Comments on: Adding Anosognosia to the DSM http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/ Author and Mental Health Advocate Wed, 08 Sep 2010 05:00:42 +0000 hourly 1 http://wordpress.org/?v=3.0 By: Kittens http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-681 Kittens Tue, 18 May 2010 14:30:44 +0000 http://www.peteearley.com/blog/?p=149#comment-681 I belief that We don’t have much time as the deadline for public comments is less that one month away. Please look at the two articles linked in the column to the right as they will likely be helpful to you . I belief that We don’t have much time as the deadline for public comments is less that one month away. Please look at the two articles linked in the column to the right as they will likely be helpful to you .

]]> By: Kittens http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-633 Kittens Tue, 18 May 2010 10:30:44 +0000 http://www.peteearley.com/blog/?p=149#comment-633 I belief that We don’t have much time as the deadline for public comments is less that one month away. Please look at the two articles linked in the column to the right as they will likely be helpful to you . I belief that We don’t have much time as the deadline for public comments is less that one month away. Please look at the two articles linked in the column to the right as they will likely be helpful to you .

]]> By: Rims http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-613 Rims Thu, 29 Apr 2010 08:30:16 +0000 http://www.peteearley.com/blog/?p=149#comment-613 Anosognosia is not good for all. Mike was ill. He was immediately labeled with Biopolar disorder. Anosognosia is not good for all. Mike was ill. He was immediately labeled with Biopolar disorder.

]]> By: D.A. Sanger http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-514 D.A. Sanger Mon, 01 Mar 2010 23:19:12 +0000 http://www.peteearley.com/blog/?p=149#comment-514 Diagnostic recognition of anosognosia in the DSM-5 will have many benefits to the mentally ill and those who love and care for them. In addition to the ones already mentioned: <br><br>(1) It will stimulate funding for more research into the condition. The big research NIH grants are skewed toward research on conditions already in the DSM (classic Catch-22). Since evidence is the best basis for accurate assessment and appropriate treatment, more research will promote better diagnosis and care.<br><br>(2) It will establish diagnostic standards for anosognosia. The DSM is far from a perfect reference work, and diagnosis of mental illness is notoriously imprecise. Nonetheless, research-based diagnostic standards will foster more accurate and consistent recognition of anosognosia regardless of where or by whom patients are being evaluated. <br><br>(3) It will result in co-recognition by the World Health Organization, publisher of the diagnostic bible used by most of the rest of the world. Co-recognition will improve the likelihood of accurate diagnosis and appropriate treatment of anosognosia in people with schizophrenia and bipolar not only in the US but worldwide. Diagnostic recognition of anosognosia in the DSM-5 will have many benefits to the mentally ill and those who love and care for them. In addition to the ones already mentioned:

(1) It will stimulate funding for more research into the condition. The big research NIH grants are skewed toward research on conditions already in the DSM (classic Catch-22). Since evidence is the best basis for accurate assessment and appropriate treatment, more research will promote better diagnosis and care.

(2) It will establish diagnostic standards for anosognosia. The DSM is far from a perfect reference work, and diagnosis of mental illness is notoriously imprecise. Nonetheless, research-based diagnostic standards will foster more accurate and consistent recognition of anosognosia regardless of where or by whom patients are being evaluated.

(3) It will result in co-recognition by the World Health Organization, publisher of the diagnostic bible used by most of the rest of the world. Co-recognition will improve the likelihood of accurate diagnosis and appropriate treatment of anosognosia in people with schizophrenia and bipolar not only in the US but worldwide.

]]> By: D.A. Sanger http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-513 D.A. Sanger Mon, 01 Mar 2010 23:14:56 +0000 http://www.peteearley.com/blog/?p=149#comment-513 I should have been more precise. Dr. Torrey has encouraged submitting comments to the APA during the public-comment period on conditions under consideration for DSM-5. I'm having trouble finding the precise page on which to submit comments. The comment box is generally on the page were the condition is listed, but I can't find anosognosia on the APA site. Can you help? I should have been more precise. Dr. Torrey has encouraged submitting comments to the APA during the public-comment period on conditions under consideration for DSM-5. I'm having trouble finding the precise page on which to submit comments. The comment box is generally on the page were the condition is listed, but I can't find anosognosia on the APA site. Can you help?

