DSM

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."

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.

In preparing DSM-IV, we worked hard to avoid causing confusion in forensic settings. Realizing that lawyers read documents in their own special way, we had a panel of forensic psychiatrists go over every word to reduce the risks that DSM IV could be misused in the courts.

The DSM-5 attempt to “dimensionalize” the diagnosis of personality disorder has worthy goals, but has suffered from grievously incompetent implementation.

I recently experienced the odd coincidence of receiving 2 separate emails on the same morning each asking almost the very same question. . . how can I remain so high on psychiatry while at the same time being so critical of some of its recent trends and so fearful of the likely future harmful impact of DSM-5?

A newly appointed DSM-5 scientific review group is meant to “review the reviews”-but it is working in secret and so far appears to be a remarkably porous filter . . .DSM-5 has shown no capacity to self-monitor and self-correct. An outside review is sorely needed-and fortunately a ready mechanism is in place.

I just read a blog by Dr Dayle Jones that could have an important influence in the endgame effort to save DSM-5 from itself.

Psychiatric symptoms are fairly ubiquitous in the general population- most normal people have at least one, many have a few. When present in isolation, a single symptom (or even a few) does not a psychiatric disorder make. Two additional conditions must also be met before a symptom can be considered to be part of a mental disorder.

Psychosis Risk (AKA attenuated psychotic symptoms disorder) has always had 3 strikes against it.