May 18, 2013

Do psychiatric guide's new labels put ‘normal’ at risk?

DSM-5, the updated source for diagnosing mental problems, has many questioning its legitimacy.

By LINDSEY TANNER The Associated Press

(Continued from page 1)

male eating disorder
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A psychiatric patient stands next to a painting he did at a hospital in Elgin, Ill. Even the head of the U.S. National Institute of Mental Health has complained that the proposed new manual for diagnosing mental disorders lacks scientific validity.

Stacey Wescott/Chicago Tribune/MCT

Calling excessive thoughts or feelings about pain or other discomfort "somatic symptom disorder," something that could affect the healthy as well as cancer patients. Critics say the term turns normal reactions to a disease into mental illness.

Adding binge eating as a new category for overeating that occurs at least once a week for at least three months. It could apply to people who sometimes gulp down a pint of ice cream when they're alone and then feel guilty about it.

Removing Asperger's syndrome as a separate diagnosis and putting it under the umbrella term "autism spectrum disorder."

Dr. David Kupfer, chairman of the task force that oversaw the DSM-5, said the changes are based on solid research and will help make sure people get accurate diagnoses and treatment.

Dr. Jeffrey Lieberman, the psychiatry association's incoming president, said challenging the handbook's credibility "is completely unwarranted." The book establishes diagnoses "so patients can receive the best care," he said, adding that it takes into account the most up-to-date scientific knowledge.

But Insel, the government mental health agency chief, wrote in a recent blog posting that the guidebook is no better than a dictionary-like list of labels and definitions.

He told The Associated Press he favors a very different approach to diagnosis that is based more on biological information, similar to how doctors diagnose heart disease or problems with other organs.

Yet there's scant hard evidence pinpointing what goes wrong in the brain when someone develops mental illness.

Insel's agency two years ago began a research project to create a new way to diagnose mental illness, using brain imaging, genetics and other evolving scientific evidence. That project will take years.

The revisions in the new guide were suggested by work groups the psychiatric association assigned to evaluate different mental illnesses and recent research advances. The association's board of trustees decided in December which recommendations to include.

Advocacy groups have threatened Occupy-style protests at this week's meeting.

"The psychiatric industry, allied with Big Pharma, have massively misled the public," the Occupy Psychiatry group contends. Organizers include Alaska lawyer Jim Gottstein, who has long fought against overuse of psychiatric drugs.

The new manual "will drastically expand psychiatric diagnosis, mislabel millions of people as mentally ill, and cause unnecessary treatment with medication," says the website for the Committee to Boycott the DSM-5, organized by New York social worker Jack Carney.

Committee member Courtney Fitzpatrick, whose 9-year-old son died seven years ago while hospitalized for a blood vessel disease, said she has joined support groups for grieving parents "and by no means are we mentally ill because we are sad about our kids that have died."

Gary Greenberg, a Connecticut psychotherapist and author of "The Book of Woe," says pharmaceutical industry influence in psychiatry has contributed to turning normal conditions into diseases so that drugs can be prescribed to treat them.

Many of the 31 task force members involved in developing the revised guidebook have had financial ties to makers of psychiatric drugs, including consulting fees, research grants or stock.

Group leaders dismiss that criticism and emphasize they agreed not to collect more than $10,000 in industry money in the calendar year preceding publication of the manual.

 

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