Psychiatry: Medical Fraud or Incompetence

 

Trauma (including abuse and neglect, both childhood and adult, physical, sexual and emotional) is, according to researchers, inexorably linked as a causal factor for 80-90% or more of all psychiatric diagnoses and treatments.  This is pretty widely accepted now but there are still those who hold that thereÕs such a thing as Òmental illness.Ó 

 

FACT: There are no biochemical markers, no biological tests, no hard evidence at all, to "prove" the existence of "mental illness." ÒProofÓ means to demonstrate a reliable association between a clearly specified pattern of observables and other reliably measurable event(s) that operate as antecedents. (This is same level of proof used for TB, cancer, diabetes, etc.)

 

So, how shall we account for the 10-20% of people who may exhibit unusual behaviors and thereÕs no apparent causal link to trauma?  Read on and discover how psychiatry has failed to perform honorably as physicians and should be dropped as a medical specialty.

 

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Psychiatrists often fail to regard behaviors as having a physiological basis.

 

Medical Problems Cause Psychiatric Symptoms by:

 

¥  Altering the structure and function of brain neurons;

¥  Altering the processes in learned pathways, which results in an inability to cope;

¥  Altering or distorting sensory input from external sensory pathways or centers;

¥  Altering internal sensory input, which results in distortions in body image and function;

¥  Disrupting the bodyÕs regulatory system.

 

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Some Psychiatric Symptoms Caused by Medical Illnesses

 

Psychosis with halluncinations and delusions can be caused by:

 

Hepatitis

Amphetamines and other

               Sympathomimetics

Porphyria

Alcohol withdrawal (paranoia also)

Von GierkeÕs Disease

Anticholinergic intoxication

Cerebral allergies

Hallucinogens (PCP, LSD, etc.)

Hypertension (seizures)

Temporal lobe epilepsy

Mixed sensory lobe seizures

PickÕs Disease

Medication toxicity (antabuse,

               cimetidine, Levadopa,

               anticonvulsants, etc.)

AddisonÕs Disease

Limbic seizures

Cerebral vasculitis (SLE)

SchilderÕs Disease

Hypothyroidism

Uremia (chronic)

Multiple sclerosis

Azotemia (chronic)

Neurosyphilis

Hypocalcemia

Encephalitis

Hypontremia

FanconiÕs Syndrome

Metal poisonings

HuntingtonÕs Disease

Vitamin A toxicity

Brain tumors

SimmondÕs Disease

Pernicious anemia

Electrolyte imbalances

Hypoparathyroidism

WilsonÕs Disease

Hyperthyroidism

Vitamin B-12 deficiency

Sensory deprivation

Hyperinsulinism

 

 

Excited states (mania and hypomania) can be caused by:

 

Amphetamines and other

               sympathomimetics

Alcohol (intoxication or

               withdrawal)

Hyperadrenalism

Hyperparathyroidism

Hyperthyroidism

KleinfelterÕs Syndrome

Psychosis section conditions,

               sometimes part of

               symptomology

Steroids or CushingÕs Disease

 

 

Depression can be caused by:

 

Alcoholism

SyndehamÕs Chorea

Carcinoid syndrome (small

               intestine cancer)

Malignancies, especially of the

               pancreas

Parkinsonism

Sedative/hypnotic abuse

Amphetamine and other

               sympathomimetics

Folic acid deficiency

Insecticide and gaseous

               poisonings

HartnupÕs Disease

Viral illnesses (mono, etc.)

Steroids and other medications

               (see Psychosis section, also

               anti-arrythmics,

               anti-hypertensives, oral

               contraceptives,

               anti-inflammatory medications,

               etc.)

Endocrinpathologies (thyroid,

               parathyroid, adrenal gland and

               pituitary diseases)

 

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Endocrine Disorders

Relationship to Psychiatric Symptoms

 

Disorder

% of endocrine patients with psychiatric symptoms

Symptoms

Thyroid

 

 

hyperthyroid

as high as 50%

agitation, depression, schizoid paranoia, hallucinations

hypothyroid (myxedema madness)

as high as 20%

mania, schizoid paranoia, catatonia, depression

Adrenals

90%

some psychiatric disturbances

hyperadrenal-corticolism (CushingÕs Disease)

20 to 30%

depression, delerium, agitated paranoia, hallucinations, suicidal tendencies

hypoadrenalism

60 to 90%

hallucinations, paranoia, catatonia, bizarre posturing – all episodic

Pancreas

 

 

hyperglycemia (Diabetes Milletus)

not known

impotence, schizoid depression

hypoglycemia

not known

violence, unprovoked anger, confusion, amnesia

Pituitary

 

 

hypopituitarism (Simmonds Disease)

as high as 70%

anorexia, confusion, apathy, depression

 

Based on the work of R.C.W. Hall and T.P. Beresfors

 

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Behaviors and Conditions Associated with Occult Seizures

 

¥  Multiple personalities, especially when there is dissociation.

