As the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders continues to develop, there has been more and more reaction from professional groups with concerns. The most recent of these is an open letter that was sponsored by group of American Psychological Association divisions, and you can read it here: Open Letter to the DSM-5.
The biggest complaint here is that the DSM-5 development committee appears to have departed from the “atheoretical” approach that the past two version of have taken, in favor of a clear biomedical approach. The DSM-5 also seems to be changing the very definition of mental disorder by adding the criterion: ‘[A behavioral or psychological syndrome] that reflects an underlying psychobiological dysfunction.’
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If it is biochemical then that means you will need to be prescribed medication for it…. does anyone else see or question the connection and influence of pharmacology on the DSM-V?
Thank you for speaking up about this issue, and I hope many more in the mental health community stand up for common sense.
As a psychiatrist, so far from what I have read both in psychiatric literature, as well more main stream sources, the DSM 5 seems to be focused on labeling anything that is not textbook ‘normal’ to be a disorder, like for instance, listing ‘temper tantrums’ as a disorder? Seriously?
Five different subtypes of Bipolar disorder? Seriously, again? And get this, non clinician readers, there are alleged Key Opinion Leaders in my profession who are championing for mood disorders to be a subset of psychotic disorders. Yeah, I know, Seriously?!
You think reading such absurd tangential thinking like claiming mood disorders are a subset of psychosis is only aiding and abetting the pharmaceutical industry?
Look at the ties these ‘KOLs’ have with big pharma.
They didn’t say biochemical, they said biomedical.
While these doctors are writing hopefully not to sell out to the pharmaceuticals, I have been working in the trenches with the financially disadvantaged. I see people that Phds and Psys don’t want. Many of my client-patients have made terrible social mistakes, are broke and would love to get on Medicaid. I am very careful about this. Some will not be able to afford high priced care and do not satisfy requirements for community mental health assistance. Hopefully, I won’t have to now do a biomedical dance just to treat a human after the DSM is reinvented.
As an interested, non-professional reader I’m afraid Dr. Meeks’ article was just too short to get the details of his points across to a less than professional audience. I certainly hear the business expanding message loud and clear. I do not understand how the “biomedical” phrase works to effect the “business expansion” drive.
Hello! To clarify, if the definition insists that there is a biomedical condition, then it implies that the expected method of treatment would also be biomedical (e.g. meds).
Hope that clears it up!
I don’t think it necessarily does. CBT, for example, has been shown via PET Scans to change the way our brains function. It’s not an either/or.
Interesting what you pointed out about the pharmaceutical industry influence. Hmm. I would like to see groups who are not happy with the DSM come up with their own version.
?
Go to http://www.psychiatrictimes.com and locate the article by Alan Frances entitled “Dangerous New Treatment Guidelines for ADHD Unveiled”, to learn that the American Academy of Pediatrics, NOT anything to do with any psychiatric organization, has released new ADHD guidelines that recommend medication treatment for preschoolers as young as 4 years old.
People here and at other blogs rail about psychiatrists being a detriment to mental health care standards? Who the hell is a pediatric organization setting standards of care for a mental health issue? And yet, Frances goes on to note in the middle of the article that the DSM 5 is basically “…reducing the thresholds for the DSM 5 diagnosis for ADD prove that important public health decisions cannot be entrusted to narrowly focused professional organizations.”
How many 4 year olds or younger have to endure serious morbidity/mortality events before this plan gets put where it belongs? The bigger question is, when do the alleged majority of my colleagues finally wake up and refute the incredibly poor judgment that continues to come out of the APA and their cronies? Mark my words, staying silent on issues like this will allow PPACA to eventually make psychiatry obsolete, and then you all as patients can put your trust and faith in the hands of pediatricians, family practice and internist providers, and nurse practitioners.
Again, good luck with that plan!
Agree that psychiatristis aren’t bad people and they get slammed more than they should. That said there is a lot of wisdom found in The blog written by a mother of severely-autistic son with self-injury titled (google it): “DSM-5 Autistic Spectrum Disorder Disaster” is mandatory reading for DSM-5 committee.