Talk:Schizoaffective disorder

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This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 January 2020 and 15 May 2020. Further details are available on the course page. Student editor(s): Backslash Cole, PsychStudent21. Peer reviewers: Brian Dooley, Aupri.

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Schizoaffective.org
Comment on the link just removed:
 * http://www.schizoaffective.org/ Schizoaffective.org - A support group

It seems interesting enough to include. That it is anti-psychiatry doesn't deem it uninteresting, no? Preferable would be to write next to the link: "This page is anti-psychiatry", as they boost this themselves. So can we give people the possibility of making their own opinion instead of censoring for them.

I will reinsert the link as soon as the page starts working, if no one objects.

I think that it is good to hear both sides to this. There are pros and cons to medicating a person with schizoaffective disorder.

--Fred-Chess 05:56, 26 May 2005 (UTC)


 * I am concerned that this link, with a generic name like schizoaffective.org, might be considered an authority on the disease. This site is strongly and pervasively preaching a message of "don't see your doctor" and even "don't take your meds."  This is a very dangerous message for most people suffering from a psychotic disorder since it is the continued use of their medication that allows them to make intelligent decisions.  I think if you want to include this strongly POV link in an otherwise NPOV article, you need more than a few words of disclaimer.  But I would welcome other opinions. Shoaler 08:39, 26 May 2005 (UTC)

Shoaler, I hope you're not seriously suggesting that the non-medicated mentally ill can't make intelligent decisions. Francesca Allan of MindFreedomBC 04:20, 1 December 2005 (UTC)


 * Certainly not as a generalization. But some forms and degrees of mental illness can seriously impair a person's ability to accurately evaluate their environment.  They read malice where none exists and evaluate average daily situations as threatening.  It is very difficult, if not impossible, for persons such as this to make a knowledgeable decision.  For many of these people, a specific medication or group of medications can help them be nearly asymptomatic. In such a situation, they are much more capable of evaluating their world accurately and making a knowledgeable decision -- BUT in the absence of symptoms, and if the medication has unpleasant side effects, it is easy to believe that you are no longer sick and to discontinue the medication. Especially when persuasive people tell you that you don't need your doctor or your medication. For people who have worked hard to find the right medication and for whom medication has allowed them the first real chance at living a semi-normal life, telling them not to take their meds or not to work with their doctor, I believe is cruel and abusive. –Shoaler (talk) 19:22, 1 December 2005 (UTC)

Cannabis
I have SAD and I don't take Seroquel regularly any more, getting high on Seroquel does not allow me to function with a clear mind its' effect is long lasting if taken at doses of 200mg -300mg. makes operating a machinery dangerous. — Preceding unsigned comment added by 192.41.148.220 (talk) 17:10, 9 December 2014 (UTC)

Should this growing section be moved to the talk page until a consensus is reached? It appears that there is currently only a single contributer (User:71.241.143.23) who is advocating for cannabis use for this illness, while both Shoaler & I have tried a couple of different tact's so far regarding it's inclusion. The current state of this section of the article seems to be verging on original research, and has the potential to flare-up up into an all out edit war. As a matter of fairness I have invited User:71.241.143.23 on his talk page to weigh in on this. -- 63.226.38.196 14:24, 14 March 2006 (UTC)


 * I have seen claims on the internet of the efficacy of cannabis in treating schizoaffective disorder. I have seen far more discussions of the problems of trying to sort out the symptoms of a patient with both schizoaffective disorder and cannabis abuse. I think that the use of cannabis in treating SA is currently just a footnote and deserves no greater treatment in the article. –Shoaler (talk) 15:01, 14 March 2006 (UTC)


 * I am new to wikipedia but quite familair with this disorder from all sides. As this article is to be a NPOV article, any unproven or controversial studies can be cited but should not take up 30-percent of the article (i.e. Cannabis). I agree with Shoaler that if Cannabis is to be included it should be nothing more than a footnote or link to another source. Having it in the article is irresponsible. Both students (young and old) and individuals (caregivers or people with the disorder) will rely on the information in this article. You accept a HUGE responsiblility when editing these articles since your insert of POV or unproven information can have a far-reaching, negative impact on many lives. 24.95.36.22 16:39, 1 April 2006 (UTC)DJG

I have reduced this section to a level more appropriate to the degree to which cannabis plays in treating SA. Much of the details of how cannabis is purported to work should be covered in the article on medicinal cannabis since SA is one of many disorders for which a claim of cannabis efficacy is made. I have also added citations to support the paragraph. –Shoaler (talk) 19:03, 2 April 2006 (UTC)

I actually have schizo-affective disorder and although I am pro-marijuana, it does makes my psychotic features worse.Species2112 04:05, 14 October 2007 (UTC)


 * I agree with what you did. Thanks for fixing this. -- Argon233 T  @ C  &para; U &ang; 23:33, 5 April 2006 (UTC)

I condensed the cannabis section for more encyclopedic wording, npov, the removal of uncited speculation, and consistency with cited sources. I've tried my best to report in a neutral manner what has been proven, what is speculative, and clear distinctions between the two. I think I've been even-handed. 21:06, 15 October 2007 (UTC) —Preceding unsigned comment added by Addisonstrack (talk • contribs)

I think it should be worth noting that specific Subspecies of Cannabis can be used to treat the symptoms of SchizoAffective Disorder, while other strains may aggravate the Psychotic symptoms. It is worth including that there are many claims that Cannabis can be a effective treatment in regulating the mood component of this disorder, especially with users who tend to lean on the BiPolar side. —Preceding unsigned comment added by 70.79.117.231 (talk) 21:59, 22 July 2009 (UTC)

Your claims, user 70.79.117.231, are not supported by current scientific evidence. Cannabis and psychotic disorders do not go together well, as current converging trends of psychiatric research show.76.169.29.127 (talk) 07:29, 25 July 2009 (UTC)

Yes, there is current scientific evidence that suggests Cannabinoids play a role as an effective treatment towards psychotic disorders. Including Schizophrenia specifically a 2007 German study reported improved cognition in patients who used Cannabis, and a 2008 Australian study found that patients diagnosed with schizophrenia report experiencing subjective relief from pot.

Future psychiatric research will prove my claims, as more research is conducted in regards to specific Cannabinoids which can be used as an effective treatment for Psychotic Disorders, including SchizoAffective. —Preceding unsigned comment added by 96.49.25.77 (talk) 21:44, 1 September 2009 (UTC)

Signs and Symptoms
I removed the warning message that 70.49.59.224 added to this section because, basically, I couldn't understand the point that s/he was making, and the reference din't help. Schizoaffective disorder is a diagnosis made by a mental health professional, frequently a physician (psychiatrist). The DSM is just a collection of diagnoses with numbers so the professional can communicate the diagnosis to other professionals (and to insurance companies). The DSM does not diagnose anything itself. –Shoaler (talk) 13:02, 23 October 2006 (UTC)

Clarification
From the article's intro:
 * Bipolar schizoaffective disorder is more similar to bipolar disorder than schizophrenia.

Does that mean BSD is more similar to bipolar disorder than to schizophrenia, or does it mean BSD ismore similar to biploar disorder than schizophrenia is? AxelBoldt 18:46, 29 January 2007 (UTC)

because it appears in DSM and ICD it must be true?
I have an issue about such an extensive article on this topic. It is simply one diagnostic category of DSM and ICD and probably only deserves a small mention and then a significant section left to the broader concept of Schizotypy. Only the distinct aspects of schizoaffective disorder need to be addressed here.

the continued listing of these (DSM and ICD) categories of mental illness, without balance is not a WP:NPOV - as it unintentionally supports the concept of diagnosis and categories without question - or at least without more balanced acknowledgement that these are a particular world view. Wikipedia should not be a repeat of DSM. I see similar issues with Schizophreniform disorder and schizoaffective disorder - ie they seem like a direct copy of the concept, without alerting the reading to the possible bias.

I will begin to edit as per these comments

the section on diagnosis is misleading. Schizoaffective disorder is a diagnosis. Earlypsychosis (talk) 09:36, 23 February 2009 (UTC)
 * Look at Schizophrenia for some criticism of Schizoaffective disorder (poor interrater agreement) etc. Follow the sources there. As far language goes, use the wording in the introduction to Schizophrenia; it's been heavily debated over time, and is probably the best the wiki can muster. Sorry I don't have the time to help here for now. Xasodfuih (talk) 10:34, 23 February 2009 (UTC)

or maybe all articles on mental health diagnosis need a WP:Undue if they fail to acknowledge that the concept is based on DSM and that other view points exist Earlypsychosis (talk) 08:56, 25 February 2009 (UTC)
 * This is perhaps overambitious but it might be a good idea to have a "psychiatric diagnoses" article which would include the various controversies, categories, theories, and so on.  Then specific articles would both have a place to link and the beginnings of standards for categorizing diagnoses in individual articles. OldMonkeyPuzzle (talk) 16:36, 10 April 2010 (UTC)

edit of first line illness
first line now reads more accurately that schizopaffective disorder is a diagnosis. the reference to neurobiological illness was removed for several reasons - firstly the reference to illness is not strictly WP:NPOV and secondly the link redirects to mental disorder, a subtle, yet important distinction. Earlypsychosis (talk) 00:42, 28 February 2009 (UTC)

schizoaffective disorder and school
how do i state to my college the problems this illness is having on me? I have gone from the Dean list to appealing for lack of achievement for taking to many electives. I have been having problems and have had to have medicines changed which will mostly take up another semester. I am getting credits for these classes. and have aready brought supplies for these classes. I don't want to stop going to classes but I am in no shape to take harder classes at this time. Help I have to write an appeal. What can I say with out blowing my chance to remain in school?? —Preceding unsigned comment added by 68.0.108.207 (talk) 18:10, 2 January 2010 (UTC)
 * (I know this is not appropriate for this talk page, but before it is erased, let me say:) Talk to your doctor! The one who prescribes the meds. He/she can help you write an appropriate justification, etc. –Shoaler (talk) 23:48, 2 January 2010 (UTC)

Copyright problems with diagnostic criteria
The American Psychiatric Association has not released its Diagnostic and Statistical Manual of Mental Disorders into public domain, but claims copyright. The Wikimedia Foundation has received a letter of complaint (2010030910040817, for those with access) about the use of their diagnostic criteria in this and a number of other articles. Currently, this content is blanked pending investigation, which will last approximately one week. Please feel free to provide input at the copyright problems board listing during that time. Individuals with access to the books would be particularly welcome in helping to conduct the investigation. Assistance developing a plan to prevent misuse of the APA's material on Wikipedia projects would also be welcome. Thank you. Moonriddengirl (talk) 14:00, 11 March 2010 (UTC)


 * Interestingly, the BehaveNet website reprints DSM-IV and DSM-IV-TR diagnostic criteria with permission (and has had this information available since at least 2003). Zach99998 (talk) 08:14, 5 June 2010 (UTC)


 * I also now realize you're aware of this :) Zach99998 (talk) 10:34, 5 June 2010 (UTC)

Changed section called "Introduction" to "General Features
The second section was called "Introduction" which was causing confusion, so I changed it to "General Features." I have no attachment to the title "General Features" if anyone can think of something better. OldMonkeyPuzzle (talk) 16:40, 10 April 2010 (UTC)

Coatracks, Forks, and Personal Investment
This article has about 3,000 words more than the article on schizotypal disorder, but about 3000 less than the article on schizoid disorder. The schizotypal article seems to focus on diagnostic criteria and the like, while the schizoid article seems to focus on history. Both define the diagnoses simply as disorders rather than diagnoses describing disorders.

