DSM 5 AND CLASSIFICATION OF MENTAL ILLNESS

DSM 5 AND CLASSIFICATION

OF MENTAL ILLNESS  

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On 18 May 2013, the fifth edition of the updated ‘Bible’ of the American Psychiatric Association’ Diagnostic and Statistical Manual of Mental Disorders (DSM) became available to practicing psychiatrists, clinical psychologists, neuro-psychologists, and others involved in psychiatry.  DSM 5 replaced DSM 4 which was issued in 2000.  Normally a select task force is entrusted with the required research and contribution involved in producing such a reference Manual.  In this case the Task Force was formed in 2007 and the Manual is some 947 pages.

Significance of DSM 5 on everyone

You may well ask why bother writing such a blog when it really is an intrusion on the domain of the medical profession and specifically, the specialty of psychiatry.  The reason is simply the effect DSM 5 will have either directly or indirectly on all, yes all of us!  Unless a patient who is not feeling well and his General Practitioner cannot find anything organically to explain that feeling he or she is often referred to psychiatrist or clinical psychologist.  The chances are that patient is often privately health insured.  Unless that psychiatrist or psychologist provides diagnosis based on DSM 5 classification that patient is denied medication and denied private health insurance coverage.  If not covered by the Public Health such as the Australian Medicare System that can be costly exercise for anyone undergoing treatment.

In DSM 4 excessive bereavement, homosexuality, gender identity disorders, post traumatic stress disorders, autism, certain types of schizophrenia and Asperger syndrome were included and classified as mental conditions for which medication were prescribed and all private health insurance covered.  DSM 5 sets the bars higher for diagnosis of these conditions by either adding further criteria or complete deletion of the condition.

In recent weeks there had been major discussion and criticism of DSM 5 by members of various psychiatric associations especially in USA, UK, Canada, and Australia.  The thrust of these criticisms relate to undue influence by psychiatric drug industry, lack of independent empirical support and corroborative evidence for the addition, revision, and deletions.  Perhaps the more telling criticism relates to the quality of the information in support of changes, confusion and contradictions.  The bulk of those telling criticism comes from practicing psychiatrists and clinical psychologists!   

Personally, I'm outraged. What are your thoughts?

        

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