The limited empirical research evidence supports the impression that practitioners, if they use the manuals at all, use them in a loose, informal manner and are comfortable ignoring diagnostic criteria and making their diagnoses following an informal prototypal pattern.
Why not define mental disorder just on the presence or absence of the characteristic cluster? Why was it felt to be necessary to also require distress or impairment?
Every month or so, someone (usually very smart and passionate) sends me a detailed proposal for a new diagnostic system offered as an alternative to the jumbled, pedestrian, atheoretical, and purely descriptive method used in DSM.
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From 19th century French impressionists to current-day “rockers,” it has always been a loosely held belief that creative genius encompasses (even embraces) substance use. But a recent study found that substance use impedes artistic creativity.
As early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.
When I was an undergraduate studying molecular biology in the early 1990s when the Human Genome Project had just begun, my required coursework included several lectures on the ethical implications of sequencing, understanding, and ultimately being able to manipulate the “code of life.”
The causes of Alzheimer disease and attempts to predict who is at risk for it have been confounding the medical profession ever since Dr Alzheimer first described the disorder in 1906. Finally, a breakthrough in dye and imaging technology may be the key to solving the puzzle.
Professor Hannah Decker, a distinguished historian by trade, has posted a thorough, fair, and sprightly history of the DSM5 controversy. We are all lucky to have her as chronicler.
The effects of the BP oil spill are sure to reach beyond the environment. Psychiatrists warned that the spill may have long-term psychological consequences on residents, mental health workers, and cleanup volunteers.
With Medicare reimbursement cuts looming, many physicians are considering opting out of Medicare. And it’s not just payment rates that have doctors dropping out: those who participate in Medicare are struggling to cut through the red tape just to keep their coverage active.
Consider the predicament of Mrs M-a 38-year old premenopausal mother of two. Mrs M tells her primary care physician, “I just don’t have a strong desire for sex."
Consider these 2 scenarios:
I don’t believe in witches or ghosts or things that go bump in the night. I’ve always thought that the Salem witch trials were a result of mass hysteria (on the part of the persecutors) rather than a phenomenon of dark forces at work. And seeing Arthur Miller’s The Crucible a few years ago, only confirmed my suspicions. So I was gratified to see Dr Quintanilla’s poster at this year’s meeting of the American Psychiatric Association. As a physician and researcher, she factually explains the fallacy of witchcraft. Looking at historical documents dating back to the 15th century, Dr Quintanilla was able to match the symptoms of people condemned as witches with associated neurological and psychiatric disorders, such as epilepsy and hysteria. [Editor’s Note: Natalie Timoshin]
A 17-year study found that children raised in lesbian-mother families appear to grow up to be well adjusted and have fewer psychological problems than do children reared in more traditional families.
Psychiatric Times has invited the editors of h-madness, a blog that follows the history of psychiatry, to share a monthly guest blog with our readers. You can read more about the history of psychiatry on their blog.
The DSM-5 looms, prompting mental health professionals, clients, and caretakers to look ahead with a mixture of eagerness, dread, and bewilderment. As we look at the state of things now and project forward toward possibilities for the future, it pays to also look back into the past.
The subject of physician participation in interrogations (either military or law enforcement related) continues to surface as an issue of debate. Why? Allow me to state what I believe undergirds most debates on this issue: terror. No, not terrorism per se, but terror of death.
The board of trustees at the APA has established a new code of conduct in the form of a Conflict of Interest Committee at the board level. This committee will manage potential conflicts of interest and formalize already existing procedures.
Many have challenged the claim of the APA/DSM-5 Task Force that the current process is the most “open process in the history of the manual.” Few have actually provided an argument or evidence of why this might, or might not, be so. What has changed dramatically in the DSM process since DSM-IV in 1994, and even DSM-IV-TR in 2000, is the rise of Internet culture and the “blogosphere.” What does this have to do with DSM-5?
Dr Medina is a developmental molecular biologist and private consultant, with research interests in the genetics of psychiatric disorders. For more about Dr Medina, visit www.brainrules.net.
Richard M. Berlin, MD, is Senior Affiliate in Psychiatry at the University of Massachusetts Medical School. His second collection of poems, Secret Wounds, which won the 2010 John Ciardi Poetry Prize, is published by BkMk Press.
A recent essay by Michael W. Kahn, MD, explores whether psychiatrists are going too far in denying patients’ requests for drugs. When first year psychiatry residents were asked how they would react to a request from a patient for narcotic painkillers or antianxiety medications, the general consensus was that they would do no harm by playing it safe and would not provide the requested drug.
In a report by Pew Research Centers, Internet & American Life Project, 61% of patients are going online for information about their health. In 2000, that figure was 46%.
At the end of life, psychiatrists are often asked to assess a patient’s capacity to refuse treatment, but the role of the psychiatrist in this situation is much broader.
