Monday, January 10, 2011

Hysteria As Misdiagnosis - Then and Now


Over 45 years ago Dr. Slater documented the frequent misdiagnosis of neurological diseases as “hysteria”. He published his findings in the British Medical Journal in 1965.

Following 85 patients admitted to a mental hospital, nine years later 50% were dead or disabled; 50% were living independently; 22% were symptom free.

The dead or disabled were found to have had vascular disease, epilepsy, vestibular lesions, angioma of the brain stem or neoplasms such as brain tumors.

At least 50% of those patients admitted to a mental hospital had physical diseases yet were diagnosed as “hysterical”, the old way of saying “It's all in the head.”

The idea that physical illnesses were manifestations of feelings and thoughts started with Charcot in the 1880's. His pupil, Freud, advanced that idea with a series of writings that have since been found to be largely fabricated.

For instance, a man knocked unconscious for 5 days by a carriage was unable to speak, walk or remember the accident when he regained consciousness. Charcot diagnosed him as being hysterical because of the psychological trauma of the event.

As Richard Webster says “Le Log - the classic example of a patient who supposedly suffered from traumatic hysteria, did not forget because he was frightened. He forgot because he was concussed. His various symptoms were not produced by an unconscious idea. They were the result of brain damage”

When a 14-year old patient of Freud's died of abdominal cancer two months after he diagnosed her with “unmistakeable hysteria” he claimed her hysteria had caused the tumor.

Webster explains how hysteria, renamed conversion disorder or somatoform disorder, became so popular:

“What made the resulting labyrinth of medical error all but inescapable was that practically every other physician had become lost within it. Over and over again, highly trained medical practitioners, confronted by some of the more subtle symptoms of epilepsy, head injury, cerebral tumours, multiple sclerosis, Parkinson’s disease, Tourette’s syndrome, autism, syphilis, encephalitis, torsion dystonia, viral hepatitis, reflux oesophagitis, hiatus hernia and hundreds of other common or uncommon conditions, would resolve their diagnostic uncertainty by enlarging the category of hysteria yet further. As a result medical misconceptions which sprang from one misdiagnosis would almost inevitably receive support, and apparent confirmation, from misdiagnoses made by other physicians.”

After brain scans of patients sufferering from chronic fatigue syndrome were shown to an expert scan reader in 1984, he said the punctate lesions he saw looked like the scans of AIDS patients. Months later the CDC issued its verdict. The town of Incline Village NV was suffering from mass hysteria.

Misdiagnosis of neurological disease in 1890 or even in 1965 is understandable.

It remains a mystery why the Centers For Disease Control (CDC) continues to place research on CFS in the Chronic Viral Diseases Branch of the National Center for Emerging and Zoonotic Infectious Diseases, yet has refused to research the viral associations with this illness and, instead, pursues mental illness as a diagnosis 27 years after those brain scans showed it to be a neurological disease.

"Somatoform disorder" is characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained fully by tests used by the attending physician. It is newspeak for "hysteria". In the tradition of Charcot and Freud, some doctors who cannot find the reasons for a patient's illness resort to the default diagnosis of somatoform disorder. That they stubbornly stick to this diagnosis even when physical signs and symptoms should alert them to change their diagnoses is a testament to the egos, culture and political considerations that get in the way of pure science.

To quote Slater:"The malady of the wandering womb began as a myth, and a
myth it yet survives. But, like all unwarranted beliefs which still attract credence, it is dangerous. The diagnosis of " hysteria " is a disguise for ignorance and a fertile source of clinical error. It is in fact not only a delusion but also a snare."

Cartoons by T. McCracken

14 comments:

  1. Superb!

    Extremely important, well-written, great choice of examples. Really glad you are blogging.

    This is a great place to point people. This stuff needs to be widely known.

    Thank you!

    Samuel

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  2. Great article Oerganix! You are a great writer and I am looking forward to reading your future blog posts.

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  3. Hey Oerganix, loving your blog! Always knew you were a great writer. So glad to see you using it for this cause.

    Thanks!

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  4. I was given the diagnosis of somataform disorder by Dr. Steven Straus Infectious Disease doctor over CFS at the NIH. I was there to be studied in the HIV Clinic for a depleted t-cell count the same as
    an AIDs patient who would be acquiring infections
    (185). No doctor in the HIV Clinic thought Dr. Straus diagnosis was odd. (Dr. Straus was NOT over the study I was in...Dr. Fauci was).

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  5. This appears to be the same article that appeared at http://www.associatedcontent.com/article/6199142/neurological_disease_misdiagnosed_as.html?cat=58#comments, but it is presented here without attribution or a hotlink to the original.

    Are you the author of this article, or have you secured the rights to reprint this material?

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  6. This is great! I just linked to the equivalent article in Associated Content in my own blog. :)

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  7. Great work Oerganix! I hope you consider turning this into a longer article - I could see it in a major newspaper or magazine.

    That long quote from Webster is outstanding.

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  8. Great stuff. I will repost also :))))

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  9. Thanks for writing this oerganix! Great work. As you know, I always ask the question - does this mean I have to change my screen name from Hysterical Woman to Conversion Disorder Woman?

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  10. Maxine, you could change it- or you could use "Somatoform Sister" or "Fainting Female". But I kind of like Hysterical Woman. As long as a certain clique of psychiatrists is stuck in that 1890's paradigm, seeing you as Hysterial Woman always makes me smile!

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  11. @ UrbanTravels, yes I am the author of this piece. As you can see, this version is much longer than the one I posted on Yahoo - they limit articles to 500 words and it really takes more than that to do the subject justice. I published it there first, without giving Yahoo exclusive rights, so there is no conflict.

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  12. 'Interesting you've picked on BMJ considering the assault their waging on Lancet. Wakefield being a fraud with all these patents and financial involvements has got to be every vaccine maker's dream. As said elsewhere, where money is involved, all truth is lost. None of it helps autistic kids. Nice piece.

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  13. Yes, as I've said elsewhere, the vaccine industry is doing a hatchet job on Wakefield.

    Now the ME/CFS denialists are trying to smear Dr. Mikovits with the old "guilt by association" ploy - a real stretch of the imagination, but they're making it.

    The only valid comparison I can see between them is that they both investigated illnesses the drug and vaccine industries were not interested in and in which they may have contributed to the disease process. To do this, Wakefield and Mikovits accepted research money from the patients, their families and in Wakefield's case, some lawyers of the families.

    The source of the research funding was then used to claim "conflict of interest". In a climate where researchers who aren't trying to prove some drug is a miracle, let alone prove it, or a vaccine, caused a problem, and therefore can't get research money, where is the money for research going to come from?

    I've seen WPI and Mikovits smeared for similar reasons. This is especially disgusting when it comes from phony "advocates" like CAA and PR/Cort.

    It's the 'ole double standard of morality and pretzel logic. Why aren't they asking whether there is a "conflict of interest" in all those "studies" paid for by the drug industry?

    The corruption of undue influence by giant corporations has reached the point where anyone who opposes them is forced into the role of David. (vs. Goliath).

    In the long run, though, David won.

    Dr. Myhill got her license back. There's hope for Dr. Wakefield, too.

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  14. Harvard-trained Dr. Peter Breggin's book, Toxic Psychiatry, gives a wealth of examples and background for these medical and social abuses.

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