Intended for healthcare professionals

Rapid response to:

Letters

Post-traumatic stress disorder

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7297.1301 (Published 26 May 2001) Cite this as: BMJ 2001;322:1301

Rapid Response:

quacksalber diagnosis

I would remind you that most of the psychiatric 'diagnoses' are no
diagnosis at all, but classifications according to (possible delusive?)
thoughts and projections in the patient.

If a patient has PTSD(?), a broad range of patients is classified
without a proper diagnose that gives an absolute certainty about causes and
effects.
Without this certainty for the doctors, it's impossible to give a medical
diagnoses; only a classification according to discussable thoughts.

Of course stress can play a big role in symptoms related to PTSD.
But what is stress?
Stress can also be physical and neurological.
Coffee, smoke, chemicals, (brain) allergies (neurogenic inflammation,
disturbed NO-metabolism, allergy on own brain tissue, sometimes related to
food, sometimes to smoke or aerosols), scar-tissue, eye problems and
others physical problems that give physical negative stress, etc.

Maybe in some way there is no real difference between mental and physical
stress in the way it affects biological paths.

PTSD gives a lot of physical symptoms, so it's for real, isn't it?
Without absolute certainty, a medical projection to a psychiatric disorder,
is in my opinion 'quaksalbery'.
All those disorders are classifications.

Take schizophrenia; what is that?
Why not just diagnose that someone has visions and hallucinations?
Another diagnosis is perhaps social isolation.
But not everyone with hallucinations has social isolation.
And also only 80% of people who are thought to be schizophrenic has the specific
deterioration of brain-tissue, so 20% of diagnoses are totally wrong.
But what is a medical diagnosis in 'schizophrenia', is an immune disease
where the patient's brain tissue is attacked.
This can be in (thought to be classification) schizophrenia and in any
other mental disease.
Why not diagnose for these, instead of projecting possible group delusions
in a patient?
Most of the time with so called psychiatric patients, no necessary
research is made.
No functional-MRI, no research for (brain-) allergies, brain-tissue-
allergy, neurogenic inflammations and all other physical conditions.
Instead: unproven quacksalber classifications and narcotic drugs to
surpress symptoms ,instead of investigating the cause(s) and finding real
solutions.

Mark Metzelaar--Amsterdam

Competing interests: No competing interests

25 May 2001
Mark Metzelaar