The American Psychiatric Association has released a beta version of its Diagnostic and Statistical Manual of Mental Disorders. The DSM-V website is live as of today. The APA will be accepting comments to the proposed revision before it is published.
Today's New York Times carries the report, "Revising Book on Disorders of the Mind," by Benedict Carey.
Far fewer children would get a diagnosis of bipolar disorder. “Binge eating disorder” and “hypersexuality” might become part of the everyday language. And the way many mental disorders are diagnosed and treated would be sharply revised.
These are a few of the changes proposed on Tuesday by doctors charged with revising psychiatry’s encyclopedia of mental disorders, the guidebook that largely determines where society draws the line between normal and not normal, between eccentricity and illness, between self-indulgence and self-destruction — and, by extension, when and how patients should be treated.
The eagerly awaited revisions — to be published, if adopted, in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, due in 2013 — would be the first in a decade.
"Revision to the bible of psychiatry, DSM, could introduce new mental disorders," is the title of Rob Stein's Washington Post article.
The product of more than a decade of work by hundreds of experts, the proposed revisions are designed to bring the best scientific evidence to bear on psychiatric diagnoses and could have far-reaching implications, including determining who gets diagnosed as mentally ill, who should get powerful psychotropic drugs, and whether and how much insurance companies will pay for care.
"It not only determines how mental disorders are diagnosed, it can impact how people see themselves and how we see each other," said Alan Schatzberg, the association's president. "It influences how research is conducted as well as what is researched. . . . It affects legal matters, industry and government programs."
The proposals will be debated in an intense process over the next two years, with potentially billions of dollars at stake for pharmaceutical companies, insurance companies, government health plans, doctors, researchers and patient advocacy groups.
But perhaps more important, the outcome will help shape which emotions, behaviors, thoughts and personality traits society considers part of the natural spectrum of the human persona and which are considered pathological, requiring treatment and possibly even criminal punishment.
Lauran Neergaard writes the AP report, "Changes proposed in how psychiatrists diagnose," available via Google News.
Don't say "mental retardation" — the new term is "intellectual disability." No more diagnoses of Asperger's syndrome — call it a mild version of autism instead. And while "behavioral addictions" will be new to doctors' dictionaries, "Internet addiction" didn't make the cut.
The American Psychiatric Association is proposing major changes Wednesday to its diagnostic bible, the manual that doctors, insurers and scientists use in deciding what's officially a mental disorder and what symptoms to treat. In a new twist, it is seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them.
The manual suggests some new diagnoses. Gambling so far is the lone identified behavioral addiction, but in the new category of learning disabilities are problems with both reading and math. Also new is binge eating, distinct from bulimia because the binge eaters don't purge.
Sure to generate debate, the draft also proposes diagnosing people as being at high risk of developing some serious mental disorders — such as dementia or schizophrenia — based on early symptoms, even though there's no way to know who will worsen into full-blown illness. It's a category the psychiatrist group's own leaders say must be used with caution, as scientists don't yet have treatments to lower that risk but also don't want to miss people on the cusp of needing care.
Another change: The draft sets scales to estimate both adults and teens most at risk of suicide, stressing that suicide occurs with numerous mental illnesses, not just depression.
But overall the manual's biggest changes eliminate diagnoses that it contends are essentially subtypes of broader illnesses — and urge doctors to concentrate more on the severity of their patients' symptoms.
The Wall Street Journal has, "Shifts Ahead for Mental Diagnoses," by Shirley S. Wang.
The Los Angeles Times, "Revising the book on mental illness," by Shari Roan, along with the sidebar, "The DSM story."
Specialized blogs have more technical coverage. AAAS Science Insider posts, "New Criteria for Psychiatric Diagnoses Proposed," by Greg Miller and Constance Holden.
Today the American Psychiatric Association (APA) releases proposed revisions to the most influential book in psychiatry: the Diagnostic and Statistical Manual of Mental Disorders (DSM). These draft criteria for diagnosing mental disorders are the result of a decade of labor by scores of researchers and clinicians. After gathering comments on the draft criteria and conducting field trials to test them, APA plans to publish a new, fifth edition of the DSM in 2013.
By classifying mental disorders and giving them names, DSM not only influences how doctors diagnose and treat their patients. It also sways how insurance companies decide which conditions to cover, how pharmaceutical companies design clinical trials, and how funding agencies decide what research to fund. Making changes to such a widely used document was bound to be controversial, and it has been. "It's sort of like repairing an airplane while it's still flying," says psychiatrist Steven Hyman, provost of Harvard University and a member of the committee leading DSM-V revisions.
The researchers and clinicians working on DSM-V had several ambitious goals, including using new findings from neuroscience and genetics to shape diagnoses, minimizing vast diagnostic dead zones of abnormal behavior that fall in the cracks of current criteria, and introducing the idea of "dimensions" to reflect varying degrees of symptom severity and the overlap among disorders.
Some critics, including the two psychiatrists who led the previous two major revisions to DSM, have argued that such an ambitious overhaul should not have been attempted until more is known about the biological underpinnings of mental illness.
"Psychiatry's draft new 'bible' goes online," by Peter Aldhouse is at New Scientist.
After more than two years of deliberation, the suggestions from 13 expert groups that have been working on the next edition of the Diagnostic and Statistical Manual of Mental Disorders are now available online. Interested parties have until 20 April to comment. The APA will then revise its proposals and launch a series of field trials to test the new diagnoses.
"DSM-V offers new criteria for personality disorders," by Jared DeFife, Ph.D., at Psychology Today.
Forensic Psychologist posts, "DSM-V: Get ready, get set . . . here it comes!"
Related posts are in the mental illness index.
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