QUDOS:  a research resource for anyone who believes they are wrongly diagnosed as having schizophrenia.  We hope to provide useful information for those who believe they have been wrongly stigmatized with this diagnosis.

About the QUDOS project

During their contact with psychiatry, those deemed to be mentally ill can receive several different diagnoses, including schizophrenia. Often this appears to be a diagnostic dustbin to which the most difficult-to-diagnose patients are consigned.

Referring to the case reported in the Sunday Times (see below), Professor of  Community Psychiatry,  Dr Sashi Sashidharan, commented that schizophrenia can be a "ragbag" classification used for people who do not readily fit other diagnostic categories.  Anyone who feels  they have received a false diagnosis is entitled to a second opinion.  This could result in reclassification of their condition or - exceptionally - removal from psychiatric classification altogether.

"The psychiatrist may often be wrong...in his interpretation of his patient's behaviour"

Dr Anthony Storr

"Once you cross the threshold of the hospital, your chances of being declared sane are zilch."

Professor Sashi Sashidharan

"You can't prove me a witch!" cried Martha before she was led away to prison....But what she couldn't prove, what no one at all accused of such a thing could not prove, was that she wasn't."

M.L Starkey -'The Devil in Massachusetts'

"Being considered or labelled mentally disordered is the most profoundly discrediting classification  that can be imposed on a person..."

Dr Irving Goffman - 'Stigma'

QUDOS hopes to provide information for those who feel they have been wrongly diagnosed as having  schizophrenia.

However, please note

QUDOS is not intended to contribute to controversies surrounding the causes and treatments of psychiatric illness and does not encourage the pursuit of  legal claims. Our sole objective is to help people to clarify their diagnostic status where this is in doubt.

Well, no-one's perfect...

In August 1998, Margarette Driscol in the Sunday Times Magazine revealed the story of Christine, a former art student previously incarcerated in a psychiatric hospital near Birmingham.  Following a false diagnosis of schizophrenia she was given neuroleptic drugs and her brain was repeatedly blasted with electroshocks.  Now her memory is permanently impaired.  Psychiatrists subsequently admitted that the diagnosis was wrong:  Christine never had schizophrenia. (Driscoll, 1998).

In February, 2001, Kay Sheldon received a substantial out-of-court settlement from a health authority in recognition of her horrendous ordeal following a false diagnosis of schizophrenia. Kay was prescribed powerful anti-psychotic drugs which produced horrific side-effects. When she resisted treatment, she was hauled back into hospital and forcibly drugged.

Kay said: "The sense of frustration that this treatment was wrong, together with the dreadful side-effects and being consistently told that I 'lacked insight' into my condition eventually took its toll and over the next four and a half years I attempted suicide three times".

Referring to Kay's ordeal, Mind's Principal Solicitor, Simon Foster, said: "Every year Mind hears of dozens of cases where someone is saddled with treatment which is clearly inappropriate for their needs. Unfortunately, once a psychiatrist has formed a diagnosis, it can be extremely difficult to get it reviewed or changed. I am delighted that the authority finally took a realistic approach to this case. I hope it will encourage other people to challenge decisions which are plainly wrong".

To be fair to psychiatrists

To be fair to psychiatrists,  the controversial condition  known as 'schizophrenia' is not analogous to physical illness, like a broken leg or ruptured appendix.  No consistent physiological markers for schizophrenia have ever been  found (Chua and McKenna 1995; Johnstone, 2000b). Consequently, the diagnosis  may have to be based largely on doctors' subjective interpretation of symptoms.   Sometimes they can make little more than an informed guess (Muller, 2000; Skrabanek and McCormick, 1989).

Psychiatrists themselves have acknowledged that even the most careful and conscientious practitioner may be misled by the diverse and ambiguous symptoms which sometimes accompany mental distress. As consultant psychiatrist Dr John Cutting (1995) comments:  "Even the best psychiatrists can make mistakes...because schizophrenia is such a difficult diagnosis to make".  Writing in the Lancet, Dr Raj Shiwach commented: "The so-called cook-book approach of the DSM [psychiatric diagnostic] manuals has led to lazy practices akin to astrology..." (Shiwach, 2002). 

In recent years, false diagnoses could also have increased due to sensationalised media handling of incidents attributed to 'schizophrenics' (usually substance-abusers). Resulting publicity  may have encouraged doctors to practise defensive medicine by becoming over-inclusive in  making this diagnosis: no-one wishes to be responsible for failing to identify schizophrenia in patients who later injure themselves or others.

Also, as Doctors Skrabanek and McCormick (1989) reveal, while British jurors are required to give an accused person benefit of the doubt, trainee psychiatrists are encouraged to adopt an approach of  "if in doubt, diagnose"; so it is unsurprising if erroneous diagnoses of schizophrenia are made.

Diagnosis of psychiatric conditions is rightly recognised as being one of  the more  unreliable areas of medicine: Doctor Hans Eysenck , Emeritus Professor of Psychology at the University of London, cited a study in which psychiatrists could agree on a diagnosis in only 20% of cases (Eysenck and Eysenck, 1981).

