There is conflicting information about whether deworming reduces HIV progression and viral load and increases CD4 counts in antiretroviral naive and experienced individuals, although the most recent Cochrane review found some evidence that this approach might have favorable effects. Chronic illness
Chronic helminthiasis may cause severe morbidity. Helminthiasis has been found to result in poor birth outcome, poor cognitive development, poor school and work performance, decreased productivity, poor socioeconomic development, and poverty. Malnutrition
Helminthiasis may cause chronic illness through malnutrition including vitamin deficiencies, stunted growth, anemia, and protein-energy malnutrition. Worms compete directly with their hosts for nutrients, but the magnitude of this effect is likely minimal as the nutritional requirements of worms is relatively small. In pigs and humans, Ascaris has been linked to lactose intolerance and vitamin A, amino acid, and fat malabsorption. Impaired nutrient uptake may result from direct damage to the intestinal mucosal wall or from more subtle changes such as chemical imbalances and changes in gut flora. Alternatively, the worms’ release of protease inhibitors to defend against the bodys digestive processes may impair the breakdown of other nutrients. In addition, worm induced diarrhoea may shorten gut transit time, thus reducing absorption of nutrients.Malnutrition due to worms can give rise to anorexia. A study of 459 children in Zanzibar revealed spontaneous increases in appetite after deworming. Anorexia might be a result of the bodys immune response and the stress of combating infection. Specifically, some of the cytokines released in the immune response to worm infestation have been linked to anorexia in animals.
It has also been argued due to the poor consistency and efficiency of diagnosis due to overlapping traits that SzPD should be removed altogether from the DSM.A 2012 article suggested that two different disorders may better represent SzPD: one affect-constricted disorder (belonging to schizotypal PD) and a seclusive disorder (belonging to avoidant PD). They called for the replacement of the SzPD category from future editions of the DSM by a dimensional model which would allow for the description of schizoid traits on an individual basis.Some critics such as Nancy McWilliams of Rutgers University and Parpottas Panagiotis of European University Cyprus argue that the definition of SzPD is flawed due to cultural bias and that it does not constitute a mental disorder but simply an avoidant attachment style requiring more distant emotional proximity. If that is true, then many of the more problematic reactions these individuals show in social situations may be partly accounted for by the judgements commonly imposed on people with this style. However, impairment is mandatory for any behaviour to be diagnosed as a personality disorder. SzPD seems to satisfy this criterion because it is linked to negative outcomes. These include a significantly compromised quality of life, reduced overall functioning even after 15 years and one of the lowest levels of "life success" of all personality disorders (measured as "status, wealth and successful relationships"). However, determination of what qualify as "impairments" or as "negative outcomes" is itself potentially subject to cultural bias.