Some diseases are a lie.

[SkepticLance]

I was reading a book review on the new book :"The Noble Lie" by psychotherapist Gary Greenberg.

 

http://www.overcomingbias.com/2008/09/noble-lies.html

 

He has some interesting cases of 'diseases' that are recognised as such but which are not diseases by any scientific definition. Classic example : alcoholism. There is nothing in science to make this a disease. It has no clear causative agent. No pathogen. There is no remedy. The decision to call it a disease appears to be purely a moral, not scientific, decision. It has proved to be a very good decision, helping millions of people - but is not science.

 

Homosexuality is the opposite. It was once defined as a disease, but in 1973, as a result of political pressure, was removed from the Diagnosis and Statistical Manual of Mental Disorders. It now appears to be more regarded as a lifestyle choice, though I am not comfortable with that classification.

 

Depression is widely regarded as a disease, though it lacks scientific criteria for that classification.

 

Opens up the question : How scientific is medicine?

[Pangloss]

Are there any conditions that are generally accepted by the scientific and medical community to be "diseases" that have no physical causes whatsoever? I.E. if a patient is crazy due to having a screwed-up home life as a kid, as opposed to a specific injury or genetic disorder in the brain, is it still considered a disease?

[iNow]

He has some interesting cases of 'diseases' that are recognised as such but which are not diseases by any scientific definition. Classic example : alcoholism. There is nothing in science to make this a disease. It has no clear causative agent. No pathogen. There is no remedy. The decision to call it a disease appears to be purely a moral, not scientific, decision.

This is wrong in so many ways.

 

I ask you, Lance. Why do some people drink and not become alcoholic, yet others drink and do? Why do some people metabolise alcohol faster and more efficiently and hence experience fewer of its effects?

 

There is nothing "purely moral" about the variables which impact alcoholism. It's an interesting thread idea you have here, but is completely bankrupt from the start since you begin with so many inaccuracies, including with your other examples.

[blazarwolf]

We seem at a point in time when the term "deasease" is no longer proper, even for the layman....

 

Alchoholism has genetic and eviormental factors which cause an interuption to fruitfull life... it would be better classified as a disorder to that... But what if someone just wanted to be shitbrains there whole life? Like a monk, but for alchohol rather than spirituality? is this a disorder? or is it a condition?

 

Homosexuality is much to the same... I believe most cases to be of Genetic (nature) influences. However I am certin (more so to females as to my unscientific personal expirence) There are some instances of Homosexuality that arrive primarily from Enivormental cuasation (nurture). As to most things in science, it is often a combination of many factors.

 

This is why Psychology is the most "arty" of all medicines... I think psychology is at its core medicine, and important to modern thought/understanding... I also hope most students of such realize the horrors of the art which wont be properly documented for another 50 years..... Anyone that reads the DSM knows that it either ignores, or has very little to say of cuasation... Peoples minds and expirences are so unique. It seems as though almost any psychological situation, can arise from almost any cause.

 

 

Also is homosexuality a psychological problem if it arose from a nurture element? that is as it is to there mind? People tend to avoid such loaded questions, but most psychologists would say no, so long it dosent significantly impair ones normal functioning... But what is normal functioning? Everybody will have there own definition.

 

And to forget the wrench that is epigenitics being thrown it to the gears.... As run dmc would say "its tricky....tricky...tricky,tricky,tricky,tricky.

Edited September 24, 2008 by blazarwolf

[SkepticLance]

To iNow

 

Not so much of the "you", please. This began with a review of a book, and I reported on the book's ideas. A big reason for posting this is to see what other people think, and whether Greenberg is on the ball or off the planet.

 

Are these complaints definable as disease? I think that is a valid query.

[insane_alien]

see, i've found its only utter wankers that call alcoholism and depression diseases. people who have no ****ing idea what the hell they're on aboot.

 

alcoholism is an addiction and depression is a mental disorder AT BEST.

 

anyonw who says other wise doesnae have a bloody clue.

[I_Pwn_Crackpots]

Isn't there evidence that alcoholism may be genetic?

[iNow]

There are genetic risk factors which significantly increase ones predisposition toward alcoholism, yes.

[blazarwolf]

Yes. As to alcholism is the most common drug of abuse, genetic studys have been flooding in... I could not say anything is difinitive, nor could i remember anything specific that ive read (theres alot).

 

This was the second link on google search "alcholism genetics"

 

http://alcoholism.about.com/od/genetics/Genetics_of_Alcoholism.htm

[Dak]

I can't help but feel that this is entirely semantic. If we define 'disease' as 'something transmittable with a microbiological basis', then obviously no, your examples were not diseases, but i feel that's not really how people use the word.

