DSM-5

BACKGROUND A couple of days ago (June 12) I posted Autism Prevalence Increasing. The article drew attention to a post by Kelly Brogan, MD, called See No Evil, Hear No Evil which had appeared on Mad in America on June 9. Dr. Brogan’s article had cited an alarming increase in the incidence of autism over the past few decades, and mentioned some possible causative factors. I checked the figures against the DSM and CDC prevalence estimates and found they were broadly in line. I mentioned the possibility that diagnostic expansion, particularly as embracing milder presentations, might be a confounding factor, but that given the reported increase (1 in 5000 to 100 in 5000) over 38 years, I expressed the view that this was a bit of a stretch. ...

On two occasions in the past week or so, I have been involved in discussions on the increasing prevalence of autism. In the more recent of these, the individual with whom I was talking expressed the concern that the recent DSM enlargement of autism disorder to autism spectrum disorder might be an APA-pharma designed artifact to draw attention away from the steady increase in the incidence of autism in recent decades. ...

On May 27, David Brooks, a New York Times columnist, wrote a piece on psychiatry called Heroes of Uncertainty. It’s an interesting and somewhat contradictory article. Here are some quotes: "As the handbook’s [DSM-5] many critics have noted, psychiatrists use terms like 'mental disorder' and 'normal behavior,' but there is no agreement on what these concepts mean." "What psychiatrists call a disease is usually just a label for a group of symptoms." ...

BACKGROUND On 19 April, The Conversation ran an article titled Mental disorders: debunking some myths of the DSM-5, by Perminder Sachdev, MD. Dr. Sachdev is a psychiatrist, and was a member of the DSM-5’s Neurocognitive Disorders Work Group. He works at the School of Psychiatry, University of New South Wales, Australia. (Thanks to Dave Traxson on Twitter for the link.) ANALYSIS Let’s start with the title. “…debunking some myths of the DSM-5.” This sounds good. You might get the impression that he’s going to address the myth of mental illness – the myth that all human problems are illnesses and are best treated by drugs. But – alas – you would be mistaken. Dr. Sachdev lists four myths that he plans to debunk. He refers to these as the “…four key criticisms about DSM-5…” Let’s examine what he says about these one by one. ...

Joel Paris, MD, is an eminent psychiatrist, and is also a Professor of Psychiatry at McGill University in Montréal. He has recently written a very timely book titled: The Intelligent Clinician’s Guide to the DSM-5, published by Oxford University Press. I have placed an order for this book through our local inter-library loan system, and when it comes in, I’ll publish a review. But in the meantime, Dr. Paris has posted on Oxford University Press’s website a brief essay to promote the book. The essay has lots of interesting aspects, and I thought it might be helpful to examine it in some detail. ...

Jeffrey Lieberman, MD, is president-elect of the APA, and is scheduled to take over the reins from Dr. Dilip Jeste this month. Never in its history has the APA been subject to such scrutiny or criticism from such diverse sources, and one might reasonably have expected Dr. Lieberman to open on a conciliatory note, promising investigations, reforms, etc…. But no! He’s in the ring slugging furiously from the opening bell. Two days ago (May 20) he published an article in Scientific American titled DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice. ...

Today I received the following email from Emily Underwood, a reporter with Science Magazine. I am a reporter with Science magazine -- after reading your Twitter feed and blog I thought you might be interested in a live video chat I’m hosting this week on the controversy surrounding the DSM V. My guests are Allen Frances of Duke University, William Eaton of Johns Hopkins University, and Frank Farley of Temple University; given their different takes on the subject it promises to be a lively conversation! ...

Mental Health Europe (MHE) is a non-governmental organization “… committed to the promotion of positive mental health and well-being, the prevention of mental health problems, the improvement of care, advocacy for social inclusion and the protection of the human rights of (ex)users of mental health services and their families and carers.” It is composed of associations, organizations, and individuals who are active in the mental health field, including users and ex-users of services, volunteers, and professionals. MHE subscribes to the following values: dignity and respect; equal opportunities; freedom of choice; non-discrimination, social inclusion, democracy and participation. You can read more about them here. ...

There’s an interesting article in the NY Times Sunday review. You can see it here. It was written by Sally Satel MD, a psychiatrist, currently a resident scholar at the American Enterprise Institute. The article is called: “Why the Fuss Over the DSM-5?” Dr. Satel’s central point is that psychiatrists only treat symptoms anyway and pay little attention to the DSM. She expresses the belief that the manual’s diagnoses are “…passports to insurance coverage, the keys to special education and behavioral services in school and the tickets to disability benefits.” ...

BACKGROUND The “diagnosis” of separation anxiety disorder has been around since DSM-III. In DSM-IV it is defined as “…excessive anxiety concerning separation from the home or from those to whom the person is attached.” (DSM-IV-TR p 121). The APA’s prevalence estimate is 4%. This “diagnosis” is listed under the heading: “Other Disorders of Infancy, Childhood, or Adolescence.” One of the criteria is that the problem must begin before age 18, and in practice the “diagnosis” was generally confined to children under the age of 10 or so. ...