Tuesday, August 21, 2012

We Need the Eggs

The ICD-10 Classification of Mental and Behavioural Disorders
World Health Organization, Geneva, 1992

F21 Schizotypal Disorder

A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies have occurred at any stage. There is no dominant or typical disturbance, but any of the following may be present:

(a) inappropriate or constricted affect (the individual appears cold and aloof);

Hmm, I don't think so, but would I know?


(b) behaviour or appearance that is odd, eccentric, or peculiar;

Definitely.


(c) poor rapport with others and a tendency to social withdrawal;

A tendency to social withdrawal, certainly. I don't think I have a poor rapport with others, though.


(d) odd beliefs or magical thinking, influencing behaviour and inconsistent with subcultural norms;

Oh yes, always I have had odd beliefs; and being inconsistent with subcultural norms has always been a bit of a specialty of mine. Magical thinking? Dunno. To me, a lot of what the culturally normal do looks like magical thinking. (See? Those odd beliefs, again.)


(e) suspiciousness or paranoid ideas;

Nope.


(f) obsessive ruminations without inner resistance, often with dysmorphophobic, sexual or aggressive contents;

Do I do anything without inner resistance? I doubt it. I do write a lot of dysmorphic prose and poetry, in which I imagine myself to be huge, or misshapen, or tiny, or insubstantial. I think about sex a lot; about aggression, very little. Obsessive rumination might be my middle name, but I'm not sure that's what this is driving at.


(g) unusual perceptual experiences including somatosensory (bodily) or other illusions, depersonalization or derealization;

Pretty much all the time.


(h) vague, circumstantial, metaphorical, overelaborate, or stereotyped thinking, manifested by odd speech or in other ways, without gross incoherence;

This makes me giggle. “Vague, circumstantial, metaphorical, overelaborate.” Why didn't I make that the name of my blog?


(i) occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation.

Quasi-psychotic? Aren't we chasing the chickens with chickens here? You tell me if they're quasi-psychotic. They're intense, certainly.

The disorder runs a chronic course with fluctuations of intensity. Occasionally it evolves into overt schizophrenia. There is no definite onset and its evolution and course are usually those of a personality disorder. It is more common in individuals related to schizophrenics and is believed to be part of the genetic "spectrum" of schizophrenia.

And here I thought I was supposed to be the vague and circumstantial one! (Why, I wonder, is “spectrum” in quotation marks?)

Well, that doesn't get us terribly far. But I am rather taken by the idea that this particular genetic spectrum survives because it supplies tribes with their prophets and shamans. Though why having prophets and shamans should be an evolutionary advantage is not altogether clear. "We talk to the dead, so you don't have to!" Reminds me of the Woody Allen joke:

"My poor uncle thinks he's a chicken." -- "Why don't you take him to a psychiatrist?" -- "Well, we would, but we need the eggs."

6 comments:

marly youmans said...

Perhaps it's time for a secondary blog. Why waste a good title?

Sabine said...

I tell you for nothing that the majority of doctors who apply this code for prescription and treatment of patients never read all that fine print. This applies to all of the ICD codes. There is a recent study somewhere confirming this. (I wonder who was on the "expert" panel putting this "stuff" together - intense illusions????)
Apparently it has made "life" easier for "experst" to use code - instead of time wasting assessment and thinking. All quotation marks are mine, btw.

Always remember: The world is completely sane.

rbarenblat said...

Obsessive rumination might be my middle name, too.

:-)

I love "vague, circumstantial, metaphorical, overelaborate."

Zhoen said...

Letting the chaos in, random shaking up of staid thinking, leadership when the unprecedented happens. Shoving a whole band out of a stable, but deteriorating situation, when a rational, traditional solution would lead a village without such a wildcard into self destruction.

It's crazy, but it might just work.

Dale said...

Sabine, yes, if this is science then I'm a bunny rabbit. It has the nicely judged vagueness of the daily astrology column: it's hard to imagine an individual you couldn't include, or exclude, on these criteria, just as you pleased.

Rachel, Marly -- :-)

Zhoen, perhaps that's it! It seems a bit farfetched though.

Incidentally, all, I'm not worried about this.

Jayne said...

Ha! Love that Allen joke.

Dale- I wouldn't think you'd be worried about this. But the exercise was quite entertaining. Way back when I was a caseworker who worked chronic mentally ill patients. I used to love poking through the DSM III. Amazing how many illnesses were characterized by behavior that could apply to just about anyone. Of course, not always consistently. Still, I often thought many of the patients were saner than most of us "normal" folks. ;)