By Marvin Ross
The problem with science (research) often lies in its interpretation. Scientific research findings are not static but are ongoing and evolving as more work is done and the results are dissected by those who understand the topic. It is all nicely summarized by a poster that I just saw on Facebook of all places.
Science is not the truth
Science is finding the truth
When science changes its opinion, it didn’t lie to you, it learned more.
That’s fodder for a number of blogs but I wanted to share two reports that a reader just sent me in response to the last two blog on the topic of social determinants of mental illness.
The first is “The Social Determinants of Mental Health” which appeared in the International Review of Psychiatry in 2014. On page 14, the authors stated that:
Mental disorders include anxiety, depression, schizophrenia, and alcohol and drug dependency. Common mental disorders can result from stressful experiences, but also occur in the absence of such experiences; stressful experiences do not always lead to mental disorders. Many people experience sub-threshold mental disorders, which means poor mental health that does not reach the threshold for diagnosis as a mental disorder. Mental disorders and sub-threshold mental disorders affect a large proportion of populations. The less commonly-used term, mental illness, refers to depression and anxiety (also referred to as common mental disorders) as well as schizophrenia and bipolar disorder (also referred to as severe mental illness).
In countries around the world, a shift of emphasis is needed towards preventing common mental disorders such as anxiety and depression by action on the social determinants of health, as well as improving treatment of existing conditions. (emphasis mine)
Social determinants do not always lead to mental disorders. And, looking at the research they cite, they only talk about depression and anxiety which is not surprising.
The second paper I was sent is from Simon Fraser University in Vancouver called Homelessness, Addiction & Mental Illness: A Call to Action for British Columbia. The authors of that paper state on P 14 that:
Nearly all of the modifiable burden of illness associated with substance use and mental illness is socially determined (WHO, 2013). A body of research integrated by the World Health Organization affirms that mental health and addiction are determined by social, economic, and physical environments, and that the inequitable distribution of these determinants has profound effects on individuals and societies (Allen, Balfour, Bell, Marmot, 2014; WHO, 2013).
Their source for stating that is the first paper I referred to above and, as you saw, that paper says no such thing.
Unfortunately, personal bias and ideology can lead to tunnel vision when it comes conducting resarch and interpreting it. A few years ago, I noticed a comment in Mad In America (MIA) “debunking” what they called the myth of schizophrenia as a progressive brain disease. They based that on a research study co-authored by Dr Robert Zipurski. MIA stated that “decreases in brain tissue volumes are attributable to antipsychotic medication, substance abuse, and other secondary factors.”
As I know Dr Zipurski, I called him to find out what he really said which you can read in my Huffington Post article. I wrote:
“As for brain deterioration, he does state that MRI studies show significant brain volume reduction in chronic schizophrenia and in patients presenting with first episode psychosis and schizophrenia. Those changes seen in patients at first episode are developmental changes in the brain. The changes in the brain are present initially before any medication has been given. And, he points out that changes in brain volume are also caused by cannabis and tobacco use for everyone. Those with schizophrenia smoke more than those who do not. A sedentary lifestyle and stress in everyone also results in reduced brain volumes again, regardless of antipsychotic use.”
If we really want to make progress in understanding and developing better treatments, we have to purge ideology from our research and its interpretation.