The schizoaffective article has an odd tone. There seems to be a great deal of personal investment by the main author. It seems to consist mostly of various ideas and approaches to who is schizoaffective and ideas about treatment. This is necessarily pretty fuzzy.

There is no real model as far as I can see. But this needs some work to be coherent, factual, and inclusive. OldMonkeyPuzzle (talk) 17:32, 10 April 2010 (UTC)
 * I just made a couple of edits to the intro: I removed a "not to be confused with schizophrenia" warning, a line that began "Schizoaffective disorder is often misunderstood by the general public ...," an obsolete warning box about the intro being too long; and a typo.OldMonkeyPuzzle (talk) 17:53, 10 April 2010 (UTC)

OT
Unable to figure out the references for this text therefore removed.

===Occupational therapy===

The role of occupational therapy in treating a mental health condition like schizoaffective disorder is primarily focused on support, education, advocacy, evaluation through assessment and skills training in a variety of settings. Occupational therapy intervention may take place in rehabilitation programs in in-patient, out-patient, community mental health settings, as well as in group therapy sessions and family meetings. One of the main goals of occupational therapy is to create intervention plans, and provide rehabilitative services that meet the needs of each individual client. As a result, occupational therapists may be involved in many different therapeutic interventions depending on the unique needs of their client. Occupational therapists may be involved in more than one therapeutic process with each client at a given time. For example, an occupational therapist may educate a client’s family about schizoaffective disorder in addition to running a skills based therapy session involving the client. One of the main areas of involvement for occupational therapists working with clients with schizoaffective disorder is improving social functioning. In a 2008 study, Grimm et al. suggest that in order "to improve the occupational or social functioning of individuals with schizophrenic disorders, it is important to [first] assess their specific strengths and problem areas and the overall effect of these on [their daily activities]". (26) Impairments in cognitive and social functioning have a significant affect on a person’s daily activities across many areas. Executive function skills such as planning, attention, reasoning, problem solving, learning and memory yield the strongest relationship with functional performance (27). These same skills are required in social functioning because effective social relationships require appropriate perception and cognitive skills (28). Because areas of cognitive and social functioning are most impacted, the aim of occupational therapy in the treatment of schizoaffective disorder is to "[improve cognitive] and social deficits as well as motor, process, communication and social interaction skills" (28). Therapy may take place in an individual or group context and may include a variety of methods and programs: social skills training, cognitive behavioral therapy, cognitive remediation therapy, assertive community training, life skills training, supported employment, group therapy, and psychoeducation are some examples. A further description of each therapy type can be found at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=nicecg82&part=ch8#ch8.s125. Group therapy sessions are often lead by occupational therapists and provide opportunities for observational learning and create an environment where clients can practice the skills being learned. "Groups can also provide opportunities to bolster social support" (27). Through group therapy sessions, individuals can also make contact with other individuals with schizoaffective disorder, which can be very therapeutic. Social skills training targets social and living skills and can affect a number of dimensions important to recovery in persons with schizoaffective disorder. Techniques used in social skills training programs by occupational therapists include: behavioral demonstrations, role-playing, coaching, modeling, shaping and generalization training. (27). Cognitive behavioral therapy is an "insight focused therapy that emphasizes recognizing and changing negative thoughts and maladaptive beliefs" (29). Cognitive behavioral therapy has been effective at reducing the severity of positive and negative symptoms in persons with schizophrenic disorders thereby improving community functioning and quality of life (27). Cognitive remediation therapy aims to improve the cognitive functions and executive thinking skills in persons with schizoaffective disorder. Improvements in thinking skills such as planning, attention and reasoning lead to improvements in an individual’s occupational and social functioning. "Life skills training, such as money management, meal preparation and transportation can produce positive results when done in the natural environment where activities occur" (28). In addition to leading different skills based groups, occupational therapists play an important role in providing support for clients with mental illnesses such as schizoaffective disorder. They directly support their client by providing them with education regarding their illness, including common signs and symptoms that are to be expected. Occupational therapists also provide support through advocating on their client’s behalf, searching out possible privileges, and/or entitlements that may be available to individuals with mental illness. These privileges are often obtained in the context of work, school, or employment agencies. Occupational therapists are a fundamental part of the involvement and education of clients’ families in the therapy process. "When families become involved in treatment, relapse, noncompliance, and re-hospitalization rates significantly go down". (28) Education of family members occurs through family meetings, occupational therapists can be the contact person for the family to ask questions and express their concerns. Occupational therapists may also provide families with education on crisis intervention, problem solving training and other tools that will help them support their family members in recovering from schizoaffective disorder. Additionally, occupational therapists use various assessment tools to evaluate a client’s strengths, weaknesses, improvement, and whether occupational therapy would be helpful to the client. Creek & Lougher (2008), describe assessments used by occupational therapists in three categories, including, initial assessments, ongoing assessments, and later assessments. Each category serves a specific purpose in the therapeutic process. For example, initial assessments are used to evaluate the client’s strengths, problem areas, and whether occupational therapy is appropriate (30). Ongoing assessments display change, and whether outcomes have been reached (30). Furthermore, later assessments display ongoing problems, and help to determine whether changes in the intervention are necessary (30). Throughout the evaluation process occupational therapists use many different specific assessments. A list of specific assessments can be found at http://www.qotfc.edu.au/mental-health/documents/links/ot_resources_townsville_mhs.pdf. Occupational therapists help people living with Schizo-affective Disorder by supporting, educating, advocating for them and by providing evaluation through assessments and skills training in a variety of settings. Through these methods occupational therapy improves the clients functioning based on what the individual is having troubles with as well as helps the individual improve in areas that they deem as meaningful to them.

Doc James (talk · contribs · email) 02:01, 28 May 2010 (UTC)

Claims about the causes of the disorder
The article says: "Genetics, early environment, neurobiology, psychological and social processes are important contributory factors." As a professional I have yet to come over sound research showing clear causal relations between any of these factors (especially genetics and neurobiology) and the diagnosis. If you do, please make sure to give references. Otherwise, I suggest a reformulation of "are important contributory factors" to "may be contributory factors". —Preceding unsigned comment added by 91.186.74.5 (talk) 09:30, 28 July 2010 (UTC)


 * I was about to make the same comment. Declaring in an off-hand way that genetics is one of the causes is a very subtle but ultimately mendacious way to introduce causation without scientific validation.Historian932 (talk) 20:21, 25 March 2011 (UTC)


 * These are potential causes and should be read as such.-- Doc James (talk · contribs · email) 20:23, 25 March 2011 (UTC)

Schizoaffective disorder
Some peolpe think that Schizoaffective disorder is from family members and that if you have it you have to be on meds to "controll" it. But what the doctors don't know anything they beileive that every case is the same and its not take me for exsample i've had Schizoaffective disorder for as long as i can remember, and i'm only 18. i refuse to take my meds because all it dose is make me unable to think strate or walk right. the pills themselfs are worst then delling with my disorter. i say to the docs. if you dont have or if you do try those pills for two weeks and see how they affect you and i bet you'll take them off the shelfs and stop trying to fix us. theres nothing wrong!!!!!!! — Preceding unsigned comment added by 129.71.148.90 (talk) 18:02, 2 June 2011 (UTC)

From section re: cannabis and epidemiology
I'll leave this here in case there's actuallly a decent source to back it up. News articles are not acceptable per WP:MEDRS.
 * Also, Sweden and Japan--where self-reported marijuana use is very low--have similar rates of psychosis to the U.S. and Canada.

Watermelon mang (talk) 05:26, 29 April 2012 (UTC)

pdd missing from dsm
I think this is note worthy. In the dsm schizophrenia lists pervasive development disorder as a preferable alternative diagnosis if there are symptoms of a pdd and unless delusions are bizzar. This isn't the case for schizoaffective disorder even though along with schizophrenia it's a common missduagnosis esp when comorbid adhd is taken into account. — Preceding unsigned comment added by 92.40.253.206 (talk) 12:49, 24 January 2013 (UTC)
 * Thank you for your comment! So in what way would you like to change the article?  Lova Falk     talk   14:13, 26 January 2013 (UTC)

Orphaned references in Schizoaffective disorder
I check pages listed in Category:Pages with incorrect ref formatting to try to fix reference errors. One of the things I do is look for content for orphaned references in wikilinked articles. I have found content for some of Schizoaffective disorder's orphans, the problem is that I found more than one version. I can't determine which (if any) is correct for this article, so I am asking for a sentient editor to look it over and copy the correct ref content into this article.

