Psychotic syndrome or perception syndrome?
In our submissions to the APA DSM-5 Psychotic Disorders Work Group we made a pitch
for perception syndrome. Perception is something that everyone understands, and it is not
hard for the man in the street to imagine what it is like when it goes wrong. There are
gradations from sane to mad, just as there are grey areas between black and white. Although
that is not to say that there is no difference between them.
The DSM-5 Psychotic Disorders Work Group does not (yet) accept either perception
syndrome or salience syndrome. The relevant chapter title in DSM-5 may well become
‘psychotic syndromes’. That, as a consumer organisation, we cannot accept. It is after all our
experiences that the psychiatrists are talking about and legislating over. Psychotic syndrome
carries with it far too negative an affect. Although accurate, it is pathological. I could accept
it as applying to myself from my own mouth; I would never use it to refer to someone else; I
would not accept it when it is used by someone else to refer to me. If psychiatrists are to
achieve the adherence they are so anxious to achieve – in our interests – they must use
neutral or positive-sounding language and in so doing have the good manners to give us
back our self-respect and dignity.