Diagnosis of a DSM 5 News Cycle
As I was sitting around catching up on some mental health news on Saturday, I inadvertently stumbled upon another manufactured news cycle about the DSM 5. Considering no new significant research findings were released in the past week on the DSM-5 revision efforts, I was a little surprised.
This latest fake news cycle started on Thursday, apparently with the release of a Reuters news story from Kate Kelland. Kelland notes the newest concern comes from “Liverpool University’s Institute of Psychology at a briefing in London about widespread concerns over the manual.” There’s no link to the briefing. And I’m not sure what a “briefing” is — a press conference? (And since when is a press conference a news item? It’s not really equivalent to a new research study, is it?)
Kelland fails to note that Europe and the U.K. don’t actually use the DSM to diagnose mental disorders — it’s a U.S. reference manual for mental disorders diagnosis. So while it’s nice that some Europeans are expressing concern about this reference text, their concern isn’t exactly much relevant. Context is everything, and Reuters failed to provide any useful context in that article.
Sadly, Reuters is a brand name. And once you write an article under that brand name, it cascades down an entire news cycle. Let’s follow it for fun!
Reuters begins with:
Millions of healthy people – including shy or defiant children, grieving relatives and people with fetishes – may be wrongly labeled mentally ill by a new international diagnostic manual, specialists said on Thursday.
In a damning analysis of an upcoming revision of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM), psychologists, psychiatrists and other experts said new categories of mental illness identified in the book were at best “silly” and at worst “worrying and dangerous.”
Wow, glad there’s no fear-mongering going on there. A nice, balanced approach to the news.
These are the same “experts” who have been beating their drum all fall and winter, but who decided to convene a press conference in the UK last week to generate more press. And more press they did generate.
The Kelland article again regurgitates half-truths about the issue, such as this beauty:
More than 11,000 health professionals have already signed a petition […] calling for the development of the fifth edition of the manual to be halted and re-thought.
Apparently Reuters doesn’t do any fact checking any longer. As we discussed more than a month ago, not all of the “signatures” are mental health professionals — only approximately 88 percent self-reported they were. Sloppy reporting from Reuters.
The rest of the “briefing” was simply rehashing all of the same old arguments that both we and many, many others have already covered. It’s silly and a little demeaning to try and argue these things in the press, over and over again, because it comes down to one set of professional opinions against another. Whose set is “better” or more legitimate? Nobody can tell, because nobody has access to the future.
Oh. Except for Allen Frances, M.D. He has apparently left his position as a doctor and taken up residency as a psychic, because he told the U.K.’s Telegraph,
“DSM5 will radically and recklessly expand the boundaries of psychiatry. Many millions will receive inaccurate diagnosis and inappropriate treatment.,” said Allen Frances of Duke University, North Carolina.
Wow, really? You always seem to miss mentioning how the current DSM-IV — overseen by the same Allen Frances — has done exactly the same thing (according to its critics).
Because this press conference — uh, I mean “briefing” — was conducted in the U.K. by U.K. organizations, it was picked up in the U.K. media. (Here’s a nice summary of the coverage.)
Now, in order to capitalize on this new news cycle in the U.S., American outlets needs to bring their own sexy angle to the story.
A day after the UK press conference, ABC News took the bait and Katie Moisse wrote it up as though the petition was a new thing (it was started in October 2011 and had 10,000 signatures two months later, in December 2011). Our knight in shining armor against the DSM-5, Allen Frances, again is liberally quoted:
“You can’t have one professional organization, like the American Psychiatric Association, responsible for something so important,” he said.
The change of heart is amazing. When the APA was signing checks to Frances, he had no problem supporting them. Now that he’s out of the process, he suggests the APA shouldn’t be the one publishing the reference text.
Keep in mind, the use and adoption of the DSM is completely a market-driven, voluntary choice. Nobody is demanding professionals use the DSM to diagnose mental disorders in the U.S. Another international system already exists called the ICD-10, and is used throughout the rest of the world. All the 600,000+ U.S. mental health professionals need do is agree to start using that instead of the DSM. It doesn’t require government intervention, and it doesn’t require endless hand-wringing.
The NY Daily News ran with the latest news cycle today with their own unique spin. This newspaper initially claimed that “DSM-5 lists Internet addiction among mental illnesses.” The headline was later changed to, “DSM-5, the new mental illness ‘bible,’ may list Internet addiction among illnesses.” Note that “may” was slipped in, and of course, typical of Internet news articles, no mention was made of the edit to the headline to reflect that absolutely nothing has changed about the status of Internet addiction in the new DSM-5. It will still likely not appear except in a general “behavioral addiction” disorder category — something we’ve known for about 2 years now.
Probably mostly unnoticed in this latest blip in the DSM-5 news cycle is this thoughtful article over at Medscape about the bereavement exception for depression. Well worth a read, as it actually is a nicely balanced piece of actual journalism. It’s thoughtful, examines both sides of the issue without bias, and presents a wealth of data to let the reader draw their own conclusion.
A refreshing change from the dribble passing for journalism from Reuters and others these days.
So a quick recap — no new news has occurred with the DSM-5. Some professionals who started a petition back in October 2011 held a press conference, and some news media attended it, and decided to write up these professionals opinions. These opinions are in opposition to other professionals’ opinions.
I will make a prediction right here and now, much like the psychic Allen Frances: When the DSM-5 is published next year, the world will not end. We will not face a new epidemic of diagnoses of any of the disorders listed therein. And mental health professionals will adapt to the new changes with little effort on their part.
For further reading…
Read the Reuters story: New mental health manual is “dangerous” say experts
Read NY Daily News story: DSM-5 lists Internet addiction among mental illnesses
Read the ABC News story: American Psychiatric Association Under Fire for New Disorders
Read the Fierce Pharma story (with links to UK coverage): Psychologists petition against DSM-5 revisions
Grohol, J. (2012). Diagnosis of a DSM 5 News Cycle. Psych Central. Retrieved on November 26, 2015, from http://psychcentral.com/blog/archives/2012/02/12/diagnosis-of-a-dsm-5-news-cycle/