The unreliable nature of such diagnoses generally was highlighted by revelations relating to the discredited theory known as Munchausen Syndrome By Proxy which resulted in the stigmatising and -sometimes jailing - of numerous innocent women. The Countess of Mar told the House of Lords: "There are many thousands of women who have been...labelled as having Munchausen Syndrome By Proxy...They have no recourse to the courts and, each time they protest, they are told they are in denial and that it is a sign of having Munchausen Syndrome By Proxy" (Doward, 2004).

The lack of any consistent  physiological features makes schizophrenia particularly liable to mis-identification. Researchers Kirk and Kutchins (2000) have convincingly raised doubts about the reliability of the diagnostic manual used by many British and American psychiatrists (Kirk and Kutchins, 2000; Kutchins and Kirk, 1999) and instances of  mis-diagnosis occur so frequently that many mental health workers readily concur with Doctors Colby and Spar (1983) in identifying unreliability of diagnosis as constituting one of the major difficulties facing psychiatry today.

A note of caution

Although diagnoses of schizophrenia have often proved unreliable, second-opinion doctors may conclude that patients have infact experienced states which, given the current premises of  psychiatry, would warrant this verdict. And while the whole concept of schizophrenia is scientifically disputatious (Boyle 1990; 1996/7 and Johnstone, 2000b, et al) this diagnosis is still widely regarded as having a legitimate place in doctors' diagnostic repertoire.

Even when psychiatrists are prepared to over-turn a diagnosis of schizophrenia, they may  replace it with some similarly serious condition. Typical alternatives are Personality Disorder or Manic Depressive Psychosis - although  people with Asperger's Syndrome and Temporal Lobe Epilepsy are notoriously susceptible to being classified as schizophrenics.  Even so, in the current climate of prejudice, anything may be preferable to this particular stigma.

Given the potentially adverse legal, medical and social consequences of being labelled schizophrenic, we believe that  patients should always receive an appropriate diagnosis -and where appropriate, be declared free of psychiatric classification altogether.   

We hope success stories like those of Kay Sheldon and Christine will inspire others, falsely labelled, to challenge their damaging and unreliable diagnosis of schizophrenia.

Practical Steps:

A second-opinion diagnosis can sometimes be arranged through your G.P. There is also a national second-opinion unit which may be contacted at:

The Second Opinion Clinic, The National Psychosis Unit, Maudsley and Bethlem Hospital Trust, Denmark Hill, London, SE5 8AZ

Tel: 0208 776 4418 

QUDOS regrets

As this project is managed by part-time personnel who visit the Mind office on an irregular basis, we cannot arrange to see clients at the Mind in Manchester building -but if you feel that you have anything to contribute to this site, please write or Email us c/o the address below.

Anyone who wishes to send a financial contribution to the QUDOS project should make donations payable to Mind in Manchester Ltd. 

SOURCES

Boyle, M (1990) 'Schizophrenia: A Scientific Delusion?' Routledge.

Boyle, M (1996/7) 'Diagnosis, Science and Power' Asylum Magazine, Vol. 10 No1.

Chua, S.E. and McKenna, P.J. (1995) 'Schizophrenia: a brain disease?' British Journal of Psychiatry. 166, pp.563-582.

Colby K M and Spar J E (1983) 'The Fundamental  Crises in Psychiatry: Unreliability in Diagnosis' CC Thomas.

Cutting, J. and Charlish A (1995) 'Schizophrenia' Thorsons.

Doward, J (2004) 'Ministers told Child Harm Theory Flawed' Observer, January 25

Driscoll, M (1998) 'Stolen Years' Sunday Times Magazine. August 30th.

Eysenck, H and Eysenck, M (1981) 'Mindwatching'  Michael Joseph.

Johnstone, L (2000) 'Users and Abusers of Psychiatry: A Critical Look at Psychiatric Practice' (2nd. edition). Routledge.

Johnstone, L (2000b) 'What is Wrong with Psychiatry?' Mental Health Practice, Oct. 2000 Vol.4 No.2

Kirk, S and Kutchins, H (2000) 'Revolution - in rhetoric' Openmind 104 pp8-9 July/August 2000.

Kutchins, H and Kirk, S (1999) 'Making Us Crazy: DSM -The Psychiatric Bible and the Creation of Mental Disorders'. Constable.

Muller, R.J. (2000) 'The Narrative in Psychiatric Diagnosis' Psychiatric Times Feb. 2000 Vol. XV11 Issue 2.

Shiwach, R (2002) 'Bipolar Disorder' The Lancet, Volume 359, Number 9318, 11 May 2002

Skrabanek, P. and McCormick, J. (1989) 'Follies and Fallacies in Medicine' Tarragon Press.

Siebert, A (2000) 'What is Wrong With Psychiatry?' Journal of Humanistic Psychology, Vol.40, No1, Winter, 2000. pp.34-58.

Storr A. (1989) 'Churchill's Black Dog and Other Phenomena of the Human Mind' Collins.