You got everything exactly right, and I also find it strange that a psychiatrist can't identify variables that are causally related.

For instance, a schizophrenic who has it so bad that he drowns his pain in alcohol, becomes depressed as a result, loses his job and becomes unemployed, gets later arrested and becomes imprisoned (or later in life on probation).... etc.

Not to mention that basically every schizophrenic I've ever met that wasn't homeless was on disability, and within those who are on disability you have a few cases of people trying to work or volunteer 2-5 hours a week to try to maintain a connection to the world and the overwhelming majority who are unemployed.

Most of these indicators aren't something you can separate out statistically, the same people who have one of the things he listed have multiple. Granted four are considered mutually exclusive in his script, but that's still only taking into account four mutually exclusive variables and not including the causal relationship between the many many others.

Also, you're exactly right about psychiatrists seeing the worst and specializing. I see a psychiatrist that specializes in psychotic illnesses, mood disorders, and related mental distress cases. Every time I meet with him (there are only two doctors in the whole office), it's a constant flow of patients in and out to see him. He consistently repeats to me every time I see him that I'm the only patient of his that is doing well in life overall and can't really understand how I am able to move past and ignore symptoms that would otherwise cripple his other patients. That seems like a very very low percentage of patients that he sees that are doing well and has to distort his views on how things are going as you said.