The disease of alcoholism...

[Archaea]

Do "diseases" which are not based upon an invasive pathogen behave similarly to diseases arising from invasive pathogens?

I recognize we classify invasive versus noninvasive pathogens as diseases, but is the path identical for the two branches?

[OhioBlue]

Originally Posted by SeattleUte

I do think that those who do drink compulsively have a form of disease but what breeds ignorance may be calling drinking the disease addiction rather than identifying some more deep seated illness.

Sure. Technically, if you're playing the diagnosis game, you work to establish that the set of symptoms you've identified are not better accounted for by a different diagnosis. Often, very often, substance abuse/dependence disorders are comorbid; hence an entire field of study dedicated to "dual diagnosis" individuals.

So yeah, absolutely there could be something else more responsible for the problem. Here's the unfortunate reality, at times, for psychologists, psychiatrists, social workers, or anyone else in the field for that matter: The diagnostic system presents a very alluring mode of ambiguity management, and human beings are nothing if not complex. Too often professionals will foreclose on a diagnosis and dive into treating that problem because they see that diagnosis as an endpoint. Clients are often willing participants in this process, too, as sometimes they are happy to collude with the 'expert' in externalizing and abdicating responsibility, or avoiding the deeper, more fundamental issue.

It's likely different with the more severe population that Waters works with, but I generally (not always) work with fairly 'normal' individuals who can maintain at least a semblance of functionality. I can't tell you how many times I've had someone come in, say "yeah, I've got (thus and such) disorder and I need help," only to find after some work and establishing some trust that we're dealing with far more than was originally disclosed. Often these people have diagnosed themselves on some internet site or have heard it from a doctor who saw them for 5 minutes and gave them a 10 question screener. So yeah, I guess what I'm saying is definitely there can be something more to any problem, including alcoholism, that will be key to address in order to facilitate full recovery and healthy living. In fact, I'd use the words 'very often' at least in my work.

To be fair, conversely there are those in my field that are ALWAYS digging deeper, trying to find something that isn't there. It's not surprising to hear of practitioners here and there who have entire caseloads of abuse victims, or of people with multiple personalities--and not because that is their niche, but because that's what they always 'find'.

That was a way longer answer than you were looking for, but I was just talking with someone about this phenomenon so it's on my mind.

[OhioBlue]

Originally Posted by SeattleUte

Well said.

Is there a school of thought that calls smoking addiction or eating disorders a "disease?" If not why not.

Yes, absolutely. In fact, going strictly by the definitions presented earlier in this thread, some have argued that same-sex attraction is also a disease.

Just goes to show you that calling something a disease doesn't necessarily lead anywhere of practical significance.

[SeattleUte]

Originally Posted by OhioBlue

Clients are often willing participants in this process, too, as sometimes they are happy to collude with the 'expert' in externalizing and abdicating responsibility, or avoiding the deeper, more fundamental issue.

ADD

[MikeWaters]

Originally Posted by SeattleUte

Well said.

Is there a school of thought that calls smoking addiction or eating disorders a "disease?" If not why not.

There is a diagnosis for "nicotine depedence." So yes, it is coded as a medical disease/condition.

Yes eating disorders are also classified as diseases.

Bulimia nervosa
Anorexia nervosa
Eating disorder Not Otherwise specified.

http://www.psychiatryonline.com/content.aspx?aID=3610

[MikeWaters]

Originally Posted by OhioBlue

Yes, absolutely. In fact, going strictly by the definitions presented earlier in this thread, some have argued that same-sex attraction is also a disease.

Just goes to show you that calling something a disease doesn't necessarily lead anywhere of practical significance.

You were answering CatBlue about eating disorders. I hope you are not suggesting that calling eating disorders diseases is unwarranted.

Pulled this from emedicine:

The mortality rate in anorexia nervosa is 10-20%. Overall, 50% of patients recover completely. Another 20% remain emaciated, 25% are thin, and 5-10% remain overweight or die of starvation.

[Jeff Lebowski]

Originally Posted by Archaea

To offer a different perspective, the disease of alcoholism impacts society in a far more egregious manner than does OCD.

My own family, extended that is, has lost millions due to this disease characteristic being prevalent. It led to the destruction of families, and in some instances loss of life.

OCD doesn't do that.

Not to downplay alcoholism, but OCD most certainly destroys families and takes lives. I have seen it happen.

[MikeWaters]

Originally Posted by Jeff Lebowski

Not to downplay alcoholism, but OCD most certainly destroys families and takes lives. I have seen it happen.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

OBJECTIVE: There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking. METHOD: Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a non-neurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised. RESULTS: The authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive-compulsive group had obsessions only. Comorbidity occurred in 62% of these individuals, which was significantly greater than the group with other neuroses (10%). Co-occurring neuroses were depressive episode (37%), generalized anxiety disorder (31%), agoraphobia or panic disorder (22%), social phobia (17%), and specific phobia (15%). Alcohol dependence was present in 20% of participants, mainly men, and drug dependence was present in 13%. Obsessive-compulsive disorder, compared with other neurotic disorders, was associated with more marked social and occupational impairment. One-quarter of obsessive-compulsive disorder participants had previously attempted suicide. Individuals with pure and comorbid obsessive-compulsive disorder did not differ according to most indices of impairment, including suicidal behavior, but pure individuals were significantly less likely to have sought help (14% versus 56%). CONCLUSIONS: A rare yet severe mental disorder, obsessive-compulsive disorder is an atypical neurosis, of which the public health significance has been underestimated. Unmet need among individuals with pure obsessive-compulsive disorder is a cause for concern, requiring further investigation of barriers to care and interventions to encourage help-seeking.

[OhioBlue]

Originally Posted by MikeWaters

You were answering CatBlue about eating disorders. I hope you are not suggesting that calling eating disorders diseases is unwarranted.

Pulled this from emedicine:

Haven't I made myself quite clear yet? Whether its warranted or not is hardly my concern. When I have a client in front of me who is eating less than 500 calories a day on top of at least 2 hours of hard exercise, purging daily, who is experiencing chest pains, hair loss, amenorrhea, etc, the last thing on either of our minds is whether or not we should call it a disease. We do... so what? We don't....so what? The call for help doesn't end with a label. "Yeah, so you have a pretty bad disease, go get yourself some fluvoxamine and I'll see you in a month."

I can't think of many more ways to try to make my point.

[MikeWaters]

Originally Posted by OhioBlue

Haven't I made myself quite clear yet? Whether its warranted or not is hardly my concern. When I have a client in front of me who is eating less than 500 calories a day on top of at least 2 hours of hard exercise, purging daily, who is experiencing chest pains, hair loss, amenorrhea, etc, the last thing on either of our minds is whether or not we should call it a disease. We do... so what? We don't....so what? The call for help doesn't end with a label. "Yeah, so you have a pretty bad disease, go get yourself some fluvoxamine and I'll see you in a month."

I can't think of many more ways to try to make my point.

What was your point again? That telling someone with Anorexia that they do not have a disease is the equivalent to telling that someone that they do?

No greater value is to be placed on the one approach or the other?

I think I'll pass on that philosophy.

Doctors treat disease. Folks with anorexia are not put in the ICU for their non-disease.

If you are not interested in thinking of any human condition as disease, just say so. So we know what we are dealing with.