]]> By: bm5070 http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-512 bm5070 Mon, 01 Mar 2010 01:25:35 +0000 http://www.peteearley.com/blog/?p=149#comment-512 Does it matter whether we call it anosognosia or denial or whatever?<br><br>"A rose by any other name would smell as sweet"<br><br>If someone exhibits the symptoms should they be treated even if they refuse treatment? <br><br>What if they have the plague? Of course we would treat them, because, if not, there is a high risk that they would harm others.<br><br>This is the situation with the seriously mentally ill who refuse treatment. We do not need an attorney to define "harm". <br><br>Should we not treat them because they have "rights" - what a silly idea - should someone have the right to harm others? - of course not.<br><br>A qualified doctor should be legally free to assess "harm" and to treat, with sensible medical (not legal) checks and balances (multiple opinions or whatever is deemed sensible by the medical profession). Does it matter whether we call it anosognosia or denial or whatever?

“A rose by any other name would smell as sweet”

If someone exhibits the symptoms should they be treated even if they refuse treatment?

What if they have the plague? Of course we would treat them, because, if not, there is a high risk that they would harm others.

This is the situation with the seriously mentally ill who refuse treatment. We do not need an attorney to define “harm”.

Should we not treat them because they have “rights” – what a silly idea – should someone have the right to harm others? – of course not.

A qualified doctor should be legally free to assess “harm” and to treat, with sensible medical (not legal) checks and balances (multiple opinions or whatever is deemed sensible by the medical profession).

]]> By: jmc15 http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-511 jmc15 Sun, 28 Feb 2010 21:40:59 +0000 http://www.peteearley.com/blog/?p=149#comment-511 The reference to anosognosia is only found in the current manual, the DSM-IV-TR (the TR stands for Text Revision) version which was published in 2000. The following information is found on page 304: "A majority of individuals with Schizophrenia have poor insight regarding the fact that they have a psychotic illness. Evidence suggests that poor insight is a manifestation of the illness itself rather than a coping strategy. It may be comparable to the lack of awareness of neurological deficits seen in stroke, termed anosognosia. This symptom predisposes the individual to noncompliance with treatment and has been found to be predictive of higher relapse rates, increased number of involuntary hospital admissions, poorer psychosocial functioning, and a poorer course of illness." The reference to anosognosia is only found in the current manual, the DSM-IV-TR (the TR stands for Text Revision) version which was published in 2000. The following information is found on page 304: “A majority of individuals with Schizophrenia have poor insight regarding the fact that they have a psychotic illness. Evidence suggests that poor insight is a manifestation of the illness itself rather than a coping strategy. It may be comparable to the lack of awareness of neurological deficits seen in stroke, termed anosognosia. This symptom predisposes the individual to noncompliance with treatment and has been found to be predictive of higher relapse rates, increased number of involuntary hospital admissions, poorer psychosocial functioning, and a poorer course of illness.”

]]> By: Mark http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-510 Mark Sun, 28 Feb 2010 19:56:12 +0000 http://www.peteearley.com/blog/?p=149#comment-510 My sister lost her life because of anosognosia. She stopped taking her meds for schizophrenia a few years ago and deteriorated quickly. She did not believe she was sick and thought everyone around her were the sick ones. She was extremely delusional and it was incredibly frustrating and wore on the whole family. She froze to death on a concrete floor in the back of her fathers old house she broke into thinking it was still hers. Please read her story in our local paper that they did after her death. <a href="http://www.readingeagle.com/article.aspx?id=142135" rel="nofollow">www.readingeagle.com/article.aspx?id=142135</a>. My sister lost her life because of anosognosia. She stopped taking her meds for schizophrenia a few years ago and deteriorated quickly. She did not believe she was sick and thought everyone around her were the sick ones. She was extremely delusional and it was incredibly frustrating and wore on the whole family. She froze to death on a concrete floor in the back of her fathers old house she broke into thinking it was still hers. Please read her story in our local paper that they did after her death. http://www.readingeagle.com/article.aspx?id=142135.

