Do you think if the same experiment were to be repeated today; the results would be different?
The link mentions related experiments with similar results as recent as 2008.
Anyway, judging by "The Diagnostic and Statistical Manual of Mental Disorders", Fifth Edition (DSM-5) (2013) there has been no paradigm shift in the last 40 years.
> Do you think if the same experiment were to be repeated today; the results would be different?
Yes. Big institutions have closed. Smaller hospitals replaced them and most people get treated in the community.
For example: my county has a population of about 600,000 people. About 4,500 people are on the books of the local MH trust at any time. There are only about 150 inpatient beds at any time.
People only go into hospital if they are a danger to themselves or others - hearing a voice that says "empty" or "hollow" or "thud" is not something anyone would be hospitalised for.
To get a diagnosis of schizophrenia you have to match the symptoms over a six month period and be assessed by the same doctor during that time. one of the benefits of the DSM / ICD is that doctors now use a set of standards when diagnosing mental illness.
The paper suggests that this is only a problem with psychiatry. This is something you hear from lot of people. "No test exists to diagnose a psychiatric illness, thus psychiatry is a sham. Look, I can get diagnosed if I lie to doctors!" This ignores the fact that there are a bunch of physical-health diseases you can get diagnosed with if you lie to doctors, but we don't call those a sham. Your link even talks about that:
> Many defended psychiatry, arguing that as psychiatric diagnosis relies largely on the patient's report of their experiences, faking their presence no more demonstrates problems with psychiatric diagnosis than lying about other medical symptoms. In this vein, psychiatrist Robert Spitzer quoted Kety in a 1975 criticism of Rosenhan's study :[5]
>If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labeled and treated me as having a bleeding peptic ulcer, I doubt that I could argue convincingly that medical science does not know how to diagnose that condition.
Your link mentions RD Laing in the lead. RD Laing is now thoroughly discredited. (Although he did have some interesting ideas). You should read some of his books.
> Many defended psychiatry, arguing that as psychiatric diagnosis relies largely on the patient's report of their experiences, faking their presence no more demonstrates problems with psychiatric diagnosis than lying about other medical symptoms. In this vein, psychiatrist Robert Spitzer quoted Kety in a 1975 criticism of Rosenhan's study :[5]
If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labeled and treated me as having a bleeding peptic ulcer, I doubt that I could argue convincingly that medical science does not know how to diagnose that condition.
> The link mentions related experiments with similar results as recent as 2008
No it does not.
There's a probable hoax from someone who can't provide any evidence, from 2004; and a totally different "experiment" (tv show) from 2008 where doctors were not allowed to interact with patients. You'd get similar results if the patients had physical health ailments.
How does the closing of big institutions improve the scientific rigor
of a psychiatric diagnosis?
The misunderstanding is probably my fault -- the message was too
short. Let's establish the basics: There can't be any science if you
can't measure. Reproducibility (replication): theory and experiment
(prediction <-> measurement spiral) are corner stones that support
each other and build on the language of math.
"the results" -- as the very first message I've posted on the topic
says -- are about the reliability of psychiatric diagnoses. If we
can't have that (an ability to measure) there is nothing to discuss.
On "150 inpatient beds" -- how many people are in jail instead? And
again, how does it relate to scientific foundations of psychiatry?
Both "lye to the doctor" excuse and "bleeding peptic ulcer" are
addressed on the very same wiki-page where the quotes come from.
"Your link mentions RD Laing in the lead. RD Laing is now thoroughly
discredited." Here's the only occurrence of the name in the
article:
"while listening to one of R. D. Laing's lectures that Rosenhan
wondered if there was a way in which the reliability of psychiatric
diagnoses could be tested experimentally."
Does "the lead" mean "an inspiration"? In what way precisely anything
about RD Laing changes the results of Rosenhan experiment?
I can go on pointing out imprecise statements but it don't see the
point. What would be nice to see is even a single reference to an
experiment that shows that yes we can reliably diagnose psychiatric
illnesses and here's what changed in out assumptions -- where is the
paradigm shift?
On 2008 experiment: the result: "The experts correctly diagnosed
two of the ten patients, misdiagnosed one patient, and incorrectly
identified two healthy patients as having mental health problems. If
you think that the result:
psychiatric diagnoses are unreliable
is invalid due to the way the experiment was conducted (some
methodological issues) then do point them out.
> doctors were not allowed to interact with patients.
Diagnosing a mental illness is a serious business with long term
consequences. Have any of the "experts" refused to diagnose on the
account of insufficient information? -- I don't know.
I'd like to be proven wrong and see psychiatry in the hard science camp.
Have I mentioned that psychiatric diagnoses are unreliable ;)
You posted something from 40 years ago.