¥  Depression with withdrawal, psychomotor retardation, loss of interest, slowed thinking and/or fatigue.

¥  Automatic behavior, often with bizarre movements and agitation.

¥  Visual auras, with or without feelings of confusion, strange sensations in the head or other parts of the body.

¥  Hallucinations, especially auditory.

¥  Abdominal sensations, with an awareness of having illusions, and rigidity or adversive (away from the body) movements.

¥  Thoughts described as Òcloudy,Ó claims to have Òdifficulty thinking,Ó and use of expressions like Òthings are mixed up,Ó complaints of vague perceptual distortions.

¥  Episodes with fixed, staring gaze and unresponsiveness, even while continuing to perform tasks.  Usually canÕt remember what occurred during that period of time.

¥  Episodic bouts of violence.

¥  Inappropriate actions or gestures, unresponsive or irrelevant replies, aimless wandering around or dazed, vacant facial expression, often with amnesia.

¥  Hysterical dissociation, a confused state while still performing tasks, with amnesia often lasting hours, days or weeks.

¥  Regular episodes of schizophrenic behavior of short duration but sometimes severe enough to require hospitalization; between episodes, normal behavior resumes, although may appear more withdrawn than before episodes began.

¥  A history of schizophrenia and no response in medications.  Ambivalence along with a decrease in speech cohesiveness and organization.

¥  Episodes of schizophrenic behavior that always seem to start in the same way.

 

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Research Results

Percentage of Patients With Medical Problems Involved in Their Psychiatric Symptoms

 

Researcher                    %

Hall (1981)                     46%

Hall (1978                       9.1%*

Hoffman                          63%

Davies                               4.1%

Koranyi (1979)             37%

Koranyi (1972)             51%

Marshal                            22%

Summers                          17.7%*

Pokorny                           30%****

Salter                                 30%**

Herridge                           26%

Bunce                                52%

Robbins                            33%***

Weingarten                     51%

Johnson                            12%*

LaBuzza                           5%*

 

*            The percentage with medical problems as the sole identified cause of their psychiatric symptoms.

**          The percentage of people with hysteria caused by their medical problems.

***       The percentage with dementia caused by medical problems.

****    The percentage with neurological abnormalities causing psychiatric symptoms.

 

All other studies in the above chart show the percentage of patients with medical problems that causes or greatly exacerbated their psychiatric symptoms.

 

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Characteristics of the High Risk Group for Medical Problems Involved in Psychiatric Symptoms

 

¥  First psychotic episode

¥  Onset of psychotic symptoms at middle age

¥  Abrupt onset or episodic course of symptoms

¥  Absence of severe psychological distress

¥  Thought disorder or hallucinations

¥  Current use of street drugs

¥  History of alcohol or drug abuse

¥  History of impaired organic brain functioning

¥  Family history of an inheritable brain or metabolic disease

¥  Poor response to psychiatric medications

 

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If psychiatrists practiced real medicine, theyÕd identify the actual causes of unusual behavior in a person.  TheyÕd perform the following tests to find out whatÕs going on.  Instead, they diagnose and label behaviors in a most unscientific manner.  They then prescribe psychiatric drugs to quell the labeled behavior.  This is malpractice akin to prescribing pain killers for a broken limb in the emergency room and then sending the person home.

 

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General Medical Screen for Problems That Can Cause Psychiatric Symptoms

 

CBC (Complete blood count), with differential

SMA 26 (26 blood chemistries and electrolytes)

T3 and T4

Serum folate level

Serum Vitamin B-12 level

Urinalysis

 

These lab values may provide markers for the following conditions/diseases:

 

Anemia

Diabetes Milletus

Folic acid deficiency

Hepatitis

Hypoglycemia

Parathyroid adenoma

Pernicious anemia

PickÕs Disease

Some renal and hepatic disorders

Thyroid dysfunction

WilsonÕs Disease

 

These tests should be supplemented by a careful medical history and a physical exam.  The exam should include a thorough neurological evaluation.  EEG and CAT scan studies may be required if the above screen and neurological exam reveal no disease or abnormal conditions.

 

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Recommended Review of Systems by Medical History

 

Nervous system

 

General

 

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Recommended Review of Systems by Physical Exam

 

Ears, eyes, nose and throat

 

Neurological

                              Recent memory

                              Calculations

                              Repeat digits (backward/forward)

                              Abstractions

                              General knowledge

                              Current events

 

The remainder of the exam is a routine physical.

 

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The Most Common Disease/Conditions Detected by Laboratory Studies (plus medical history and physical exam)

 

AddisonÕs Disease

Cardiac problems

CushingÕs Disease

Diabetes Mellitus

Hypertension

Hypoglycemia

Malnutrition

Metal Poisoning

Porphyria

Post-concussive syndrome

Seizures

WilsonÕs Disease

 

Some of the above diseases/conditions require further testing to rule out their presence.  The initial screen and exam are designed to point toward more specific diagnostic testing.