]]> By: D.A. Sanger http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-509 D.A. Sanger Sun, 28 Feb 2010 19:51:27 +0000 http://www.peteearley.com/blog/?p=149#comment-509 Can you provide information about where on its site the American Psychiatric Association has listed anosognosia? It doesn't come up in a general search, and I can't find it under schizophrenia.<br><br>Thanks. Can you provide information about where on its site the American Psychiatric Association has listed anosognosia? It doesn't come up in a general search, and I can't find it under schizophrenia.

Thanks.

]]> By: jmc15 http://www.peteearley.com/blog/2010/02/25/changing-the-dsm-anosognosia/comment-page-1/#comment-506 jmc15 Fri, 26 Feb 2010 22:15:14 +0000 http://www.peteearley.com/blog/?p=149#comment-506 As stated in an article “About Poor Insight and Diagnosis,” by Dr. Xavier Amador, there have been many scientific research studies that prove that anosognosia does exist in individuals with severe mental illnesses such as schizophrenia and bi-polar disorder. Anosognosia was included in the DSM-IV-TR (Text Revision) edition based on scientific consensus, by “bringing together experts from around the United States and overseas to review the research and independently review the [proposed] text….” After a peer review and independent review by experts on the APA Task Force for the DSM-IV-TR, it was determined that “a majority of individuals with schizophrenia lacked insight into having a psychotic illness and that this problem was a manifestation of the illness itself rather than a coping strategy.”<br> <br>Additional scientific research studies are also listed on page 32 of Dr. Amador’s book “I Am Not Sick I Don’t Need Help!” Just to name a few of the sixteen studies sited: Morgan and David (review in Insight and Psychosis; 2nd Edition; Drake et al. Schizophrenia Research, 2003, Bucklet et al. Comprehensive Psychiatry, 2001; and Smith et al. Journal of Nervous and Mental Disease, 1999.<br><br>An excellent source of information on anosognosia can also be found on the Treatment Advocacy Center’s web site: <a href="http://www.treatmentadvocacycenter.org/index.php?option=com_content&task=view&id=469&Itemid=234" rel="nofollow">http://www.treatmentadvocacycenter.org/index.ph...</a> (this same information is also posted on NAMI National’s web site.) As stated in an article “About Poor Insight and Diagnosis,” by Dr. Xavier Amador, there have been many scientific research studies that prove that anosognosia does exist in individuals with severe mental illnesses such as schizophrenia and bi-polar disorder. Anosognosia was included in the DSM-IV-TR (Text Revision) edition based on scientific consensus, by “bringing together experts from around the United States and overseas to review the research and independently review the [proposed] text….” After a peer review and independent review by experts on the APA Task Force for the DSM-IV-TR, it was determined that “a majority of individuals with schizophrenia lacked insight into having a psychotic illness and that this problem was a manifestation of the illness itself rather than a coping strategy.”

Additional scientific research studies are also listed on page 32 of Dr. Amador’s book “I Am Not Sick I Don’t Need Help!” Just to name a few of the sixteen studies sited: Morgan and David (review in Insight and Psychosis; 2nd Edition; Drake et al. Schizophrenia Research, 2003, Bucklet et al. Comprehensive Psychiatry, 2001; and Smith et al. Journal of Nervous and Mental Disease, 1999.

An excellent source of information on anosognosia can also be found on the Treatment Advocacy Center’s web site: http://www.treatmentadvocacycenter.org/index.ph... (this same information is also posted on NAMI National’s web site.)

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