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January 26, 2011
The Battle Over the DSM-V (Or "DSM-5," Since Roman Numerals are Getting the Axe Too)Follow the money. ![]() The book is the basis of psychiatrists’ authority to pronounce upon our mental health, to command health care dollars from insurance companies for treatment and from government agencies for research. It is as important to psychiatrists as the Constitution is to the US government or the Bible is to Christians. From Wired. Al Frances, editor of the DSM-IV and Robert Spitzer, editor of the DSM-III, joined in criticizing the upcoming DSM-5. (No kidding, roman numerals are out.) There is a tremendous amount of change proposed for the DSM-5, and it appears that not all of it is supported by good science or good sense. In trying to solve the problems of the DSM-IV, the new editors are creating bigger problems. Frances and Spitzer are worried about disaster. [He accuses] his colleagues not just of bad science but of bad faith, hubris, and blindness, of making diseases out of everyday suffering and, as a result, padding the bottom lines of drug companies. These aren’t new accusations to level at psychiatry, but Frances used to be their target, not their source. He’s hurling grenades into the bunker where he spent his entire career. (Emphasis mine.) From the Washington Examiner, the changes "reflect new political realities about how psychiatric medicine gets paid for and by whom." Under the new revisions, almost everyone could be labeled with some kind of disorder. Behavior that has always been regarded as normal is now considered suspect. Some of the diagnoses that are being considered include:
Frances and Spitzer agree that augmenting the current approach and quantifying gradations for illnesses would reduce the numbers of people hurt by the current binary approach to diagnosis. But in trying to solve that problem, the approach taken by the editors of the DSM-5--creating more diagnoses, some vaguely defined--incentivizes psychiatrists and pharmaceutical companies to increase the numbers of people considered to have psychiatric illnesses. They stand to gain. From the Washington Examiner article: Because given new political realities like mental health parity and Obamacare -- which extends Medicaid benefits to the middle class and keep “children” on policies till they’re 26 -- it’s becoming increasingly clear that the DSM is not being re-designed so much to treat mental illnesses, but to invent them. Maybe I just have a case of too skeptical for my own good syndrome, with a touch of sick of the bullshit fugue. And maybe a little everybody seems to have a way to scam money from the government but me anxiety. Yeah, there's that. | Recent Comments
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