DSM-5 troubles
Both Shrink Rap and Mind Hacks report on a debate about how transparent the process for developing the upcoming DSM-V should be. This debate is published in the LA Times. Those in charge of the revision want secrecy, nobody knows why. It is suggested in the comments it could have something to do with the insurance companies?
Besides transparency of the making of the new revision of this psychiatric diagnostic bible other problems were mentioned on this blog as well as others:
- Psychiatrists updating the DSM did not disclose ties with pharmaceutical drug companies
- Will Internet addiction be a new diagnosis in the DSM V? Medicalize problems again. In an editorial in the American Journal of Psychiatry Internet Addiction is proposed as a new diagnosis in DSM V. Now the American Journal of Psychiatry used to be a serious peer reviewed journal although some of us doubt this feature for a while now.
- More than half the 28 new members of writers of the next edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) have ties to the drug industry.
- The Last Psychiatrist also has an opinion about Internet addiction in the DSM V.
- Suicidal behavior as Sixth Axis in DSM VIt is suggested in an editorial of the American Journal of Psychiatry that suicidal behavior be considered a separate diagnostic category documented on a sixth axis. Ridiculous. Suicidal behavior (death and attempts) is a symptom of various psychiatric conditions. We will need a seventh axis for addiction, another item often overlooked. It is a kind of safe guard against lack of interest, lack of empathy for psychiatric patients.
There is still a long way to go. The DSM-V is due out in May 2012, and all mental illness and proposals for the classifications of new mental illness are currently under review by the DSM-V committee.
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July 14, 2009 @ 4:04 am
The Diagnostics and Statistical Manual (DSM), the Shrink’s bible, has been around for over 50 years. Within this manual, there are now possibly nearly 300 mental disorders.
As a dictionary of suspected mental illnesses, many redefined diagnoses are added to this manual with each edition, and how such disorders are classified and assessed.
On occasion, a mental disorder is deleted from the DSM, such as homosexuality in the early 1970s. Its purpose, this manual, is to assist mental health professionals to diagnose and classify mental disorders.
How a group sponsored by for profit pharmaceutical industry corporations that promote psychotropic drugs for various mental issues that may or may not fully exist make the determinations that they do while maintaining objectivity is a phenomenon.
Published and designed by the American Psychiatric Association (APA), the DSM is also used, I understand, for seeking mental diagnostic criteria to assure reimbursement.
The DSM is organized in part by the following:
I- Mental disorders
II- mental conditions
III- Physical disorders/syndromes, medical conditions (co-morbidity)
IV- Mental disorder suspected etiology
V- Pediatric assessments
The APA has historically directed the creation of each edition of the DSM, and assigns selected task force members to create this manual. This situation has proven to be controversial.
The next DSM involves 27 people. About 80 percent of these individuals are male, and only 4 members are not medical doctors. Most have had relationships with the NIH, and about 25 percent of these task force members have had relationships with the WHO.
Historically, at least a third of task force members have had, or do, have often monetary pharmaceutical industry ties in some way.
This makes sense, as about one third of the APAs total financing is from the pharmaceutical industry.
The APA required this task force for the next DSM edition to sign non-disclosure agreements- which is rather absurd and pointless. Lack of transparency equals lack of credibility because of these agreements of the content of the next DSM. It opposes any recovery model necessary regarding such disorders, I believe.
The DSM should be evaluated by another unrelated task force or a peer review of sorts to assure objectivity. This is particularly of concern presently, as many more are diagnosed with mental dysfunctions presently at a concerning rate- with very young children in particular.
Dan Abshear