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Comment by wpietri | Hacker News Reader

> are blind people more likely to be living in a circumstance where their mental health troubles are more easily managed/ignored/suppressed without the involvement of doctors who would otherwise diagnose schizophrenia? That seems not at all unlikely to me.

Could you explain your thinking to me? I'd think that people with one serious condition would me much more likely to have a second serious condition diagnosed, purely because of increased attention from medical professionals. That's certainly been my experience.

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The issue is that psychosis/schizophrenia isn't like testing for a bacterium or looking at an x-ray. It's really a label for a set of presenting behavioral patterns, and is heterogeneous (I don't mean this critically, just the way it is).

So let's say someone is blind, and they come in. They will almost certainly be more likely to receive attention than someone who is not. But how their presenting disorganized thoughts, etc. are described is likely to be different given their history of blindness, especially if they had a lifetime history of associated cognitive deficits or issues.

It's also the case that overlapping presence of two pathologies is not necessarily same as them disjointly. So blindness etiological factors + psychosis etiological factors may not equal schizophrenia with blindness, but rather a more severe cognitive and/or physical disorder that receives an entirely different diagnosis. This latter scenario isn't necessarily a measurement issue, but it could be construed that way.

>But how their presenting disorganized thoughts, etc. are described is likely to be different given their history of blindness, especially if they had a lifetime history of associated cognitive deficits or issues.

Another thing to consider is that a lot of people with mental illness can tell something is wrong with them because they can compare themselves to others. It's much harder for a blind person to do that because they don't get a lot of the information most people get passively by simply being near other humans.

I have (untreated) asthma, but nobody ever explained to me what having asthma means. I was well into my adulthood before I found out that it is not normal to have difficulty breathing hours and sometimes days after simple aerobic activities. And I didn't even have the issue that I couldn't see that other people didn't have this issue. I just thought that this was normal and they were better trained.

> I'd think that people with one serious condition would me much more likely to have a second serious condition diagnosed, purely because of increased attention from medical professionals.

Does that apply to blindness at birth, though? I mean, you don't get continuing "treatment" or checkups for blindness, right? (At least, no more than a sighted person would go in for a yearly eye exam.) Obviously there are unique needs a blind person has to function in society, but it's not like something like cancer or a mental illness where you need to follow up and have continuing care and treatment for many years, possibly the rest of your life. For birth blindness, it's basically "yep, kid's blind; need to adapt to that", and that's it from the standpoint of medical care, no?

No.

That depends on the specialty, if the symptoms are overlapping and the treatment produces strange side effects - that diagnosis could be delayed for many years.

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