Reference named "Stahl": From Tiagabine: Stahl, S. Stahl's Essential Psychopharmacology: Prescriber's Guide. Cambridge University Press: New York, NY. 2009. pp. 523-526</li> <li>From Treatment of bipolar disorder: [[cite book|author= Stahl SM | title=Stahl's Essential Psychopharmacology: Neuroscientific basis and practical applications| publisher=Cambridge University Press | year=2008}}</li> </ul>

I apologize if any of the above are effectively identical; I am just a simple computer program, so I can't determine whether minor differences are significant or not. AnomieBOT ⚡ 02:54, 17 March 2013 (UTC)
 * Lova Falk    talk   14:30, 4 May 2013 (UTC)

Lead too long
"The lead is the first part of the article most people read, and many only read the lead. Consideration should be given to creating interest in reading more of the article, but the lead should not 'tease' the reader by hinting at content that follows. Instead, the lead should be written in a clear, accessible style with a neutral point of view; it should ideally contain no more than four paragraphs and be carefully sourced as appropriate." The current article has seven paragraphs in the Lead. Checkingfax (talk) 03:23, 3 December 2013 (UTC)

Spell check
I did a spell check of the easy words. Checkingfax (talk) 23:30, 12 December 2013 (UTC)

My brother was diagnosed with Schizoaffective disorder
My 67 year old brother was diagnosed with Schizoaffective disorder at age 17. He is a ward of the State of California and has been living in group homes, however, now he is in a locked facility. He's absolutely miserable at the Green Acres Lodge. The person in charge has decided that my brother can't go on outings or to the program. My brother loves to be outside and is very depressed. His case manager will only listen to the person in charge at Green Acres Lodge. At this point, I feel I should take custody of my brother and help him find some personal happiness. The dilemma is I live in on the East Coast. Getting my brother from the West Coast to the East Coast won't be easy. Also, I am not sure how damaged he is given that he's been on psychiatric drugs for 50 years. I hate to take responsibility for his care and them regret it. Any advice will be greatly appreciated.

December 24, 2013 — Preceding unsigned comment added by 50.55.134.64 (talk) 16:48, 24 December 2013 (UTC) Couple things to point you in the right direction: First, Wikipedia is an online encyclopedia, not a forum for support about schizoaffective disorder. That being said, you can do a few things to get help from sources that are designed to help you. First, look up your local NAMI chapter; if your IP address (the number at the end of your entry) is correct, NAMI Durham may be able to help you out. Do a search for them. You can also check with Duke University Dept of Psychiatry or the hospital at Duke, but ask for help from social workers as they usually have extensive knowledge of sources of support within your community. You can also do a search for social services in Durham. Your other question of whether you, as a caregiver want to/are able to provide the support needed to help your brother is one you will have to weigh carefully and answer yourself, some of the people at NAMI are family members who can probably help. Good luck.Youtalkfunny (talk) 01:05, 28 December 2013 (UTC)

Using SAD as an abbreviation.
My wife was diagnosed with SAD, but it is referred to as Societal Anxiety Disorder, the abbreviation SAD is also used in other disorders as well. Her SAD is where she gets panic attacks from anxiety when going to unfamiliar places, talking to new people, having to deal with a group of people, or sometimes just at random on the thought of having to do one of the previous.

Edit
Not sure what is with this edit ? Therefore reverted. Doc James (talk · contribs · email) 16:44, 11 July 2015 (UTC)
 * Reverted again. Ref says "Episodic disorders in which both affective and schizophrenic symptoms are prominent but which do not justify a diagnosis of either schizophrenia or depressive or manic episodes"  Doc James  (talk · contribs · email) 20:28, 13 July 2015 (UTC)

Evolution of an article
The SZD article was [//en.wikipedia.org/w/index.php?title=Schizoaffective_disorder&oldid=1017183 launched] by an IP in 2003. Checkingfax (talk) 22:06, 4 October 2015 (UTC)

Inclusion of painting
I came here from a posting on Jimbo's page. What is the painting intended to illustrate and how does it enhance the article? The imagery alone is biased even if the title is suppressed. I am removing the image based on WP:IMAGE RELEVANCE because illustrating a disorder with the interpretations of a single artist gives WP:UNDUE weight to their vision of horror and can give a biased and stigmatized view of the disorder. J bh Talk  23:44, 20 October 2015 (UTC)


 * , I suppressed the painting name as being a stigmatizer. Have you ever heard of [[Phillipe Pinel]]? He released the lunatics from their asylum so they could get fresh air. My grade school was named after him. What was on Jimbo's page that brought you here? I have done a few small edits on this page including adding the SZD and SAD abbreviations, a Hatnote, and suppressing the word lunatic from the painting. Cheers!


 * This [//en.wikipedia.org/w/index.php?title=User_talk:Jimbo_Wales&diff=686732057&oldid=686725188] comment by an IP user. The issue I have is with the imagery even more than the title. It shows a dark horror which leads readers to say this is what it is like . After looking here I went over to Bipolar disorder which has, what I see as, an image which is nearly mocking or at the very best a caricature. Images are the labels which stick in peoples' minds and, at least in the two cases I have mentioned, we are perpetuating a very biased view of these disorders. Thank you for getting back to me. I do think I understand what you are trying to illustrate with this picture. It is very powerful. I just do not think it is the best thing for people coming to the page for information to be confronted with. Cheers.  J bh  Talk  00:22, 21 October 2015 (UTC)


 * , just so we're clear, I did not insert the painting. I just suppressed the title. The only relevance that I can muster from the painting is that the artist was suffering from a mental illness with symptoms similar to acute SZD when he painted it. See if you can come up with a better image please then insert it instead. Cheers!  00:35, 21 October 2015 (UTC)
 * I will see what I can find. Have a good evening. (or day or whatever per your timezone...) J bh  Talk  00:39, 21 October 2015 (UTC)


 * , UTC-7 (PDT). 5:52 pm. Thanks. Cheers!  00:54, 21 October 2015 (UTC)

In wikipedia, images are not just decorations. THey have illustrative purpose. There is no evidence that the image depicts the disorder in question. In no way it helps to understand the article topic. In you claim otherwise, kindly provide educated opinions, with references. Staszek Lem (talk) 02:29, 21 October 2015 (UTC)

I fail to see how a painting by a disturbed person can clarify the text of an encyclopedic article. I do understand that medical professionals may gain insights into a troubled mind by analysing paintings. But then in our article we would need specific comments of a shrink who explains what he sees of. There are zillions of paintings of dark mind. It would be a good idea to find the ones commented by zchizoanalytics. Staszek Lem (talk) 02:57, 21 October 2015 (UTC)
 * It was painted by someone with "episodes of hallucinosis, depressed mood, and emotional outbursts" who was trying to depict mental illness per  Doc James  (talk · contribs · email) 02:59, 21 October 2015 (UTC)

I support the removal of this anachronistic and stigmatising image. --Anthonyhcole (talk · contribs · email) 03:37, 21 October 2015 (UTC)
 * Although I agree that this image is not appropriate for this particular article, there is no need to deride this painting, Yard with Lunatics, by one of the greats of art, Francisco Goya. There is no doubt that Goya struggled with his mental state, and suffered from a combination of physical and psychiatric conditions. This painting depicts his own personal experience in an asylum over 200 years ago, and is both a great work of art as well as a depiction of the horrors associated with the mistreatment of mentally ill people back then. He did not name the painting in English. Respect the art, please, while removing it from this article. <b style="color:#070">Cullen</b><sup style="color:#707">328  Let's discuss it  04:10, 21 October 2015 (UTC)


 * Comment - We got off on a bit of a bad foot here because the anonymous editor blanked the whole infobox which Doc James later restored. After the infobox was restored I added the words that Goya was "inspired to create" and I suppressed the word "lunatic" by piping it to the phrase "this painting". If the word "lunatic" hadn't been out in the clear I don't think this painting would have ever been called out as an issue.

I wish the anonymous editor had discussed this matter on this Talk page instead of on Jimbo's. Cheers! 04:53, 21 October 2015 (UTC)
 * This picture presents a historical perspective of mental illness. Treatment not that long ago was generally very inhumane. History is important as it helps keep us from repeating it and hopefully helps us learn to do better. Note that the one supposedly "sane" person in the image is beating the others with a stick. Doc James  (talk · contribs · email) 07:31, 21 October 2015 (UTC)
 * Which means that it is, hopefully, not a suitable depiction of the condition at present for the infobox! Perhaps, as the previous comments suggest, if you could get sources that back it up, it could be useful in the "History", or a "Stigmatism" section. I think we have to be very careful when using art to depict mental illness, and consider the possible consequences of how it is used. &#8209;&#8209; Yodin T 10:21, 21 October 2015 (UTC)
 * It is far from a suitable depiction. Goya suffered from madness for years and created other works, to say this work illustrates the condition as opposed to any of the other works he did is improper and UNDUE. As I understand there is also some question to the cause of his 'disorder' including organic problems like stroke, lead poisoning etc. I also see the picture in the infobox at Bipolar disorder to be a similar problem with illustrating mental illness articles with caricatures of the lay perception of the illness - in that case it is a literal caricature. It is better to have no infobox pictures in these cases. J bh  Talk  12:40, 21 October 2015 (UTC)
 * Would you be willing to raise this at relevant Wikiproject(s)? It reminds me of Time to Change's Get the Picture campaign, and is something that would benefit from a lot of eyes working across all the relevant articles. Maybe a better image for infoboxes (if necessary) would be ordinary pictures of people reliably confirmed to have suffered from the condition? &#8209;&#8209; Yodin T 15:43, 21 October 2015 (UTC)
 * I am not sure which projects would be the place to raise this. In general, I think it is best not to have pictures in the infoboxes for this kind of article. The one on Schizophrenia seems better than the other two - at least it is by a clinically diagnosed individual - but, it still plays to stereotypical views of the disease.  J bh  Talk  16:26, 21 October 2015 (UTC)
 * There is a guideline about which images are appropriate WP:IMAGE/MOS:IMAGE. Just follow the guideline: "Images must be relevant to the article that they appear in and be significantly and directly related to the article's topic. ", and more. Staszek Lem (talk) 16:31, 21 October 2015 (UTC)

