrenia.
There are likely almost as many SDIP cases as those of schizophrenia. The high degree of association between the diagnoses of schizophrenia and substance dependency is well known. Despite the almost universal prior existence of the dependency in these cases any causal relationship here has been (conveniently) dismissed as both being due to “common genetic factors.” Abstinence from addictive substances is necessary, but not by itself sufficient, for improvement or recovery from a SDIP.
Persons with SDIP are usually less ill than those with schizophrenia. One obvious advantage of making the diagnosis is that one third of SDIP patients have responded to an additional individualized substance dependency treatment with a complete and usually permanent remission of all psychotic signs and symptoms. General awareness of the SDIP diagnosis would add to the motivation for continued recovery for substance-dependent persons. This is because such a return to substance use can increase the risk of a SDIP beyond that of having simply continued in the practice of the dependency.
One NIMH (National Institute of Mental Health) agency has actively supported the diagnosis, but others have refused to even discuss it. Two medical schools have backed off of serious initial interest in doing the needed research on the diagnosis—obviously because of the great negativity of its politically incorrect label.
I was able to recently learn that the University of Melbourne’s program, named EPPIC (Early Psychosis Prevention Intervention Center), covertly treats cases of SDIP for young persons only. The SDIP diagnosis is withheld from these patients. Understandably, the university is not carrying out a much needed clinical trial for the diagnosis. Dr. Alan Hobson, a Harvard psychiatrist, has recently written the valuable book: Out Of Its Mind: Psychiatry in Crisis and has given his support for further research on the SDIP diagnosis. So also has Robert Whitaker, author of the excellent, but shocking, recent book: Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill. Additional material on the diagnosis is available at http://home.wideopenwest.com/~ngersabeck/index2.html
Norman Jay Gersabeck, MD, is a temporarily retired psychiatrist driven to assist in the design and operation of a formal clinical trial for the SDIP diagnosis. He was the psychiatric consultant for Brighton Hospital in the early 70s. It was then the leading hospital for the treatment of substance dependency in the state of Michigan. He would likely never have started his quest for the SDIP diagnosis if it weren’t for his four years at a community mental health center in Wilmar, MN in the early 90s. It was located close to a state hospital where there were plenty of cases of SDIP to treat.