Environmental Chemistry and You by Aas Kjell;

Author:Aas , Kjell;
Language: eng
Format: epub
Publisher: Austin Macauley Publishers
Published: 2018-03-30T00:00:00+00:00

Scientific Progress, Intermissions and Failures

In medicine, the base for diagnosis is research-based evidence with objective criteria that have been confirmed by several scientists and accepted methods. Exceptions from this are diagnosis in psychiatry and a few disorders associated with pain such as migraine and other headaches. In such cases the diagnostic worker relies entirely on qualified conversations and perhaps subjective interpretation of test symbols. Clinical assessment can be supplemented by the use of symptom scales for specific disorders. The investigator must be thoroughly trained to interpret the results, but the interpretation always remains subjective. Lack of objectivity in psychiatric interpretation frequently becomes illustrated by disagreement between forensic psychiatrists (Lézé, 2008).

The possibility to prove the mechanisms of disorders without any objective signs may be a matter of scientific progress or not. Disorders that are unexplained today will not necessarily stay unexplainable in the future; this year’s scientific knowledge hasn’t reached further than to this year. Typically, until about 30 years ago stomach ulcers (ulcus ventriculi) were labelled as mainly having psychological causes supported by the observation that the patients got worse when stressed. Now we know that the main cause is an infection by a certain bacterium (Helicobacter pylori). However, it is still justified to label stomach ulcer as a psychosomatic disorder because stress continues to be a contributing factor in this multifactorial disorder.

For some other disorders such as chronic fatigue syndrome/ myalgic encephalopathy (ME) and fibromyalgia formerly considered to be unexplainable, somatoform disorders, researchers have found enough evidence with advanced techniques to accept a medical diagnosis. However, in clinical practice physicians must rely on the patient’s history as presented in the consultation because the advanced techniques used in research are not available and are too expensive (Wolfe et al, 2010). A global disease riddle – migraine still awaits scientific clarification. So does environmental chemical intolerance (chapter 31) and several other unexplained disorders too.

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