MAIN POST
Please refer to some of the readings and videos in this discussion as you share your thoughts.
What do you think about the DSM-5 description of the symptoms?
Any comparisons/contrasts between the treatment John Nash encountered and the Open Dialogue approach? Could the US implement and find success with an open dialogue approach with those who experience hallucinations and delusions?
Simply share your thoughts about all you have read and viewed. Remember to use references at least in your first post if not in other responses.
Stevens respond to the main post
Black (2014) recommends that diagnosis for such significant disorders are a slow, timely process because symptoms evolve gradually. Lesser symptoms should be ruled out prior to moving on to the more What appears to be one diagnosis today may likely manifest into something different in two years time. This is in part because of the complexity of the disease (Wilson, 2014).
In the DSM-V schizophrenia is characterized by delusions, hallucinations, diminished emotional expressions, deterioration in social, occupational, or interpersonal functioning, and having symptoms lasting for at least 6 months. Over the years the symptomology of schizophrenia would change, starting with Kraepelin (1919), Bleuler (1950), then Schneider (1959). Scheiders eventual descriptions, while informed by prior categorical symptomology, would largely inform both the DSM-III & IV (Black, 2014).
The symptoms of schizophrenia in the DSM-V are: delusions; hallucinations; disorganized speech; grossly disorganized or catatonic behavior; negative symptoms (diminished emotional expression or avolition)(DSM-V). One variant from previous versions is that the DSM-V requires there to be two-three symptoms from the list must be evident, and at least one must be delusions, hallucinations, or disorganized speech. This is a change from DSM-IV, where only one symptom was required (Black, 2014, pp. 74). When considering a diagnosis, the symptoms must be such that typical levels of achievement must be limited as a result of the symptoms.
The renowned mathematician John Nash was made famous not only by his Nobel Price, but by the movie A Beautiful Mind (2001). There are a number of differences between the treatment received by John Nash and the Open Dialogue therapeutic approach. At the time of Nashs diagnosis, the field was still learning to develop their understanding of schizophrenia (BBC, 2015). Nashs treatment included crowded institutions, confinement, insulin treatment, electro-shock therapy, and a range of medications that up to that point had been either discontinued or debilitating to daily functions (BBC, 2015).
Open Dialogue takes a different approach to treatment. Through recent years, Open Dialogue patients were typically able to return to school after 5 years (Fall, 2013). Medications were less commonly used overall, but even those that are the dosage is significantly lower than is typical. In Sweden only 20% ended up on disability, compared to 80% with typical treatment (Fall, 2013). The results are common for other countries using Open Dialogue as well. Open Dialogue brings in all of the actors related to the treatment and interaction of the suffering individual and gives a voice to everyone involved in the life of the patient. With this, all become part of the treatment of the person. This allows everyone to contribute to the solutions to the challenges of treating the individual.
REFRENCES
Black, D. W., & Grant, J. E. (2014). DSM-5 Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Vol. Fifth edition). [Washington, DC]: American Psychiatric Association Publishing. Retrieved from http://search.ebscohost.com.tcsedsystem.idm.oclc.org/login.aspx?direct=true&db=nlebk&AN=1610168&site=ehost-live
BBC – 2015 A Beautiful Mind- The Documentary of John Nash – video dailymotion. (n.d.). Retrieved February 1, 2020, from https://www.dailymotion.com/video/x5oi9x7
Craighead, E. W., Miklowitz, D. J., & Craighead, L. W. (2013). Psychopathology: History, diagnosis and empirical foundations (2nd ed.). Hoboken, NJ: Wiley.
Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, DC: American Psychiatric Association. (Saybrook University library: PsychiatryOnline database.)
Fall, W. (2013). Open Dialogue for Psychosis w/ Mary Olson | Madness Radio. Open Dialogue for Psychosis. Madness Radio. Retrieved from Open Dialogue for Psychosis w/ Mary Olson | Madness Radio
Longden, E. (2013). The voices in my head. Retrieved from https://www.ted.com/talks/eleanor_longden_the_voices_in_my_head
Wilson, J. (2014). Schizophrenia is actually 8 diseases, study says. Retrieved February 1, 2020, from https://www.cnn.com/2014/09/16/health/schizophrenia-eight-diseases/index.html