Please don't turn this section into idle chat. The issue is plain and simple: please prove that the particular image illustrates the specific concept: Schizoaffective disorder or anything else explicitly discussed in the article. In the latter case please provide a caption which links the picture with the article text. All these musings about historical madness and Goya suffering are irrelevant. This article is not about Goya, and the image must illustrate article text in a clear and direct way: wikipedia is not a poetry, where readers are encouraged to read between lines and second guess the mysteries of the content. Staszek Lem (talk) 16:31, 21 October 2015 (UTC)
 * My 2 cents after this was on Jimbo's talk page: the painting is clearly unsuitable and unnecessary here. There would need to be some direct relevance to the subject matter, which there isn't.-- ♦Ian Ma c M♦  (talk to me) 17:26, 21 October 2015 (UTC)
 * I agree that the picture doesn't illustrate the subject in this case, which makes it an easy decision. I don't think it's the reason a number of us have looked into this though, with WP:LEADIMAGE and WP:OM also applying, not only to this, but also a lot of other articles on mental-health, created with good intentions. I'd also agree that this probably isn't the right place to discuss it (though it probably needs centralised discussion), and as points out, there doesn't seem to be an obvious Wikiproject: where would you suggest? &#8209;&#8209; Yodin T 12:54, 22 October 2015 (UTC)
 * I don't think there is anything to discuss; the guidelines I mentioned above WP:IMAGE/MOS:IMAGE are extremely clear. If you don't want to edit many mental-health articles without alerting other people, you can point to this talk in the edit summary. But if you really want to be pedantic, the place I suggest to go would be WT:MEDRS - the place where medical pedants congregate. This is because another issue was whether it is appropriate to put disturbing images into mental health articles. I've seen at least one more case the issue arose (and was quite disputed): see [[Talk:Arachnophobia and Talk:Arachnophobia/Archived talks about spider images.Staszek Lem (talk) 16:29, 22 October 2015 (UTC)
 * Thanks for the advice. :) &#8209;&#8209; Yodin T 17:57, 22 October 2015 (UTC)
 * We are not writing a patient self help guide. Thus our articles are not required to be "patient safe". Doc James  (talk · contribs · email) 03:47, 23 October 2015 (UTC)
 * Nor are they supposed to be emotionally slanted simply for 'production value' which is all these pictures really seem to be. Medical articles hold themselves to a higher sourcing standard because it is recognized that Wikipedia is a place many people go to get an overview of medical issues. The least, and I do mean very least, that can be done is strictly follow the MOS when it comes to images. Better is to take the same care with illustration as is done with the text. Patients and their family members/friends etc should not be using Wikipedia articles but we recognize that they do. Arguing otherwise in this instance looks a bit silly. J bh  Talk  11:46, 23 October 2015 (UTC)

Yes I agree that this image is not the best for this article as the diagnosis of the artist while similar to schizoaffective disorder is unclear. Doc James (talk · contribs · email) 22:19, 23 October 2015 (UTC)
 * It is undisputed that Francisco Goya had mental health problems during his lifetime. However, we will never know for sure what modern psychiatrists would have said about them, and even if he had received a diagnosis of schizoaffective disorder the painting Yard with Lunatics is unsuitable as the lead image in this article. What has the painting got to do with schizoaffective disorder? Not a great deal, and so it fails MOS:IMAGE easily. I also agree that images used in articles about mental health on Wikipedia need to be checked carefully to prevent this sort of problem from occurring.-- ♦Ian Ma c M♦  (talk to me) 05:43, 24 October 2015 (UTC)

Getting rid of the image seems very premature to me. Just because it is not the best possible image doesn't make the alternative of no image better. It has independently been analyzed and it is agreed upon that it depicts the disorder. CFCF  💌 📧 14:04, 27 October 2015 (UTC)
 * A discussion on this topic has been opened at Bipolar disorder relating to the image used there. J bh  Talk  01:33, 27 October 2015 (UTC)
 * This painting clearly has nothing to do with schizoaffective disorder so I can't understand the fascination that some people have with adding it. See the comments above before reverting.-- ♦Ian Ma c M♦  (talk to me) 15:24, 27 October 2015 (UTC)
 * That is an extremely bold statement, and quite obviously incorrect. As I said it isn't specifically that this image is perfect, but it's a damn sight better than nothing. Can't we suggest something else instead of removing a perfectly decent and clear image with clear relevance to the topic? CFCF   💌 📧 15:29, 27 October 2015 (UTC)


 * I've hit WP:3RR on this because it is an issue about which I have strong feelings. I've never come across a case in all of my time here where other editors were obsessed with adding an irrelevant image on such flimsy grounds. MOS:IMAGE is clear that images must have some direct relevance to the subject matter. Also, "it's better than nothing" is one of the thinnest and most illogical reasons that I have ever heard for including an image. The New York Times citation accompanying the image is misleading, as it never mentions schizoaffective disorder. I can't understand why various comments by other editors about how MOS:IMAGE works are being overridden by a small number of editors who seem to think that this painting by Goya enhances the credibility of the article when it obviously does not.-- ♦Ian Ma c M♦  (talk to me) 15:33, 27 October 2015 (UTC)
 * Do you have a policy based argument to refute the decision to remove the painting or are you simply saying 'it is better than nothing'? If you do please comment, if the later then that is not the wisest footing to edit war from. Cheers. J bh  Talk  16:01, 27 October 2015 (UTC)
 * If you have a good citation that says this painting is illustrative of the condition that would be useful as would any commentary that discusses the picture in relation to the disease. Without that it is pretty much OR. J bh  Talk  16:03, 27 October 2015 (UTC)
 * Yes, policy dictates that relevant images are to be included. I will instead ask you to explain how the image does not comply with policy. You can't simply should fails MOS:IMAGE and expect that is all you need to do. CFCF   💌 📧 16:05, 27 October 2015 (UTC)
 * Unless someone can provide a reliable source in which this image is mentioned in the context of schizoaffective disorder, I don't want to see it back in the article. This is going round in circles and getting sillier by the minute.-- ♦Ian Ma c M♦  (talk to me) 16:07, 27 October 2015 (UTC)
 * What you want is irrelevant, it's what is helpful for the readers understanding that matters. It is impossible to have an image of schizoaffective disorder from this period because it is a new diagnosis. Removing the image because it is not ''perfect' is WP:POINTY and very disruptive. Deleting the painting is a net loss for the article. CFCF   💌 📧 16:18, 27 October 2015 (UTC)
 * Goya painted Yard with Lunatics in 1793-4, long before the DSM-IV codes were invented. For this reason alone, it is unwise to say "this image illustrates schizoaffective disorder". It is an irrelevant eye candy image in this article.-- ♦Ian Ma c M♦  (talk to me) 16:28, 27 October 2015 (UTC)
 * Turning the policy question around is not a valid. It is un-cited material which has been challenged. Who says it is SAD? It could be anything from organic damage to bipolar psychosis or mild schizophrenia to SAD to an artist expressing his horror at "madness" because he is a bit 'cracked'. It does not help the reader and may misinform the reader because we do not know how it relates to SAD and it implicitly asserts that Goya suffered from SAD which we have no good references for . As has been mentioned repeatedly by many editors in this thread. If you want to change consensus bring information to the table which will change opinions. You need to pull your horns in, if you want to make accusations of POINTYness and disruption you need to bring some evidence or strike it.  J bh  Talk  16:38, 27 October 2015 (UTC)
 * It is cited material. I included a reference. QuackGuru  ( talk ) 17:16, 27 October 2015 (UTC)
 * The cite you mention on my talk page [//en.wikipedia.org/w/index.php?title=User_talk:Jbhunley&diff=687771621&oldid=687743454] has only this to say "On his wife's side, there were insane members of the family in an asylum that he probably would have seen. The prison and madhouse scenes may reflect his emotions." about the series of 'dark' paintings. No mention of SAD and an alternate explanation for why he was painting such material. I would say it is better evidence for exclusion than inclusion. I guess it can as easily be considered to have failed verification as un-cited, unless I missed something.   J bh  Talk  17:23, 27 October 2015 (UTC)
 * The image represents deeply disturbing visions of sadism and suffering and it is known that Goya had mental disorders. Unless there is a better image I think we should keep this one. QuackGuru  ( talk ) 17:55, 27 October 2015 (UTC)
 * This is a rehash of the "it's better than nothing" argument. Nobody has yet found a cite in a reliable source in which the image is said to illustrate schizoaffective disorder in any way, shape or form.-- ♦Ian Ma c M♦  (talk to me) 17:58, 27 October 2015 (UTC)
 * The image does illustrate Goya's mental disorder according to the reliable source. QuackGuru  ( talk ) 18:06, 27 October 2015 (UTC)
 * No it doesn't. I read through the New York Times citation next to the image carefully. One of the main reasons why I removed the image from the infobox is that it falsely gives the impression that the link to schizoaffective disorder has the NYT seal of approval, and a reader should not get this impression when the sourcing given is not clear enough to provide a link. "The prison and madhouse scenes may reflect his emotions" is nowhere near a clear enough link to satisfy MOS:IMAGE.-- ♦Ian Ma c M♦  (talk to me) 18:13, 27 October 2015 (UTC)
 * No it does not. Show the quote because it sure can not be the one I mentioned above and illustrating "his mental disorder" does not make it appropriate for this article. From WP:LEADIMAGE "...they not only should be illustrating the topic specifically, but should also be the type of image that is used for similar purposes in high-quality reference works ,..." (Emp. mine.) Here is an interesting quote "Goya reported hearing voices, losing balance, progressive deafness and simultaneous tinnitus. Diagnoses range from Ménière's disease to paranoid dementia, though it is unlikely we will ever truly know the root cause." from [//brainz.org/10-great-painters-who-were-mentally-disturbed/] so I presume the SAD diagnosis is pretty weak and a bit controversial. I am not saying this is RS but it summarizes things nicely. Here is another "[Goya] fell desperately ill with a fever and mental confusion; he may have had encephalitis. Upon physical recovery, he still suffered with episodes of hallucinosis, depressed mood, and emotional outbursts." . I can think of at least a half dozen pathologies for Goya, I presume you can as well, and more importantly so can the sources.   J bh  Talk  18:34, 27 October 2015 (UTC)
 * Here is an extended quote from WP:LEADIMAGE:"'Lead images should be images that are natural and appropriate visual representations of the topic; they not only should be illustrating the topic specifically, but should also be the type of image that is used for similar purposes in high-quality reference works, and therefore what our readers will expect to see. Lead images are not required, and not having a lead image may be the best solution if there is no easy representation of the topic.'" Some very good advice there, and it is better not to have a lead image in this article than to include one that fails the guidelines set out in WP:LEADIMAGE.-- ♦Ian Ma c M♦  (talk to me) 20:07, 27 October 2015 (UTC)


 * You say in your edit summary . Ultimatums will not get any traction with me, and I doubt anyone else. What are you thinking? Or do you somehow feel its your way or the highway? Adversarial is really not the way to go about editing Wikipedia and you seem experienced enough to know better. It is perfectly acceptable to have no image, nothing requires it ans right now you are editing against consensus and policy. J bh  Talk  23:13, 27 October 2015 (UTC)
 * Struck. Sorry, I'm in a bit of a shitty mood tonight. Probably should not be editing. J bh  Talk  23:22, 27 October 2015 (UTC)
 * It is far better to have a decent image than none at all. If we're looking for the perfect image we will quickly find it does not exist. CFCF   💌 📧 23:25, 27 October 2015 (UTC)
 * I agree with WP:LEADIMAGE that not having a lead image may be the best solution. The current caption (for File:Van Gogh - Trauernder alter Mann.jpeg) reads like OR; do we have any sources which specifically mention this picture in relation to SAD? &#8209;&#8209; Yodin T 23:56, 27 October 2015 (UTC)
 * I've removed the van Gogh painting because replacing one irrelevant image with another does not solve the problem. It is also worrying that QuackGuru and CFCF appear to be edit warring over this, without making any serious attempt to listen to the points about WP:PERTINENCE and WP:LEADIMAGE that have been made by other editors.-- ♦Ian Ma c  M♦  (talk to me) 06:17, 28 October 2015 (UTC)


