Proposed DSM-V Criteria Getting Slammed Online

An article just posted online for the August 2010 issue of the Journal of Mental Healthhas sparked up coverage by major news corporations and much negative commentary online regarding the proposed criteria for the upcoming release of DSM-V in 2013, including a press release from the journal’s parent company Informa Healthcare. Many of those who’ve made their voices heard are focusing on the shift toward a society that will consist of more people with mental health illnesses than people who are “normal,” caused by the suggested added influx of new diagnoses. Additionally, many are claiming that the DSM criteria are, and have been, based on myths and not hard, scientific facts.

Check out what they’ve had to say below, and post a comment at the bottom of this page to let us know what you think. Are they wrong? Do they not know what they’re talking about? Or are they one to something. Is the DSM is need of a more reliable replacement? If so, how could it be created? What’s the solution? What do you use to make diagnoses? Why?

Kate Kelland for Reuters

“An updated edition of a mental health bible for doctors may include diagnoses for ‘disorders’ such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.”

“Leading mental health experts gave a briefing on Tuesday to warn that [DSM-V]… ould devalue the seriousness of mental illness and label almost everyone as having some kind of disorder.”

“Citing examples of new additions like ‘mild anxiety depression,’ ‘psychosis risk syndrome,’ and ‘temper dysregulation disorder,’ they said many people previously seen as perfectly healthy could in future be told they are ill.

‘It's leaking into normality. It is shrinking the pool of what is normal to a puddle,’ said Til Wykes of the Institute of Psychiatry at Kings College London.”

“‘It's a bit like telling 10 people with a common cold that they are ‘at risk for pneumonia syndrome’ when only one is likely to get the disorder,’ Wykes told the briefing.”

Philippa Roxby for BBC News

“The danger, say experts writing in a special issue of the Journal of Mental Health, is that there has not been enough research to back up these changes.

Even the smallest shift in how to define something like depression could have huge implications.”

“Dr Felicity Callard, senior research fellow at the Institute of Psychiatry, King's College London, says it is crucial to understand what happens when people are over-diagnosed.

‘There are very big potential implications on how people, particularly adolescents, respond to being told they have a mental illness. It's likely there will be harmful consequences,’ she said.”

“If normal behaviour is increasingly being categorised as mental illness then that creates a burden on individuals, families and on society as a whole.

As well as an emotional and social toll, there are financial implications.

It follows that money has to be set aside to care for the mentally ill and clinicians and carers have to be trained to deal with their ‘illness.’”

Dorothy Rowe for Guardian

“The Diagnostic and Statistical Manual, whose updated fifth edition will include a range of new diagnoses, is a mythology, not a scientific text. It is created by American psychiatrists who meet in groups to consider whether or not a certain diagnosis should be included in the DSM. These groups meet a number of times so that they can say that their agreement about a certain diagnosis is reliable. Thus they could reliably agree that there is a mental disorder called Guardian Readers' Personality Disorder with the symptoms of a need to read this paper regularly, an overvaluation of the Guardian, and so on. Who knows, it might already be in the most recent version of the DSM.”

“For any statement to be valid there has to be evidence for that statement outside of the statement itself. Thus any textbook of physical disorders will list not just the symptoms of each illness but evidence that exists separate from those symptoms and that is derived from a wide variety of tests. Apart from the disorders listed in the DSM as the result of brain trauma, there are no physical tests for any of the disorders listed in the DSM. No physical cause has been found for any of these mental disorders. The diagnosis you receive from a psychiatrist is no more than the psychiatrist's opinion of what you have told him. Go to another psychiatrist and you're likely to get a different diagnosis.”

Alyssa Sparacino for AOL Health

“New criteria for diagnosing mental disorders could have many more people labeled as ‘ill,’ and has left some doctors wondering if anyone will be ‘normal’ anymore.”

“But, at a recent briefing, experts warned that this updated DSM has the potential to diminish the severity of mental illnesses, as well as label healthy people as sick. This is because other new disorders that are being considered for listing in the manual include toddler temper tantrums and binge eating, Reuters reports.”

“‘Technically, with the classification of so many new disorders, we will all have disorders,’ Wykes and his colleagues said in written concerns. ‘This may lead to the belief that many more of us 'need' drugs to treat our 'conditions' -- (and) many of these drugs will have unpleasant or dangerous side effects.’

Dr. Daniel Carlat, AOL Health's mental health expert, says he believes the concerns are exaggerated because doctors should be considering several other factors about patients' symptoms, such as if they truly affect their work, relationships, concentration and sleep.

‘But, we always want to avoid falsely stigmatizing a patient, because that can itself lower their self esteem,’ Carlat tells AOL Health. ‘It's always hard to know if this is over-diagnosis versus more accurate recognition of problems that have been missed in the past.’”

Check out these related books:

• Users and Abusers of Psychiatry: A Critical Look at Psychiatric Practice
• Making Us Crazy: DSM - The Psychiatric Bible and the Creation of Mental Disorders