 

NOTES

 

Physical findings and history, along with lab testing, point to the possibility of the following frequently occurring conditions/diseases.

 

AddisonÕs Disease:  Increase in skin and mucous membrane pigmentation, especially overexposed areas, scars and in skin creases; orthostatic hypotension; usual onset during middle age; gastrointestinal symptoms, such as diarrhea and vomiting; weakness and, to varying degrees, hyponaturemia; hyperkalemia; azotemia; weight loss.

 

CushingÕs Disease:  Truncal obesity with painful upper torso fat pads; facial mooning; muscle wasting in extremities; abdominal distension; easy bruising; hypertension; amenorrhea; impaired sexual functioning; unusual hair growth and purple markings on the body; diabetes; emotional instability; agitated depression; sleeplessness.

 

Diabetes Mellitus:  High incidence of infective lesions that appear on the extremities and heal slowly; frequent urination and unusual thirst; numbness or tingling in extremities; visual impairment; obesity or weight loss; increased appetite.

 

Hypoglycemia:  Weakness; drowsiness; faintness; sweating; mental confusion; episodes of the symptoms listed under seizures; tremors; hallucinations; hypertension; anxiety.  Symptoms are usually most severe in the morning before breakfast and after vigorous exercise.

 

Porphyria:  Dermatitis on skin areas exposed to sunlight; history of dark, red urine; history of unexplained seizures; peripheral nerve palsies; diffuse chest and abdominal pain; anemia with an enlarged spleen; malar flush with a butterfly pattern on the face.  Disease symptoms may appear intermittently.

 

Seizures:  Headaches, especially ones that throb; dizziness; Òblacking outÓ; history of trauma, encephalitis, and/or meningitis; previous history of having taken anticonvulsants; episodes of explosive behavior; auditory and visual hallucinations; episodes of amnesia; multiple personalities, especially when the personalities do not know each other.

 

WilsonÕs Disease:  Flaccid muscles; abnormal posturing; tremors; fixed facial expression; flapping wrist tremors; joint discomfort; brown-green-yellow rings in the cornea of the eyes; abnormal liver enzymes.

 

Not all of the above symptoms need to occur in any one diagnostic category for the condition to be present.  A cluster of symptoms is often significant.

 

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Not had enough yet?  ThereÕs more, lotÕs more!  First thereÕs just a list but then thereÕs a more comprehensive list with greater detail and descriptions.

 

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Medical Problems Related to Psychiatric Symptoms

 

The medical problems listed here are systemic or localized diseases that cause or exacerbate psychiatric symptoms.  Some are inherited, others acquired, and psychiatric symptoms may be among the first symptoms of disease.

 

I.            Specific system dysfunction

               A.          Central nervous system

                              1.           Encephalopathy, metabolic

                                             a.           Azotemia

                                             b.           Uremia

                                             c.           Carbon dioxide retention

                                             d.           Kernicterus

                                             e.           Chronic acidosis

                                             f.            Hypertensive crisis

                                             g.           Chronic obstructive lung disease

                                             h.           Hyponatremia

                                             i.            Hypoglycemia

                                             j.            FanconiÕs Syndrome

                                             k.           CoganÕs Syndrome

                              2.           Encephalopathy, chronic poisonings

                                             a.           Insecticides

                                             b.           Gaseous poisons, usually industrial

                                             c.           Metals

                                                            1)           arsenic

                                                            2)           antimony

                                                            3)           mercury

                                                            4)           bismuth

                                                            5)           lead

                                                            6)           nickel

                                                            7)           iron

                                                            8)           cadmium

                                                            9)           beryllium

                                                            10)        thallium

                                                            11)        manganese

                                                            12)        sodium

                                             d.           Non-metals

                                             e.           Volatile organic compounds

                                                            1)           carbon tetrachloride

                                                            2)           benzene

                                                            3)           camphor

                                                            4)           ethyl alcohol

                                             f.            Volatile inorganic compounds

                                             g.           Salicylates

                                             h.           Halogens

                                                            1)           bromine

                                                            2)           flourine

                                             i.            Hypervitaminosis (A, D, and K)

                              3.           Toxic psychosis

                                             a.           Carcinoid syndrome

                                             b.           Therapeutic drug intoxication or side-effects

                                             c.           Drug abuse intoxication

                              4.           Cerebral edema

                                             a.           Pseudotumor cerebi

                                             b.           ÒPump psychosisÓ

                              5.           Biochemical cerebral abnormalities

                                             a.           BriquetÕs Syndrome

                                             b.           Gilles de la Tourette Disease

                              6.           Chronic hypoxia

                              7.           KorsakoffÕs Syndrome (from alcoholism)

                              8.           Syphilitic paresis

                              9.           Klippelfiel Syndrome – cerebral anomaly

                              10.        Partial deafness and/or blindness

               B.          Endocrine system

                              1.           Pituitary, ÒMaster GlandÓ

                                             a.           Diabetes Insipidus

                                             b.           Hyperpituitarism (anterior and posterior)

                                   &