 * Vincent van Gogh's health does not mention schizoaffective disorder as one of the conditions that he may have had, nor does any reliable source that I could find online. Again, this is WP:OR and risks giving a false impression to the reader. It seems that At Eternity's Gate was added because of a misplaced belief that the article must have a lead image at all costs.-- ♦Ian Ma c M♦  (talk to me) 07:23, 28 October 2015 (UTC)
 * No, there is no belief that an article must have a lead image, but it is a fact that it is extremely useful and that there have been multiple studies stating how readers find Wikipedia to be more when it includes high quality images. And I don't care whether our article states that van Gogh had schizoaffective order or not, but several scholarly articles do, such as this review The Illness of Vincent van Gogh stating both schizophrenia, depression and mania.
 * I find it at least as disconcerting that you are edit-warring (now at 4RR) to remove relevant and high quality (if not perfect) images. I understand the point of not wanting to stigmatize or insult, but this painting does not. Also it has strong ties to van Gogh's mental problems and was painted two months before his disease-related suicide. CFCF   💌 📧 09:06, 28 October 2015 (UTC)
 * Saying "I don't care whether our article states that van Gogh had schizoaffective order or not" is worrying as this reduces the lead image to a piece of eye candy. While it is generally accepted that van Gogh had some mental health problems, as Goya did, the link is too tenuous to satisfy MOS:IMAGE.-- ♦Ian Ma c M♦  (talk to me) 09:39, 28 October 2015 (UTC)
 * How so? It worries you that I use other sources outside of Wikipedia - I even expressly gave a link to a review article on the topic. CFCF   💌 📧 10:02, 28 October 2015 (UTC)
 * I am applying the same rules that would be applied at Good Article or Featured Article level. This means that the question is "Does the lead image have a significant and direct link to the article subject?", not "Does it look good?" or "Did the artist have a mental health problem which in my opinion looks vaguely similar to schizoaffective disorder?" So far, the arguments in favour of having any form of lead image seem to have asked only the latter two questions.-- ♦Ian Ma c  M♦  (talk to me) 15:54, 28 October 2015 (UTC)
 * There is no vague about the association, it is on the contrary very strong - and as you may notice similar images are already present at FA articles with the clear proviso that the image is not perfect. CFCF   💌 📧 15:58, 28 October 2015 (UTC)

Request for comment on the painting(s)
I've started an rfc on this, as input from fresh editors is needed. Many of the pro-inclusion comments for the painting(s) (see section above) are non-policy based and ignore the principles set out in WP:PERTINENCE and WP:LEADIMAGE. It is not an absolute must for the article to have a lead image, and if it does it should be "significantly and directly" related to the article subject.-- ♦Ian Ma c M♦  (talk to me) 06:57, 28 October 2015 (UTC)


 * Support inclusion of a relevant image with strong ties to the subject such as the one by van Gogh. None of the opposition to that image is policy-based and is based on the belief that an image must be perfect to be included. CFCF   💌 📧 09:09, 28 October 2015 (UTC)
 * See the comments above. There is no evidence in reliable sources that van Gogh had schizoaffective disorder, and the painting lacks any "significant or direct" link to the subject. This has been the sticking point all along. I can't understand the fascination with adding images just to say that there is a lead image. Not having a lead image is the best option, as it is hard to illustrate schizoaffective disorder in a "significant and direct" way. It is an abstract concept in the DSM-IV codes and van Gogh would never have heard of it.-- ♦Ian Ma c M♦  (talk to me) 09:18, 28 October 2015 (UTC)
 * No, and I would adive you to see the comments as well as the review article I linked. One major factor that he could not have been diagnosed is that the disorder did not exist when he lived. The painting most assuredly has a significant and direct link to the subject, and that was not disputed about the previous image. Not having a lead image is a horrible option, and anything that helps to illustrate is very useful indeed. Many of those who suffer from a disease will never have heard of their diagnosis prior to receiving it. This image illustrates the mood he was in prior to his death, which was very much disease related - even the title which seems very different from the image is indicative of his disorder. "Significant or direct" does not imply perfect in every way.  CFCF   💌 📧 09:39, 28 October 2015 (UTC)
 * I can also add that this image is used on other parts of the internet to specifically illustrate schizoaffective disorder (notably result 3 on a google image search for schizoaffective at http://trialx.com/curetalk/2011/09/diagnostic-tests-and-clinical-trials-for-schizoaffective-disorder/. It is also very similar to the MedlinePlus image (which of course isn't perfect either): https://www.nlm.nih.gov/medlineplus/ency/imagepages/17242.htm . CFCF   💌 📧 09:42, 28 October 2015 (UTC)

"The painting most assuredly has a significant and direct link to the subject, and that was not disputed about the previous image." If it wasn't disputed, we wouldn't be having this thread now. Although this is off topic as far as MOS:IMAGE is concerned, the "head clutcher" image is considered to be a cliché by mental health advocacy groups.. I'm feeling more like facepalm at the moment, because of the determination of some users to add a lead image that fails guidelines.-- ♦Ian Ma c M♦  (talk to me) 09:50, 28 October 2015 (UTC)
 * The dispute concerning the previous image was primarily that it was stigmatizing and that it was not clear that the disorder was primarily the one suffered by Goya. The current image suggestion has a far more pertinent link the topic and is painted by someone with a very similar condition. Concerning your comment that the disorder is an abstract concept, diagnosis is never 100 % certain and each case is different. This review article in the American Journal of Psychiatry discusses van Gogh's mental health and makes assumptions that it is in the very least very similar to the topic of the article. For this reason neither can an image be perfect, but using an image like this adds to understanding of the topic. Also of note is that this image was painted over 100 years before such a cliché is said to have evolved - and the pose was actually one of van Gogh's favorites. (Of note is also that I did not want to use one of his self-portraits because that would be unrepresentative of the condition in general.) CFCF   💌 📧 10:01, 28 October 2015 (UTC)
 * It is the same problem as with Goya. We will never know what modern psychiatrists would have said about van Gogh's mental health problems, and there have been various theories. On a related note, I think that the headclutcher cliché may stem from journalists either consciously or subconsciously copying this van Gogh painting. I had a look at Depression (mood) (yes, WP:OTHERSTUFF exists) and it has no infobox image. That is also the best option here.-- ♦Ian Ma c M♦  (talk to me) 10:11, 28 October 2015 (UTC)
 * But I just linked an article by modern psychiatrists that covered van Gogh's mental health problems? I don't see your point? Other stuff like choices at depression don't influence this article, and the fact that is a cliché may stem from the fact that it is difficult to express in any other way visually, that doesn't retract from the value of the image. As I said before: just because an image isn't perfect doesn't mean it shouldn't be included. This image is really good and as good as it's going to get. It clearly illustrates the topic of the article without either stigmatizing or being inaccurate. CFCF   💌 📧 10:17, 28 October 2015 (UTC)
 * We're going to have to agree to differ here, and get some input from non-involved editors. I still think that the image is not "significantly and directly" related to schizoaffective disorder, and this was also the consensus view about the Goya painting.-- ♦Ian Ma c M♦  (talk to me) 10:23, 28 October 2015 (UTC)


 * Oppose inclusion The source presented does not support any relation to SAD. "'.The presence of seizures, the intermittent and pleomorphic symptoms of the interictal phase, the prolonged amnestic-confusional psychotic episodes at the height of van Gogh’s illness, and, finally, the profile of his personality traits all suggest a diagnosis of epilepsy-related illness.'" This paper argues an organic cause - against even bipolar disorder and schizophrenia . Trying to stretch this to being in any way relevant to SAD beggars belief. Why not throw in some works by Louis Wain, Richard Dadd or even Michelangelo. They also are thought to have had mental illnesses which were not SAD . The whole point of the image policy is to prevent editors from putting in an image because they think it looks good . In this case inclusion goes beyond OR into plain old false information. J bh  Talk  13:21, 28 October 2015 (UTC)
 * You are arguing beside the point. It will always be impossible to get a definitive diagnosis, but the paper discusses the symptoms as the same as those of schizoaffective disorder. It can also be added that one disorder does not necessarily exclude any others. CFCF   💌 📧 15:37, 28 October 2015 (UTC)
 * Ahh... yes... "It can be argued." A lot of things can be argued but the thing about Wikipedia is we need RS to make that argument, we even have an entire policy on not making those arguments ourselves WP:NOR. Your personal preference that there be something in the infobox has no weight. I would like to see an image too, but I want one that is at least minimally policy compliant. "[T]he paper discusses the symptoms as the same as those of schizoaffective disorder.". Really? Says who? Where? Based on your expert opinion? Even if you are an expert that is not a valid argument. The paper discussed a cluster of symptoms and the author's expert opinion is that cause of that cluster of symptoms is most likely an epilepsy related condition resulting from a lesion on the brain compounded/or caused by massive absinthe use and possibly some unknown and unspecified co-morbidity. If you disagree with that publish a paper or better you find some RS to back up your claim the co-morbidity was SAD. Otherwise you are committing WP:SYNTH. To sum up the pictures violate WP:LEADIMAGE, WP:OR and WP:SYNTH. Would you care to explain how they do not? J bh  Talk  15:56, 28 October 2015 (UTC)


