Mental health experts ask: Will anyone be normal?
By Kate Kelland
LONDON | Tue Jul 27, 2010 5:23pm EDT
LONDON (Reuters) - An updated edition of a mental health bible for doctors may include diagnoses for "disorders" such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.
Leading mental health experts gave a briefing on Tuesday to warn that a new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is being revised now for publication in 2013, could devalue the seriousness of mental illness and label almost everyone as having some kind of disorder.
Citing examples of new additions like "mild anxiety depression," "psychosis risk syndrome," and "temper dysregulation disorder," they said many people previously seen as perfectly healthy could in future be told they are ill.
"It's leaking into normality. It is shrinking the pool of what is normal to a puddle," said Til Wykes of the Institute of Psychiatry at Kings College London.
The criteria are designed to provide clear definitions for professionals who treat patients with mental disorders, and for researchers and pharmaceutical drug companies seeking to develop new ways of treating them.
Wykes and colleagues Felicity Callard, also of Kings' Institute of Psychiatry, and Nick Craddock of Cardiff University's department of psychological medicine and neurology, said many in the psychiatric community are worried that the further the guidelines are expanded, the more likely it will become that nobody will be classed as normal any more.
"Technically, with the classification of so many new disorders, we will all have disorders," they said in a joint statement. "This may lead to the belief that many more of us 'need' drugs to treat our 'conditions' -- (and) many of these drugs will have unpleasant or dangerous side effects."
The scientists said "psychosis risk syndrome" diagnosis was particularly worrying, since it could falsely label young people who may only have a small risk of developing an illness.
"It's a bit like telling 10 people with a common cold that they are "at risk for pneumonia syndrome" when only one is likely to get the disorder," Wykes told the briefing.
The American Psychiatric Association did not immediately respond to a request for comment.
The scientists gave examples from the previous revision to the DSM, which was called DSM 4 and included broader diagnoses and categories for attention deficit hyperactivity disorder (ADHD), autism and childhood bipolar disorders.
This, they said, had "contributed to three false epidemics" of these conditions, particularly in the United States.
"During the last decade, how many doctors were harangued by worried parents into giving drugs like Ritalin to children who didn't really need it?," their statement asked.
Millions of people across the world, many of them children, take ADHD drugs including Novartis' Ritalin, which is known generically as methylphenidate, and similar drugs such as Shire Plc's Adderall and Vyvanse. In the United States alone, sales of these drugs was about $4.8 billion in 2008.
Wykes and Callard published a comment in The Journal of Mental Health expressing their concern about the upcoming DSM revision and highlighting another 10 or more papers in the same journal from other scientists who were also worried. DSM 5 is due to be published in May 2013.
Showing posts with label american psychiatric association. Show all posts
Showing posts with label american psychiatric association. Show all posts
Friday, July 30, 2010
Mental health experts ask: Will anyone be normal?
The APA started the DSM as a fundraiser. Now look where it's got us.
Monday, January 11, 2010
NYT: The Americanization of Mental Illness
From the essay:
'...we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.
This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places. In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro, which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that brings forth dissociative episodes of laughing, shouting and singing.
The diversity that can be found across cultures can be seen across time as well. In his book “Mad Travelers,” the philosopher Ian Hacking documents the fleeting appearance in the 1890s of a fugue state in which European men would walk in a trance for hundreds of miles with no knowledge of their identities. The hysterical-leg paralysis that afflicted thousands of middle-class women in the late 19th century not only gives us a visceral understanding of the restrictions set on women’s social roles at the time but can also be seen from this distance as a social role itself — the troubled unconscious minds of a certain class of women speaking the idiom of distress of their time.'
Link
Wikipedia has an article about mental health diagnoses in China.
'...we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.
This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places. In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro, which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that brings forth dissociative episodes of laughing, shouting and singing.
The diversity that can be found across cultures can be seen across time as well. In his book “Mad Travelers,” the philosopher Ian Hacking documents the fleeting appearance in the 1890s of a fugue state in which European men would walk in a trance for hundreds of miles with no knowledge of their identities. The hysterical-leg paralysis that afflicted thousands of middle-class women in the late 19th century not only gives us a visceral understanding of the restrictions set on women’s social roles at the time but can also be seen from this distance as a social role itself — the troubled unconscious minds of a certain class of women speaking the idiom of distress of their time.'
Link
Wikipedia has an article about mental health diagnoses in China.
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