DSM

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.

The APA has invited public comment on the proposed criteria for the upcoming DSM-5 for the third and final time. From May 2 until June 15, public responses will be considered by the DSM-5 Work Groups.

With DSM-5 scheduled for publication a little more than a year from now, we may safely assume that, barring unannounced surprises from, say, the APA Scientific Review Committee, what we will see on the DSM-5 Web site is what we will get. With that in mind it’s time to review what we will indeed get.

Until yesterday, there were only 2 reasons to stick with the projected date of DSM-5 publication (May 2013). The first just dropped out.

Much of the controversy on the relationship between grief and depression following recent bereavement has focused on whether the so-called “bereavement exclusion” in DSM-IV should be eliminated, as some have proposed, in the DSM-5.

My recent blog stimulated 2 interesting responses that illustrate the stark contrast between DSM-5 fantasy and DSM-5 reality. Together they document why publication must be delayed if DSM-5 is to be set right.

My three criticisms of DSM-5 have been: (1) risky suggestions; (2) bad writing; and (3) poor planning and disorganization.

In this guest blog, Dr Deirdre D'Orazio responds to a recent commentary by Dr Allen Frances on conducting evaluations of potential sexually violent predators.

The New York Times ran a front-page story regarding numerous controversies surrounding the DSM-5, most notably, the issue of eliminating the so-called bereavement exclusion in diagnosing a major depressive episode. Here, Dr Pies responds to Dr John Grohol, Psychologist and Editor of the Psychcentral Web site.

My biggest concern regarding DSM-5 is that it will dramatically increase the rates of mental disorder by cheapening the currency of psychiatric diagnosis . . .The whole purpose of field-testing is to identify and correct problems in the preliminary DSM suggestions before they become set in stone as official guides to diagnostic practice.

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.

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.

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.

This brief editorial clarifies the position of Psychiatric Times with regard to our intent behind posting the many blogs about DSM-5 that appear on our Web site, www.PsychiatricTimes.com.

On November 21, 2011, John Oldham, MD, president of the American Psychiatric Association (APA), wrote a response letter to Don W. Locke, EdD, president of the American Counseling Association, who had some concerns with proposed revisions for DSM-5.

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!”

The users’ revolt against DSM-5 marches on and just became a much, much bigger parade.

News flash From Medscape Medical News-“APA Answers DSM-5 Critics”-a defense of DSM-5 offered by Darrel A. Regier, MD, vice-chair of the DSM-5 Task Force.

When it comes to DSM-5, experience has proven conclusively that the APA will not attend to the science, evaluate the risks, or listen to reason. A user’s revolt has become the last and only hope for derailing the worst of the DSM-5 suggestions.

Last week I challenged the American Psychiatric Association (APA) to end its silence in the face of widespread criticism and finally to mount its belated public defense of DSM-5. These are the 5 questions that cry out for straight answers.

Both the DSM-5 Web site and Psychiatry News have recently heralded the proposed DSM-5 revision for diagnosis of personality disorders.

Psychiatrists may be more reluctant than are other mental health clinicians to sign a petition questioning the safety and value of DSM-5. After all, it is the American Psychiatric Association that is sponsoring DSM-5 and there is a natural tendency to want to trust the wisdom of one’s own Association.

The DSM-5 petition is now 12 days old and has already been signed by nearly 3500 people. It can be accessed at http://www.ipetitions.com/petition/dsm5/

After all this controversy and opposition, there is one thing (and one thing only) that will save the credibility of DSM-5 and guarantee its safety--a credible process of external scientific review.

So far, opposition to DSM-5 has been expressed by at least 11 organizations.

The petition to reform DSM-5 continues to gain momentum. In its first full week, more than 2300 people have already expressed their disapproval of the DSM-5 proposals and their desire to see dramatic changes. And the numbers are growing each day.

Just a few days ago, 3 divisions of the American Psychological Association posted a well crafted open letter spelling out the many risks posed by DSM-5 and inviting mental health professionals to sign a petition requesting much needed changes. You can see the letter and (if you agree with it) sign the petition at http://www.ipetitions.com/petition/dsm5/

Several divisions of the American Psychological Association have just written an open letter highly critical of DSM-5.They are inviting mental health professionals and mental health organizations to sign a petition addressed to the DSM-5 Task Force of the American Psychiatric Association. You can read the letter and sign up at http://www.ipetitions.com/petition/dsm5/. It is an extremely detailed, thoughtful, and well written statement that deserves your attention and support.

The mental health professions are currently awaiting the American Psychiatric Association’s newest version of the Diagnostic and Statistical Manual. The need for a fifth revision underscores the lack of satisfaction within the professions with our diagnostic schema

A recent front page story by Shari Roan in the Los Angeles Times explores the heated controversy over the DSM-5 proposal to include a Disruptive Mood Dysregulation Disorder (DMDD) in DSM-5. I very much oppose the inclusion of this new "disorder."