 * Also oppose on the basis of and 's points. In addition to failing the image criteria, the caption fails to cite a reliable source to support its being there, and uses WP:WEASELWORDS ("is widely believed to...") to try to justify WP:OR and WP:SYNTH. As I mentioned above, I would personally love to see relevant, positive pictures for every mental health article, perhaps a collage of people clinically diagnosed with the condition (which could be achieved through a WMF grant application), along the lines of articles about ethnicities (e.g. Kurds). While I commend   for constructively trying to find a replacement, and respect the frustration on both sides, this painting isn't suitable. ‑‑ Yodin T 16:33, 28 October 2015 (UTC)
 * No, it currently lacks the citation, but that is basically only because it feels superflous, but here you go:http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.159.4.519
 * Also, I would strongly oppose any collage because that singles out individuals and is far less likely to be representative. CFCF   💌 📧 16:40, 28 October 2015 (UTC)
 * Ok, let me retract the constructive part. Please answer the points of above: the article you've linked to again doesn't support your claim. In fact, it says:
 * "Several authors have offered a tentative diagnosis of schizophrenia for van Gogh. In view of both the absence of any of the fundamental symptoms of the disorder and the presence of psychotic episodes with amnestic-confusional features and complete recovery, this diagnosis appears improbable, in spite of the fact that late-onset schizophrenia was diagnosed in one of his sisters."
 * Note the article nowhere seems to mention Schizoaffective disorder. &#8209;&#8209; Yodin T 16:53, 28 October 2015 (UTC)
 * Yes, a lack of all criteria for schizophrenia combined with at least one mood disorder is indicative of schizoaffective disorder. Also, that is just one of very many sources discussing his mental health in this context, there are a bunch more available with a quick google search. The problem is that any definitive diagnosis is impossible, because he's been dead for >100 years, but even so this is a very close match. CFCF   💌 📧 17:08, 28 October 2015 (UTC)
 * Are you sure it's "a lack of all criteria"? The point is, you haven't produced any reliable sources which even tentatively link van Gough to SAD, the source which you've linked to differs from your opinion, and you've been very clear that you're using original research to construct a synthesised argument to justify a picture, any picture, in the infobox. &#8209;&#8209; Yodin T 18:04, 28 October 2015 (UTC)
 * I'm also failing to see how showing lots of people who are known to have a condition is less representative than a picture of a single person who, according to the article you mention, probably didn't suffer from it. Is it up to us to define what mental health problems "look like"? &#8209;&#8209; Yodin T 18:16, 28 October 2015 (UTC)


 * Support inclusion of image; it does not violate WP:LEADIMAGE. Also see WP:PERTINENCE, which states, "Images are primarily meant to inform readers by providing visual information. Consequently, images should look like what they are meant to illustrate, even if they are not provably authentic images." There is a lot of leeway with free images. Flyer22 Reborn (talk) 16:50, 28 October 2015 (UTC)
 * Please see the "headclutcher" discussion above, and, for example, this site: the picture doesn't illustrate the condition in any meaningful way, and re-enforces a negative stereotype. Just as we must be careful when describing issues of race, gender and sexuality, we also need to exercise the same amount of caution with mental health. &#8209;&#8209; Yodin T 16:58, 28 October 2015 (UTC)
 * It seems very far-fetched to say that this image reinforces negative stereotype, unless that stereotype is that it is a debilitating condition - which is a completely true stereotype. CFCF   💌 📧 17:10, 28 October 2015 (UTC)
 * I don't imagine that you would think it was a negative portrayal, or you wouldn't have chosen it! Have you read the site I linked to? It's an entire campaign set up by a major mental health charity to encourage people not to use stereotyped images—most notably "head-clutching"—to depict mental health problems, which stigmatise these issues. According to their research "eight in 10 people told us headclutchers don't show how it feels to have a mental health problem". Then again, they might be wrong, and your assertion right. &#8209;&#8209; Yodin T 18:04, 28 October 2015 (UTC)
 * It's not necessarily that I don't think they have a point about stereotypes (not so much negative), but rather that it isn't a strong one. If we are going to avoid stepping on any toes we can't have images or articles at all, because they will always be unacceptable to someone. The fact remains that it is an image that many if not most would find very illustrative, and that also has strong ties to the subject. CFCF  💌 📧 18:55, 28 October 2015 (UTC)
 * Yes, we understand your WP:ILIKEIT argument do you have any others? The issues are 1- There is no evidence Van Gogh has any connection to SAD or that RS say he did. 2- We now have some evidence, linked above, that 'head clutching' as a symbol for mental illness is seen to be improper/offensive imagery. Even if it could be demonstrated Van Gogh suffered from SAD we should still look for more appropriate images by the same painter. Since there is not we need not. In this case there is no connection and the imagery is considered inappropriate . Plus, of course, WP:OR and WP:SYNTH. J bh  Talk  19:05, 28 October 2015 (UTC)
 * Well in that case take a look here where it specifically states van Gogh had schizoaffective disorder.  CFCF   💌 📧 21:28, 28 October 2015 (UTC)
 * I know you want to find evidence for this, but this source doesn't say that; it says:
 * "historiographical studies have diagnosed well-known artistic figures (such as Lord Byron, Sylvia Plath, Vincent van Gogh, Salividor Dali and Virginia Woolf) as having bipolar disorder, schizoaffective disorder or personality disorders"
 * It would be interesting to see which of the sources the author cites (Claridge, Pryor & Watkins, 1998; Jamison, 1993; Murphy, 2009) covers van Gough specifically, and which of those three disorders they attribute to him, but by the looks of it the academic consensus doesn't seem to point towards it definitely being Schizoaffective disorder, and at this point, a lone source wouldn't be enough to prove that that was the consensus. This way of proving someone has a certain condition reminds me a bit of those lists of "famous people who had x", where any source even vaguely mentioning someone in relation to x is enough for that person to be added to the list, and once on one list, they're added to all subsequent lists without fact-checking, regardless of historical uncertainty, or any lack of scholarly consensus. If we follow your argument through, then by extension we should use this source to add to the articles on Lord Byron, Sylvia Plath, Vincent van Gogh, Salividor Dali and Virginia Woolf, that each one had bipolar disorder, schizoaffective disorder and personality disorders. &#8209;&#8209; Yodin T 22:58, 28 October 2015 (UTC)
 * WP:LEADIMAGE covers this: "For most topics, the selection of a lead image is plainly obvious: a photograph or artistic work of a person, photographs of a city, or a cover of a book or album, to name a few. Image selection for other topics may be more difficult and several possible choices could be made... the selection of the lead image should be made with some care with respect to this advice." If the article's about, say, a bridge, then you want a picture of that bridge in the lead; if, as in this case, it's about something which isn't straightforward to depict, then it can be very difficult to find a suitable image, and "not having a lead image may be the best solution if there is no easy representation of the topic". From what you've said I think you just disagree with the policy: shall we start a discussion on this part of it on the talk page there? &#8209;&#8209; Yodin T 20:45, 28 October 2015 (UTC)


 * Support inclusion of image per. After reading Flyer22 Reborn comment I have concluded that the image does not violate WP:LEADIMAGE. Please see WP:PERTINENCE: "Images are primarily meant to inform readers by providing visual information. Consequently, images should look like what they are meant to illustrate, even if they are not provably authentic images." Images do not have to be perfect. It is very similar to this image. QuackGuru  ( talk ) 19:07, 28 October 2015 (UTC)
 * It is still OR and SYNTH that this image illustrates anything to do with SAD . Also, see "Very often, we see an image of a person holding their head in their hands. All manner of mental health stories - about anything from talking treatments to scientific research - are illustrated by a 'headclutcher' photo. But what alternatives to the 'headclutcher' and other stigmatising images do picture editors have?... We believe that a picture can be just as damaging as words when used to depict stories about mental illness. (Emp. mine.)" Which says this imagery, in particular, is considered stigmatizing. J bh  Talk  19:16, 28 October 2015 (UTC)


 * Oppose There were two major arguments for inclusion: the author is relevant or the image depicts what is in the article. Both arguments are not solid. No compelling proof presented that the author suffered SAD. No compelling proof is presented that the image faithfully depicts SAD (and I cannot imagine any image showing what's inside a szhizo brain). Staszek Lem (talk) 19:13, 28 October 2015 (UTC)
 * Extra argument - after re-reading the article, I see that in fact headclutcher is incorrect depection since it fails to capture the bipolarity of the disorder, namely "schizo" + "affective". and the "bedlam"-type painting is completely nonspecific. Staszek Lem (talk) 19:23, 28 October 2015 (UTC)
 * Then you've missed the discussion. The issue is that no image will ever be perfect as in it won't capture every aspect, but it has strong ties to the subject and should be included for that reason. Also note that the bedlam image was removed for being stigmatizing, and was live for an extended period before being removed for that reason alone. CFCF   💌 📧 19:28, 28 October 2015 (UTC)
 * Strawman. I am not talking about "every" aspect. I am talking the basic defining traits. Staszek Lem (talk) 22:57, 28 October 2015 (UTC)


 * Comment Re WP:PERTINENCE a more complete quotation from that shows what that section envisioned "Images are primarily meant to inform readers by providing visual information. Consequently, images should look like what they are meant to illustrate, even if they are not provably authentic images. For example, a photograph of a trompe-l'œil painting of a cupcake may be an acceptable image for Cupcake, but a real cupcake that has been decorated to look like something else entirely is less appropriate." It is not a license to just make stuff up. Images must still be "relevant to the article that they appear in and be significantly and directly related to the article's topic." as the immediately preceding paragraph says.  J bh  Talk  19:35, 28 October 2015 (UTC)
 * I would also say that WP:PERTINENCE is about images throughout an article, and is the minimum requirement for lead images. It by no means overrides WP:LEADIMAGE, which must be applied once WP:PERTINENCE has been established. In this case, I don't think there's a consensus that these pictures pass either. &#8209;&#8209; Yodin T 20:36, 28 October 2015 (UTC)


 * Comment Invoking WP:CITE. So far I see only opinions of wikipedians. How about a couple of sources that claim that a particular image (photo, painting, drawing, etc.) is characteristic of SAD? If you can find none, it probably means none and definitely means none per basic wikipedia rules. The lead image is a far too prominent element to leave it 100% to a wikipedians' whim. Staszek Lem (talk) 23:07, 28 October 2015 (UTC)
 * See "Evidence for a link between creativity and mental illness comes from several strands: 1) historiographical studies have diagnosed wellknown artistic figures (such as Lord Byron, Sylvia Plath, Vincent van Gogh, Salividor Dali and Virginia Woolf) as having bipolar disorder, schizoaffective disorder or personality disorders (Claridge, Pryor & Watkins, 1998; Jamison, 1993; Murphy, 2009); 2)" That works for me. QuackGuru  ( talk ) 23:59, 28 October 2015 (UTC)
 * That paper does nothing to address van Gogh but Salvador Dali might be a good candidate. I found the actual paper [//docs.google.com/document/d/16XMDhgiKWfNBFvSKPHjvXPKu0AUjcmQx8NiyprlDBmw/mobilebasic?viewopt=127 here] and from that lead it looks like there might be a solid body of work that supports Dali as having SAD. More sources are needed but it is promising. J bh  Talk  00:24, 29 October 2015 (UTC)


