Louis Wain (1860-1939) was a British artist known for his pictures of anthropomorphic cats. Some people believe that he suffered from schizophrenia, as he evinced erratic and violent behavior at times. Many experts point to the increased abstraction of his work (including his ornate backgrounds) as a sign of schizophrenia, but others argue that he may have been on the autism spectrum, as his painting never deteriorated, as it likely would have if he had suffered from schizophrenia. To make a differential diagnosis, you would need to know whether he suffered from delusions, which are characteristic of schizophrenia. If he were diagnosed with schizophrenia today, he would need treatment from a psychiatrist experienced in this area (who might recommend antipsychotic medication), as well as behavioral therapy and related services and help for his family to help them understand his condition.
Experts have linked certain biological factors, such as genes, to approximately 40% of the cases of depression (see the link from the APA below). However, 60-70% of cases are linked to stress or trauma in childhood or the present life of the patient. There may also be an interaction between stress and one's biological predisposition towards depression, as people who have one or two short alleles of the 5-HTT gene are more likely to suffer from depression after a stressful event. In other words, depression can be caused by biology, by life events, and by a combination of the two.
It is important to use the biopsychological/multi-path model to understand schizophrenia because this model emphasizes not just the biological roots of schizophrenia but also the psychological and social aspects of the patient's life. All of these factors are important in understanding the genesis and treatment of the patient. For example, a schizophrenic person with a supportive family will have a generally better outcome than a person without a supportive family, and it is important to consider the social aspects of a patient's treatment to provide the person with the best treatment possible. The dopamine hypothesis posits that problems with dopamine function in the brain can cause the symptoms of schizophrenia, but this has been disproven to some degree with PET scans that show that antipsychotic medication blocks dopamine receptors (which were thought to be the cause of their symptoms) but without causing any relief of the symptoms of schizophrenia.
The Tarasoff ruling, made by the Supreme Court of California in 1976, stated that mental health professionals must warn people who are being threatened with bodily harm by a patient. This affects mental health treatment because it means that mental health providers have a duty to warn people who their patients plan to threaten (as revealed in therapy). This ruling is positive in that it has the possibility to protect potential victims but also could lead to false accusations of the patient. In addition, the law involves a violation of the patient's important right to privacy. As people with mental illness are already treated in a stigmatized way in many parts of society, the only place in which many patients receive complete care and unconditional acceptance is with their therapist. This relationship is important to healing the patient, and what the patient says should be treated with confidentiality (save for extreme cases).
Sunday, March 3, 2019
1. Who was Louis Wain and what was he known for? What clinical diagnosis would you assign to Mr. Wain if he was your client? What information would be required to make a diagnosis or good differential diagnosis? What course of treatment would you recommend for Mr. Wain? 2. What evidence indicates a biological component to depression? Does this evidence provide an adequate explanation for all cases of depression? Please explain your rationale. 3. Why is it important to view schizophrenia from a biopsychosocial/ multipath model approach? Is the"Dopamine Hypothesis" an adequate model to explain schizophrenia? Why or why not? 4. What is the Tarasoff ruling, and why is it important to mental health providers? How might the duty to warn impact psychotherapy treatment in positive and negative ways?
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