This month, a revision of the Diagnostic and Statistical Manual of Mental Disorders—known as the DSM-5—is set to be published, but a growing number of experts in the field are questioning the scientific validity of the guide, and list a number of "potentially harmful" changes.
Known as the "bible" of mental disorders, the DSM provides standard criteria for classifying mental disorders and this revision is the first since 1994. However, Dr. Thomas R. Insel, director of the National Institute of Mental Health, told The New York Times that the while the book is currently the best tool available, he believes that it should not guide research and that it actually hinders progress when clinicians adhere too strictly to the DSM's criteria. Additionally, the DSM serves as a categorical classification system which Insel doesn't think reflects the complexity of many disorders.
Instead, Insel is looking to focus on "biology, genetics and neuroscience so that scientists can define disorders by their causes, rather than their symptoms." He, and other experts, would like to see research in the mental health field mimic that of cancer, "which is moving from classifying tumors by where they occur in the body to characterizing them by their genetic and molecular signatures."
Dr. Steven E. Hyman, a psychiatrist and neuroscientist at the Broad Institute and a former director at the National Institute of Mental Health, said that the creators of the original DSM "were real heroes at the time." However, he says:
They chose a model in which all psychiatric illnesses were represented as categories discontinuous with ‘normal.’ But this is totally wrong in a way they couldn’t have imagined. So in fact what they produced was an absolute scientific nightmare. Many people who get one diagnosis get five diagnoses, but they don’t have five diseases — they have one underlying condition.
Dr. Allen J. Frances, who chaired the Task Force that produced the DSM-IV, is particularly critical of the the DSM-5, calling the APA's approval of the revision "a sad day for psychiatry," saying it would "medicalize normality." He penned an article listing the 10 worst changes, some of which include Disruptive Mood Dysregulation Disorder (temper tantrums); Major Depressive Disorder (normal grief); first time drug users will be lumped in with addicts; and Generalized Anxiety Disorder (everyday worries).
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