The flat out rejection of DSM-5 by National Institute of Mental Health is a sad moment for mental health--and an unsafe one for our patients. The APA and NIMH are both letting us down, failing to be safe custodians for the mental health needs of our country.
Diagnostic And Statistical Manual Of Mental Disorders
I envision the day when psychiatry and psychology re-embrace the mind, along with the brain and behavior.
When critics of psychiatric diagnosis insist that terms like “schizophrenia” or “bipolar disorder” are inherently stigmatizing, they are unwittingly perpetuating the very prejudice they wish to end. It is time to shine a bright light on this self-fulfilling prophecy.
While the diagnostic categories of DSM-III and DSM-IV (and soon DSM-5) have provided the basis for much useful research, little has been written about how much of DSM—and how much “evidence-based medicine”—is built on a foundation of fantasy.
It is clear that the leadership of DSM-IV, and of DSM-III before it, views psychiatric diagnosis in the DSM system as something that should be based on “pragmatism.”
We do not need psychiatrists who fit people into categories and slots and treat them as if they are robots, according to the dictates of a recipe book called “The Diagnostic and Statistical Manual.”
Accurate diagnosis is absolutely crucial in SVP hearings because the potential outcome is so consequential—involuntary incarceration in a psychiatric hospital that may well last a lifetime. In no other clinical or forensic situation does so much ride on the presence or absence of a psychiatric diagnosis.
Below is an editorial (with the above title) taken from the newsletter of the Society of Biological Psychiatry and written by its editor Stephen M. Strakowski MD.
DSM-II was published in 1968. DSM-5 will be published in 2013. How much progress have we made? I propose that we approach this question with a quiz.
Charles Moser, PhD, MD, has forwarded an interesting suggestion to solve the problem of weak diagnoses that have received a free ride through previous revisions of DSM. His is a middle way intended to steer between the contrasting risks of continuing questionable diagnoses and the risks of eliminating them.