Addiction & Substance Use

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The designer of the DSM-5 Field Trials has just written a telling commentary in the American Journal of Psychiatry. She makes what I consider to be 2 basic errors that reveal the fundamental worthlessness of these Field Trials and their inability to provide any information that will be useful for DSM-5 decision making.

Critics of DSM-5 argue that the expansion of diagnostic criteria may increase the number of “mentally ill” individuals and/or pathologize “normal” behavior, and lead to the possibility that thousands-if not millions-of new patients will be exposed to medications which may cause more harm than good.

Some months ago, I received a stern admonition from my family doctor. My fasting blood sugar of 99 mg/dL was “right on the border”, he said, and I had better work on bringing it down. “But,” I protested, “when I was in medical school (in the 70s), the normal FBS range went up to 110 mg/dL!” "Well,” he replied a bit huffily, “they changed the criteria!”

Until recently, most people believed that hoarders were eccentric people who died surrounded by a lifetime collection of stuff. Hoarding in families was cloistered in a vault of family secrets or passed off as an individual peculiarity.