 

otoh:

 

Classic example : alcoholism. There is nothing in science to make this a disease. It has no clear causative agent.

 

alcohol

 

No pathogen.

 

alcohol

 

There is no remedy.

 

weening off, alcohol-replacement drugs, anti-seziure-sedatives etc in the case of dellirium tremens, etc, followed by councelling iirc.

 

The decision to call it a disease appears to be purely a moral, not scientific, decision. It has proved to be a very good decision, helping millions of people - but is not science.

 

I think 'purely moral' and 'not science' is a tad unfair.

 

once established, alcoholism causes phisical changes in your body, which can result in death, psychosis, seizures, etc, upon sudden withdrawl, thus there is a lot of science to back up the claim that alcoholism is a genuine condition with it's own causes, symptoms and repercussions (same with homosexuality and depression).

 

true, it seems to be mainly politics/ethics/pragmatism/etc that determines something being a disease/disorder rather than just a syndrome/condition, but meh. if you treat 'disease' as 'bad condition', then the 'bad' part is obviously going to be, at most, semi-scientific, but there's no reason why the 'condition' part can't be completely scientific, hence why i think 'unscientific' is a tad unfair.

 

e.g., take heterosexuality, homosexuality, and paedophillia -- a condition, a condition, and a bad condition (aka disease).

 

there's science there inasmuch as there's empirical evidence to support the claim that those three conditions exist, and there's at least some explanations as to their causes and effects, along with their secondary effects (e.g., that paedophillia is a greater causative agent of child-trauma than hetero- or homo-sexuality). it takes a non-scientific moral/political/practical call to tie all this together and plonk 'bad' in front of 'condition' for paedophillia (the jump from 'empirically determined to hurt childeren' to 'so shouldn't be done' is non-scientific) but not homo- or hetero- sexuality (similarly, 'sod it who cares' is non-scientific), but still it's entirely possible for the statement 'paedophillia (and not hetero- or homo-sexuality) is a disorder' to be dripping with enough science to make the statement 'its entirely non-scientific' so over-simplistic as to be misleading. try calling a condition that has no science to back up it's existance a disease to see what i mean.

 

Not entierly scientific would have been better.

 

Depression is widely regarded as a disease, though it lacks scientific criteria for that classification.

 

it's a mental condition (ask psychology) that is bad (ask depressed people), ergo it's a disease/disorder/whatever.

 

or a 'bad condition'...

[SkepticLance]

Dak's statement that this is semantics may be correct. Can anyone give a better definition of 'disease'? I would be inclined to exclude anything without a measurable organic cause. ie. Psychosomatic and other behavioural afflictions perhaps should not be called disease.

 

For example : Is morbid obesity a disease? I would be inclined to say no, since it is entirely created by an aberrant behaviour. It would be like someone attacking themselves by cutting chunks of their own flesh out, and calling the resultant wounds a disease.

[Cap'n Refsmmat]

Dak's statement that this is semantics may be correct. Can anyone give a better definition of 'disease'? I would be inclined to exclude anything without a measurable organic cause. ie. Psychosomatic and other behavioural afflictions perhaps should not be called disease.

Why should we make disorders of the brain any different from disorders of, say, the kidneys?

[big314mp]

Why should we make disorders of the brain any different from disorders of, say, the kidneys?

 

Well, people have more direct control of their minds than they do of their kidneys, so where do you draw the line between "You don't really want to get better" and "You need intervention"?

[Sayonara]

Well, people have more direct control of their minds than they do of their kidneys, so where do you draw the line between "You don't really want to get better" and "You need intervention"?

When the problem is pathological.

[Phi for All]

Classic example : alcoholism...[edit]... There is no remedy.

Quitting is a successful remedy, a theory that's not only falsifiable but has over 16 years of my own personal observation and experimentation.

The decision to call it a disease appears to be purely a moral, not scientific, decision.

More political than moral, I would say. But morality plays a part.

It has proved to be a very good decision, helping millions of people - but is not science.

It's beside the point, but I disagree. Taking full responsibility for your problem and not relying on the crutch of having a "disease" is crucial, imo, to a successful recovery.

 

 

 

I agree with Greenburg that there is a problem with some of the classifications. I'd call substance abuse a self-imposed disorder. Your normal functions are disturbed and you are the one causing the disturbance. It has an organic cause but it's not one that insinuates itself. It needs cognizant help.