 * The problem with Dali is that he hasn't been dead long enough, so we have very few of his works to choose between. I found one photography that might be representative of his work, but I'm more in favor of the van Gogh image. CFCF   💌 📧 00:38, 29 October 2015 (UTC)
 * A huge selection of his work is available at WikiArt. We need to examine the licensing but at the worst we can make an NFCC/Fair Use claim. All of the images at WikiArt are public domain or under a fair use claim. Considering the problems we are having with finding representative works using one under NFCC should not be an issue. We still need to establish that there is a reasonable claim in quality RS that Dali had SAD. There is material but I do not know how good it is. J bh  Talk  00:54, 29 October 2015 (UTC)
 * Some possibilities: Invention of the Monsters, Paranoia, The Paranoiac, The Disentagration of the Persistance of Memory J bh  Talk  01:09, 29 October 2015 (UTC)
 * No they have no right to give a Dali away (and they expressly say so), and no, we don't have fair use here.  Staszek Lem (talk) 01:29, 29 October 2015 (UTC)
 * Yes, it looks like use would fail on the Contextual significance point because we do not have to have the image and there might be other suitable free material out there. If we can find an RS that specifically discusses a work in relation to SAD however that commentary would seem to allow its use under our NFCC policy. That is, of course, hypothetical at this point so does not really matter. J bh  Talk  02:45, 29 October 2015 (UTC)
 * Actually, we will fail our own, very clear policy of fair use in which contextual significance is irrelevant. Staszek Lem (talk) 03:49, 29 October 2015 (UTC)

Umm... That would be [//en.wikipedia.org/wiki/Wikipedia:Non-free_content#Meeting_the_contextual_significance_criterion 2.3 Meeting the contextual significance criterion] which together with [//en.wikipedia.org/wiki/Wikipedia:Non-free_content#Meeting_the_no_free_equivalent_criterion 2.1 No free equivalent criterion],  [//en.wikipedia.org/wiki/Wikipedia:Non-free_content#Meeting_the_previous_publication_criterion 2.2 Previous publication criterion] and [//en.wikipedia.org/wiki/Wikipedia:Non-free_content#Meeting_the_minimal_usage_criterion 2.5 Minimal use criterion] make up the criteria which must be met for non-free image use. I take these from of our very own NFCC policy which you so kindlI linked. Cheers. J bh Talk  04:46, 29 October 2015 (UTC)
 * Thx, It looks like I did not refresh my knowledge of the policy for a long time. Staszek Lem (talk) 16:40, 29 October 2015 (UTC)
 * No problem. I had to read through it recently when there was a big to do going on about 'Fair Use' vs Wikipedia's NFCC policy. WP is indeed a lot more strict than straight fair use and we would need very solid sourcing before we could consider making use of an NFCC image here. Cheers.  J bh  Talk  16:53, 29 October 2015 (UTC)

The picture of the manic person in a straight jacket, is a useful picture of mania. People with the condition are still often restrained or locked up. Doc James (talk · contribs · email) 04:27, 30 October 2015 (UTC)
 * Straitjackets of the 19th and early 20th century variety are almost never used nowadays. As the Wikipedia article points out, the only person likely to be wearing one is an escapologist.-- ♦Ian Ma c M♦  (talk to me) 08:42, 30 October 2015 (UTC)
 * There is really not that much difference between a straight jacket and using restraits to tie someone to a hospital bed. Doc James  (talk · contribs · email) 06:54, 31 October 2015 (UTC)
 * Black and white engravings are almost never suitable for Wikipedia articles unless they are illustrating the period involved. This happened at Human penis, where someone added an engraving of urination that led to a complaint that it was child porn. Although it probably isn't child porn, it isn't suitable as an illustration for a serious medical article. The problem is that people go over to Wikimedia Commons and find black and white engravings because they are very old and out of copyright, and then use them to illustrate articles.-- ♦Ian Ma c M♦  (talk to me) 07:34, 31 October 2015 (UTC)
 * So we disagree. I think the history of medicine is an important aspect of medicine and that using historical images is occasionally appropriate. Doc James  (talk · contribs · email) 08:57, 31 October 2015 (UTC)
 * If people are restrained in modern psychiatric hospitals, it should be possible to find photographs of the equipment used. The problem is that people often traipse off to Commons and find the usual mixture of low quality photos and old out of copyright images, then add one of them to an article. This is a problem for all Wikipedia articles, but it seems to be a particular problem in medical articles.-- ♦Ian Ma c M♦  (talk to me) 09:30, 31 October 2015 (UTC)
 * People are still restrained in modern Psych hospitals with bed restraints and with walking-restraints (like handcuffs). They are still also locked in to solitary hard metal rooms with solid doors. Doc's ER has bed restraints too. He can take a picture of those and donate them to the Commons. The Commons is lacking in spot-on images for most articles. Cheers!  21:54, 31 October 2015 (UTC)
 * I could take picture of the devices themselves. I could have one of my nurses pretend to be a patient. For obvious reasons one cannot use a real patient as informed consent is not possible in such a situation. Thus a drawing is better in this type of case. Doc James (talk · contribs · email) 04:22, 1 November 2015 (UTC)
 * File:Maniac in a strait-jacket, in a French asylum. Wellcome L0011307.jpg is fine for illustrating how inmates were treated in 19th century asylums. Since it dates back to 1838, any caption would have to reflect this. Commons is full of old scanned black and white images which have been added because they are old and out of copyright.-- ♦Ian Ma c M♦  (talk to me) 07:22, 1 November 2015 (UTC)

Arbitrary break
The battle lines have been drawn here, with neither side showing signs of giving in. What has emerged as a result of this debate is that images, particularly in the infobox, need to be chosen carefully in articles about mental health problems. Failure to do this can result in the addition of images that are off-topic or portray outdated stereotypes that the media has been urged to avoid. It is hard to see how any sensible person could argue that the paintings Yard with Lunatics and At Eternity's Gate  have a "significant and direct" link to schizoaffective disorder, as Goya and van Gogh would never have heard of the DSM-IV codes. As WP:LEADIMAGE says, it is better to have no image at all than to have an off-topic one. WP:MED should look into this issue and have some guidelines which would prevent individual editors from insisting that an image that they found on Commons has a significant and direct link to a mental health diagnosis when it obviously does not.-- ♦Ian Ma c M♦  (talk to me) 08:21, 29 October 2015 (UTC)
 * The DSM4 did not invent the disease and therefore van Gogh not hearing about the book is a strange argument. Doc James  (talk · contribs · email) 04:23, 30 October 2015 (UTC)
 * Yard with Lunatics and At Eternity's Gate  are fine for illustrating the works of Goya and van Gogh. They are not fine for illustrating general concepts of mental health because they contain Bedlam-type imagery which the media has been asked to avoid. WP:LEADIMAGE is clear that some article topics may be difficult to illustrate, and schizoaffective disorder is one of them. What does it look like? It is hard to say, because it is a medical diagnosis. This is why WP:LEADIMAGE recommends having no lead image if this problem is likely to occur.-- ♦Ian Ma c M♦  (talk to me) 06:13, 30 October 2015 (UTC)
 * Yes it is hard to depict. No it is not a medical diagnosis, it is a psychiatric diagnosis. Both mania and depression can be depicted and as key aspects of this disorder would be depictions of it aswell. Doc James  (talk · contribs · email) 09:02, 31 October 2015 (UTC)
 * In Schizophrenia it was apparently agreed to have a cloth embroidered by a schizophrenic person as the lead image. Perhaps here something showing the disorder's impact on other objects could be the lead image as well, possibly like altered handwriting. Just an observation, as I don't strongly favor any image here. Brandmeistertalk  20:48, 31 October 2015 (UTC)


 * Oppose any image, for the simple reason that images are meant to illustrate points, in a similar fashion as infoboxes summarise pertinent article information. You cannot possibly objectively characterise SAD via an image - it is just impossible to do so in any standardised manner. What's more, having such an image, or any image in that regard can be seen as trivialising or charicaturising the disorder. You could argue the opposite statement as well, but bear in mind that any sort of graphical representation of a psychiatric disorder is always meant to upset someone due to its personal nature. If you want to avoid such problems, avoid using images in this way. The use of images throughout the text is a whole different issue. That's my opinion based on common sense. Cheers, FoCuS contribs ;  talk to me!  00:31, 13 November 2015 (UTC)
 * Oppose any image so far proposed. I can't imagine an image that would accurately depict schizoaffective disorder without picking out and over-emphasizing one aspect, with the probability of misleading the reader. I'm open to using some relevant decorative picture at the top of the article that doesn't inaccurately stereotype or stigmatise victims, but can't at the moment think what that would look like. Absent such an image, it is best to gave none. --Anthonyhcole (talk · contribs · email) 01:16, 13 November 2015 (UTC)
 * Therapy is the primary treatment. We occasionally use treatment images in the lead but not sure if this type of image would be specific enough.  Doc James  (talk · contribs · email) 22:44, 15 November 2015 (UTC)
 * It would be best for editors to choose one image rather than reject all images. This is weird some editors are rejecting all images. QuackGuru  ( talk ) 19:00, 18 December 2015 (UTC)
 * For some controversial articles we do decide on no image when we cannot agree on any of the possibilities. We could go with a picture of psychotherapy http://neurowiki2014.wikidot.com/individual:psychotherapy Doc James  (talk · contribs · email) 19:13, 18 December 2015 (UTC)
 * That works for me. QuackGuru  ( talk ) 19:17, 18 December 2015 (UTC)

