DSM

Five key events in 2013 will leave a longlasting mark on psychiatry. Here: a look at the impact that CPT coding, DSM-5, sunshine laws, a shrinking market for “shrinks,” and I-STOP are likely to have on our field.

"Psychosis Risk" can now be diagnosed as “Attenuated Psychosis Syndrome” and used to bill for insurance reimbursement. Many bearing the diagnostic label are young adolescents and adults in whom schizophrenia or any other psychotic disorder will never develop.

One might expect that treating nicotine use would be a leading priority for physicians. The reality is that this is not the case. More in this expert commentary, with practical tips for clinicians.

Stopping smoking affects the metabolism of a number of drugs used in the management of mental illness. Here, a summary of the author's published study on whether e-cigarettes with nicotine were more effective for smoking cessation than nicotine patches.

Smoking is the leading cause of preventable morbidity and mortality in the US. The majority of smokers want to quit, but only a fraction achieve this annually. New evidence shows it is possible to teach patients to weaken the link between craving and smoking until they are able to ride out any craving–and consequently quit.

In this brief video, Psychiatric Times’ new Editoral Board member talks about what DSM-5, the medical home, and the search for money to fund novel approaches to new psychiatric treatments may mean to the practice of psychiatry.

Articles on stigma, telepsychiatry, and designer drugs . . . matters germane, timely, and needed-that is what is here for you, our readers. Enjoy and learn.

The physician’s knowledge is almost always fragmentary and incomplete--and often, “we see through a glass, darkly.” But we must not allow these limitations to deter us from diagnosing and treating our patients to the best of our ability.

If science is defined as some kind of systematic study of observed experience applied to hypotheses or theories, and then confirmation or refutation of those hypotheses or theories, followed by new hypotheses or theories that are further tested and refined by new observations – if this is the core of any scientific inquiry, I think that no objective observer can attribute the history of DSM-III, IV, and 5 to anything that approximates this process.

Undoubtedly there will be problems with some of the additions to DSM-5, with some of the combinations, with some of the new nomenclature, and with some of the new criteria sets. But practitioners will find most of DSM-5 to be well considered and well written. It is unfortunate, however, that much of its nomenclature is out of sync with the rest of medicine.

This member of the DSM-5 Work Group for Psychotic Disorders describes the 8 dimensions used to define the presentation of psychosis-the biggest and most clinically important of the changes in the schizophrenia and other psychotic disorders section.

In this podcast, Dr Michael Miller, Director of the American Board of Addiction Medicine, discusses addiction medicine, including the new ASAM, patient placement criteria, and DSM-5 changes.

This psychiatrist's wish is that in one more generation, our profession will learn to go beyond DSM to the truths of science.

This blog address the multidisciplinary approach to mental health care.

Here are 12 tips on how best to ensure accurate and safe diagnosis, based on the introduction to Dr Allen Frances' recent book, The Essentials of Psychiatric Diagnosis.

The Diagnostic Manual of Mishegas (DMOM) is a delightful parody of the American Psychiatric Association’s “Bible of psychiatry,” the DSM-5. (Diagnostic and Statistical Manual of Mental Disorders).

Some believe that DSM-5 is filled with glaring mistakes in wording and coding on nearly every page-including some that will undoubtedly cause great confusion.

To understand the psychodynamics of the dissociative fugue, Dr Michael Sperber analyzes some of the characters in a collection of interrelated vignettes set in small town America.

"Psychiatric diagnosis is certainly imperfect -- but so is much of diagnosis throughout medicine. And whatever the current limitations, psychiatric diagnosis is useful and essential. There are no 'paradigm shifts possible til we learn a lot more. To imply otherwise is misleading and confusing to patients."

A panel of experts at the APA Annual Meeting discussed how changes in DSM-5 may affect clinical practice. Highlights here.

Education and discussion will be the most powerful ways to mitigate the risks of DSM-5. The more people know about psychiatric diagnosis, the more safe, accurate, and useful it will be.

The British Psychological Society has issued a press release that rivals the silliness of DSM-5 and the National Institute of Mental Health.

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.