Mental health experts ask: Will anyone be normal?

The APA started the DSM as a fundraiser. Now look where it's got us.

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.

DSM-V: Association of Women in Psychology "Landing Page"

This webpage from the Association of Women in Psychology,
a part of the APA, offers a "Landing Page" to introduce proposed revisions to the DSM-V.

Bias in Psychiatric Diagnosis: Concerns about DSM-V

Mission: To provide information for people (including but not limited to professionals and journalists) about biases and other problems in psychiatric diagnosis, an especially important goal in light of the American Psychiatric Association's preparation for the 2013 publication of the next edition of the psychiatric diagnostic manual.

Bios for Group Members and Contributors
NEWS FLASH

1. Psychdiagnosis.net - website about bias in psychiatric diagnosis, including stories about people harmed in a wide variety of ways by receiving such a diagnosis and including six kinds of solutions to problems resulting from psychiatric labeling

2. Click Here for an important article in New Scientist about problems in the preparation for DSM-V

3. Click here to go to a website that is presented as allowing anyone who wants to make suggestions about DSM-V to do so.

Note: AWP’s Committee on Bias in Psychiatric Diagnosis does not know what plans may have been made by the DSM-V authors to consider these suggestions.

4. Call for papers for a special issue of Social Science and Medicine, Sociology of Diagnosis

5. PSYCHOUT - A conference for organizing Resistance against Psychiatry - Call for submissions

Introduction:

Psychiatric Diagnosis: Too Little Science, Too Many Conflicts of Interest


Articles:

Anorexia Nervosa and the DSM

Borderline Personality Disorder: The Disparagement of Women through Diagnosis

Female Sexual Dysfunction Diagnoses

Gender Interupted: Controversy and Concerns about Gender Identity Disorder (GID)

Should Obesity Be Called a Mental Illness?

Problems with Parental Alienation Syndrome

Racial Bias in Psychiatric Diagnosis

Social Class and Classism in Psychiatric Diagnosis

Link

Update: DSM pathologizes women and children

Diagnosing for Money and Power
'Because most undergraduate, graduate and postgraduate courses uncritically present the DSM as an objective scientific document, this summary focuses exclusively on the rarely acknowledged critical view. It neither provides a complete analysis of psychiatric diagnosis nor denies that the DSM, if used cautiously and appropriately, can be useful, nor does it advocate against psychiatric diagnostic.
The primary goal of this web page is to promote critical thinking of psychology and psychiatry by presenting an important, however, rarely acknowledged critique of psychiatric diagnosis.

The following summary was inspired by Dr. Paula Caplan's work and the writing cited in the Selected Bibliography at the end of this page.'

DSM Critique