Motion to close
Having had a little distance to the topic I think its clear there are more people in favor of removing the image than there are in retaining them for this specific article. I agree that none of the images are ideal, but I'm very concerned with getting rid of all images from mental health articles. We can not let perfect be the enemy of good, and I've reached out to a self-confessed "schizoaffective artist" as well as having looked through some other venues for an appropriate image. Getting hold of a better image may take a while, but for the time being I think this RfC is doing more harm than good. CFCF  💌 📧 13:22, 13 November 2015 (UTC)
 * Second closing it now a consensus has emerged. I would also support 's suggestion above to take a discussion of the general issue to WP:MED to try to create guidelines that support good images being used across these articles, without just getting rid of them all as you say. ‑‑ Yodin T 14:17, 13 November 2015 (UTC)
 * Support both close and opening a discussion at WP:MED to address the general issue and formulate guidelines for inclusion of images in the lead of articles about mental disorders or mental health in general. J bh  Talk  01:47, 14 November 2015 (UTC)
 * Support We've all had our two cents on this by now. I also support opening a discussion at WP:MED to ensure that lead images in articles about mental health are chosen carefully.-- ♦Ian Ma c M♦  (talk to me) 04:20, 14 November 2015 (UTC)
 * Abstain. It is better to choose one of the images. QuackGuru  ( talk ) 07:38, 15 November 2015 (UTC)
 * How about an image of psychotherapy such as found here ? This one is definately under an open license  Doc James  (talk · contribs · email) 19:14, 18 December 2015 (UTC)
 * My preference is no picture when there is no picture that is either illustrative of the topic or somehow aids in understanding the topic. This picture seems to be more a picture for the sake of having a picture and, other than being innocuous, has much the same policy failings as the other proposed pictures. That said it is so innocuous that if most editors want a picture for the sake of having a picture I can not bring myself to object too strongly. J bh  Talk  20:38, 18 December 2015 (UTC)
 * It's not bad, but I would also still prefer no image as it doesn't seem to add any information to the article. Another thing I've just stumbled upon is Image placeholders, though haven't read it thoroughly enough to know whether it would be helpful or unhelpful here. &#8209;&#8209; Yodin T 21:42, 18 December 2015 (UTC)
 * Wait, it's deprecated; fixed the text around the link that pointed me there. &#8209;&#8209; Yodin T 21:49, 18 December 2015 (UTC)


 * It appears some editors prefer no image even when the image is useful and relevant to the topic. If that is the case I'd like to remind editors that policy says Wikipedia is not censored. But the reality is very different. QuackGuru  ( talk ) 01:08, 20 December 2015 (UTC)
 * Thanks for flagging this up . Since you mention censorship, I've given it some more thought, taken a look again at your comments, and reassessed why I think this is important. Images which I believe re-enforce negative stereotypes of mental health issues should not be censored. There is a need to be conscious that many images we associate with these conditions aren't accurate depictions of them, and in these cases they run contrary to the aim of providing visual information about the topic (e.g. this is what the topic looks like, or this depicted thing is central to the topic), which is the crux of what an image in the lead section is intended to do. When relevant to the topic, and covered in reliable sources, images should be included in a context that neutrally explains their use (e.g. historical treatments, artistic depictions of mental health problems, people known to have the condition, etc.). To me the discussion about Dali above is an especially clear example of a willingness by editors both for and against the removal of the original Goya image to engage constructively with—rather than shut down—other points of view. I've noticed in the above discussions that you don't often engage with replies that disagree with your opinion, but as this is quite a serious accusation, please elaborate if you still feel this really is a form of censorship. ‑‑ Yodin T 02:26, 21 December 2015 (UTC)

needs to be updated
a lot of the information and references in this article are outdated. i recommend someone start all over. (please)Talon grey (talk) 23:16, 19 December 2015 (UTC)talon grey

Also the article states "In DSM-5 and ICD-10 (which is being revised to ICD-11, to be published in 2015), schizoaffective disorder is in the same diagnostic class as schizophrenia" - it is now 2016; has the ICD-11 not been released? Hikikomoridesuyo (talk) 05:59, 1 May 2016 (UTC)

sad
seasonal affective disorderTalon grey (talk)talon grey —Preceding undated comment added 23:42, 19 December 2015 (UTC)
 * Agreed. Major blunder. Also, Social Anxiety Disorder. – Just passing through, 21:16, 31 May 2019 (UTC)

Current infobox image
With a heavy heart, I ask why the painting File:Courtyard with Lunatics by Goya 1794.jpg is being used in the infobox. OK, it's a good painting, it's copyright free and it is on Commons, but it has nothing to do with schizoaffective disorder. Now wait for some people to turn up and say that we *must* have it.-- ♦Ian Ma c M♦  (talk to me) 06:24, 28 December 2017 (UTC)
 * It is relevant. If you can find a better one let's talk. <b style="color: #e34234;">QuackGuru</b> ( talk ) 06:31, 28 December 2017 (UTC)
 * And the prize for deciding that we *must* have this image despite its lack of WP:PERTINENCE goes to the aptly named QuackGuru, who reverted twice.-- ♦Ian Ma c M♦  (talk to me) 06:34, 28 December 2017 (UTC)
 * Of course the image is relevant. They ae acting abnormal in the painting. I thought one of them was looking at me. Kind of scary! <b style="color: #e34234;">QuackGuru</b> ( talk ) 06:40, 28 December 2017 (UTC)
 * That is such a thin argument. "They are acting abnormal". Is that the best you can come up with?-- ♦Ian Ma c M♦  (talk to me) 06:42, 28 December 2017 (UTC)
 * See Wikipedia's Yard with Lunatics: "Some historians speculate that Goya's symptoms may indicate prolonged viral encephalitis; and the mixture of tinnitus, imbalance and progressive deafness may be symptoms of Ménière's disease. Others claim that he was suffering from mental illness. However, these attempts at posthumous diagnosis are purely, and only, speculative and hypothetical. Goya's diagnosis remains unknown. What is known, is that he lived in fear of insanity, and projected his fears and despair into his work." Freaky! <b style="color: #e34234;">QuackGuru</b> ( talk ) 06:45, 28 December 2017 (UTC)
 * Most of this source highlights the clear problem with the lack of WP:PERTINENCE and MOS:IMAGELEAD compliance. In particular, "Lead images should be natural and appropriate representations of the topic; they should not only illustrate the topic specifically, but also be the type of image used for similar purposes in high-quality reference works, and therefore what our readers will expect to see. Lead images are not required, and not having a lead image may be the best solution if there is no easy representation of the topic" Neither of these policies requires the infobox image to be freaky.-- ♦Ian Ma c M♦  (talk to me) 06:52, 28 December 2017 (UTC)
 * See "Ome medical writers have favored the diagnosis of syphilis, some consider the possibility of an exogenous psychosis, and other suggests that the symptoms of the illness are more congruent with heavy metal poisoning, particulary lead." What he had did affect is mind. <b style="color: #e34234;">QuackGuru</b> ( talk ) 08:03, 28 December 2017 (UTC)
 * Just saw this in my watchlist. Consensus still stands from the above discussion: please stop being disruptive . Why was this image restored on 6 Sept by without an edit summary? &#8209;&#8209; Yodin T 14:20, 28 December 2017 (UTC)
 * Anyway, it's out of the article at the moment and I would be amazed by anyone who would go to the wall to have this very clearly off topic image in the infobox.-- ♦Ian Ma c M♦  (talk to me) 18:19, 28 December 2017 (UTC)
 * There is an awareness ribbon for SAD we could use. Doc James  (talk · contribs · email) 02:28, 29 December 2017 (UTC)

Contributions to the page for a school assignment
I have been assigned to edit an article of my choice for my Psychology Capstone course. I chose the article "Schizoaffective Disorder" mainly because I did not know much information on the topic, because it was a class C article, and because I have a family member diagnosed with SAD. I would really like to contribute to the "signs and symptoms" portion of the article; I feel this is what most people use wikipedia for, to see what the diagnosis really entails. I would also like to contribute a bit to the "causes" heading, but instead of adding much more information, I believe it could be presented in a slightly clearer way; I would reword some sentences and maybe add a small bit of information. The main section I would like to contribute on is "treatment." The first statement in the section states that "Few medications are approved specifically for schizoaffective disorder." However, my family member that has been diagnosed with SAD is so heavily medicated to suppress her symptoms that other family members say she is nothing like the person she used to be. I believe this section could use some enlightenment on not only the available options, but also side affects of different combinations of meds. I love that other options for treatment, like therapy, have been included and have a lot of detail.

Sources I plan to use include:

https://ghr.nlm.nih.gov/condition/schizoaffective-disorder

http://www.mentalhealthamerica.net/conditions/schizoaffective-disorder

https://www.everydayhealth.com/schizophrenia/guide/schizoaffective/

Thanks, Madihuddleston (talk) 04:22, 28 January 2019 (UTC)

Concerns about this article...

 * Please don't take this the wrong way, but reading this article and Talk section serves as a good reminder that there are some articles that ought to be curated especially well (that is, some articles on particular/specific mental disorders). This should read like a reference, not a WebMD or psych forum, shouldn't it? Has anyone considered turning some of these pages into semi-protected pages? Speaking as someone with an education in psych, I'd highly recommend you consider it. I'm not saying this to insult anyone or hurt anyone's feelings, but it could be harmful or damaging (yes, I am aware some people consider the psych field to be damaging at times too, but I'm not suggesting Freudians take over the joint)... :/ – Just a concerned reader @ 21:24, 31 May 2019 (UTC)

Wiki Education assignment: Psychology Capstone
— Assignment last updated by Thatbaddie205 (talk) 02:34, 2 October 2022 (UTC)

Wiki Education assignment: Psychology Capstone
— Assignment last updated by Kennedif00 (talk) 15:49, 15 February 2023 (UTC)

Misdiagnosis of schizophreniform disorder as schizoaffective disorder
According to the introduction to this article at present: "Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia."

Psychotic depression: misdiagnosis is a result of presuming that psychotic symptoms are present outside of a major depressive episode when in fact they are not. Bipolar I is similar, but with major depressive or manic episodes.

Schizophrenia: misdiagnosis is a result of considering major mood episodes to be ongoing for more of the period of illness than is accurate. This may be done by underestimating how long the period of remission is (particularly if it consists mostly of negative symptoms) or by misidentifying heavy presence of negative symptoms as a major depressive episode.

But schizophreniform disorder? It is not clear to me how someone with schizophreniform disorder would be misdiagnosed with schizoaffective disorder. An episode involving both affective and nonaffective psychoses is on its own sufficient for the schizoaffective disorder diagnosis to be correct, as long as the time restrictions (nonaffective psychosis for at least 2 weeks; affective psychosis predominant) are respected.

Furthermore, while I have no source (and as such am not editing the article, only the talk page) schizoaffective disorder would seem to me to be more likely to be misdiagnosed as bipolar I disorder or major depressive disorer with psychotic features (due to presumption of circumscription of psychosis to major mood episodes) or as schizophrenia (due to overfocus on positive symptoms and inattention to major depressive episodes, which may mimic negative symptomatology) rather than the other way round.

Proposal: update this sentence to no longer include reference to schizophreniform disorder and include a passage which reflects misdiagnosis in both directions, with all claims made clearly cited (and obviously if my presumptions are wrong, particularly the one about schizophreniform disorder, then they shouldn't make it through to an edit!) Anditres (talk) 21:30, 26 May 2023 (UTC)