Sunday, July 03, 2016

Denial of the functional nature of schizophrenia

An article in The Lancet Psychiatry accuses those who refuse to accept the evidence for schizophrenia being an organic condition as being in denial. It does at least admit that the evidence for organicity in schizophenia may be "questionable". But it then goes on to say, "We can no longer divide [mental] illness into organic and inorganic".

I don't think I've ever heard schizophrenia called 'inorganic' before. Rather, the difference is made between organic and functional psychosis. The idea of psychosis was originally a functional concept following Ernst von Feuchtersleben (eg. see previous post). The anatomoclinical method of understanding illness developed in the 19th century, and despite all the wishful speculation since, it has not established a physical basis for functional mental illness. As I said in my previous post, "more caution needs to be made about drawing any conclusions about biological abnormalities in schizophrenia".

The article is worried about the implications of seeing schizophrenia as functional (or, in its terms, non-organic). But functional illness is as much illness as organic illness. There's no need to deny the reality of functional mental illness by calling it organic.