Saturday, April 16, 2011
The Vexing Quest for Diagnosis
Scott has Down's syndrome, and a mental illness that manifested in the mid-80s. He was hospitalized in a catatonic state, helped at Lafayette Clinic (closed by Engler) and since been variously diagnosed with schizophrenia, depression, obsessive/compulsive disorder, and now Alzheimer's disease. The current psychiatrist told me he "treats all his Down's syndrome patients of his age for Alzheimer's." Okay. Being obsessive myself, I have struggled with getting a more thoughtful diagnosis. One mental health professional asked me "Why do you care? Dementia is dementia." We see commercials for medication Scott used to be on transform into medications for disorders that are being diagnosed more in the United States than anywhere else in the world. Significantly, the USA is the only country that allows direct advertising to consumers for prescription medications. "Ask your doctor." Abilify was a med Scott was taking for schizophrenia. Bristol-Myers Squibb's commercial now tells us to get Abilify as an add-on for bipolar and depression. I've written about Dr. Robert Spitzer who put the word disorder in the manual of psychiatry, thus inundating us with drug companies pushing diagnoses based on inventory of pharmaceuticals. Some have been prosecuted and fined for promoting off-label prescription sales. Our country has seen a 75% rise in diagnosis of bipolar affective disorder, with the highest increase in children, and women over 50. 0.8% of the population will be affected by bipolar I. Why do I know so many people personally who are being medicated for it? Found a pharmaceutical market analysis for US$million for bipolar disorder. Expect more diagnoses, more pharmaceuticals. Meanwhile, I'll still try to help Scott have the best quality of life he deserves. I wish for you and yours a successful journey, too.