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On DSM-5

On DSM-5

DSM-5 must emphasize that physical symptoms deserve the respect of a thorough work-up before assuming their cause is psychiatric. And people with defined medical illnesses should not be casually mislabeled as also mentally ill just because they are upset about being sick.

With DSM-5 now approved, all discussion has been removed from the DSM-5 Web site. According to the APA, the DSM-5 leadership moved to dimensional measures as one solution to the validity problem.

The changes in the newly approved DSM-5 loosen diagnosis and threaten to turn our current diagnostic inflation into diagnostic hyperinflation.

The DSM-5 leadership is trying to put a brave face on its badly failed first stage of field testing and has offered no excuse or explanation for canceling its second and most crucial quality control stage. This field testing fiasco erases whatever was left of the credibility of DSM-5 and APA.

A recent case has caused a flurry of opposing opinions. Not surprisingly, transgender advocacy groups have praised the judge's decision that the inmate in question has an eighth amendment right requiring the state to support and pay for sex reassignment surgery.

"Internet Addiction" may soon spread like wildfire. All the elements favoring fad generation are in place . . . the profusion of alarming books; the breathless articles in magazines and newspapers; extensive TV exposure; ubiquitous blogs; the springing up of unproven treatment programs; the availability of millions of potential patients; and an exuberant trumpeting by newly minted "thought leading" researchers and clinicians. So far, DSM-5 has provided the only restraint.

For the first time in its history, DSM-5 has shown some flexibility and capacity to correct itself. Hopefully, this is just the beginning of what will turn out to be a number of other necessary DSM-5 retreats.

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