[CharonY]

So, could anyone provide me with the current accepted definition of disease?

 

For instance, the presence of remedies is clearly not necessary for conditions to be characterized as diseases.

Are genetic disorders diseases?

Are all forms of cancer diseases?

Are allergies diseases?

[big314mp]

When the problem is pathological.

 

That's just relabeling things.

 

The OP's idea was that disease is a word that is defined by people. Since the definition is by people, the line is somewhat arbitrary. In light of new diseases/disorders/issues (I don't have enough background to know specifically which ones are relevant), is the definition of disease changing?

 

I'd say it has changed from the traditional "a disease is caused by a pathogen that can be replicated in the lab and administered to test cases etc etc etc..." to more of a "It is an issue that prevents or impedes normal, daily activities."

 

Which of course brings in the separate issues of whether such a change is good (which is what I think this thread is supposed to be about), and the question of what exactly normal, daily activities are.

 

I'd say the change is good, but with some caveats. If I have trouble studying for a test, should I get ADHD meds from my doctor? I'd say that I need to work harder and/or smarter. What about difficulty in studying for every test? Get the pills.

[Dak]

When the problem is pathological.

 

tautology?

[SkepticLance]

If a person suffers from a 'difference' to other people, when that difference is harmful, but the difference is merely a case of being at one end of the normal distribution curve, can we call that a disease?

 

For example : while I doubt that alcoholism should be called a disease in the scientific sense, there are definitely vast differences between individuals in terms of their susceptibility to addiction. If you are a person who has a natural vulnerability to addiction, you could well become alcoholic. After all, there is a proven correlation between a wide variety of addictions. If you are susceptible to one, you are also susceptible to others.

 

Imagine you are at the far end of the normal distribution curve in susceptibility to addiction. Can we call that a disease?

 

I am asking in terms of science. It may be ethically advantageous to call such a thing disease, but not scientifically correct.

[iNow]

I think Sayo's point was that people are too quick to assume diseases of the mind are not diseases (as with diseases in the rest of the body). People say "it's all in your head" and think they're done with it.

 

This is an outdated and inaccurate way of thinking. Diseases of the mind are very real, indeed, and I don't quite care whether or not others agree, because I know I'm correct on this.

[SkepticLance]

iNow

No-one denies that diseases of the mind are real. However, not all have measurable, organic, microbiological, degenerative or genetic causes. Some are, as I said, merely a case of being at one end or the other of the normal distribution curve for the trait being described. Others may be a result of aberrant learning. I am not sure whether the term 'disease' applies in those cases.

 

For example : if a boy learns from his father that killing is OK, and becomes a murderer, is his ability to kill pathological? Or is it simply an unfortunate result of a perfectly normal process? What of an ex soldier who returns from war with a screwed up view of killing, and becomes a murderer?

 

These are critically important questions, since they will strongly influence how we deal with such people.

[iNow]

iNow

No-one denies that diseases of the mind are real.

Well, some of the comments in this thread seemed to suggest otherwise, hence our posts.

[Pangloss]

Ooo, what a substantive thread! So basically we've got people on one extreme saying "assume it's a disease until proven otherwise", and people on the other extreme saying "assume it's not a disease until it's proven to be one".

 

Then, amusingly, we've got one group of people saying "death to all who say that we should assume it's a disease until proven otherwise", and another group of people saying "death to all who say that we should assume it's not a disease until it's proven to be one". I knew there was a reason for the run on pitchforks and torches over in YT's lab!

 

iNow, you wanna run that bit by me again about people who "try to disregard everything as partisan"?

[Zebbygoss]

I dont believe alcoholism is genetic .. if a persons father/and or mother is an alcoholic, and they grow up in a clean enviroment with another family that has adopted them, doesnt mean they will be an alcoholic still. Its a funny issue. and I dont believe its classified "genetic" to most scientists.. Alcohol is a drug.. and is abused by experiences leading to alcholism...

 

Also, ask yourself is drug abuse a "disease" or an addiction that hurts the mind and body...??? O_O

Edited September 25, 2008 by Zebbygoss
A PS

[iNow]

I dont believe alcoholism is genetic

 

<...>

 

I dont believe its classified "genetic" to most scientists.

 

It may be time for you to reconsider your beliefs and check them for accuracy.

 

 

http://scholar.google.com/scholar?source=ig&hl=en&rlz=1G1GGLQ_ENUS275&q=genetic%20components%20of%20alcoholism&um=1&ie=UTF-8&sa=N&tab=ws