Posted by Noa on June 26, 2001, at 8:15:52
In reply to Re: Correction » Noa, posted by judy1 on June 25, 2001, at 21:59:00
Who knows?! There is always that controversy about whether disorders are qualitatively or quantitatively different than the normal continuum of traits, moods, etc. It is a big conflict in ADHD, too. Jamison-Redfiled and Goodwin go into this question w/regard to depression vs. bipolar: are they disorders along the same continuum of disorders, or are they different disorders altogether?
Ultimately, I think it is important to remember that until we have tests that can directly and definitively diagnose these illnesses on the basis of concrete biological markers, all diagnoses are just ways to conceptualize groups of symptoms in ways that hopefully are helpful in leading to appropriate treatment. Increasingly, they are validated by the biological research.
But, imho, for now they necessarily have some arbitrariness in terms of the edges---where does normal end and illness start, etc.
It may be that Akiskal's view of the spectrum of bipolar phenomena goes too far, but I think it is important to have these kinds of ideas out there. It kind of stretches the thinking. The research can either support it or not, but unless someone puts these theories out there, they wouldn't get tested. And, I imagine it has helped a lot of people who have had their problems overlooked because they don't fit the "classic" diagnostic criteria. Still, I think when it comes to the "edges", it is important that the diagnosis and treatment plan be well thought out and take into account a number of factors including how much impairment the symptoms cause, etc.
With ADHD, there is some overdiagnosis, but there are also a lot of kids (and adults) that are overlooked and never get diagnosis or treatment that could really help them. With bipolar spectrum problems, there is probably some overdiagnosis, but I would imagine that underdiagnosis is the bigger problem.
poster:Noa
thread:58936
URL: http://www.dr-bob.org/babble/20010625/msgs/67931.html