Five Mental Illnesses That Are Now Obsolete

When the DSM-5 goes live in 2012, five personality disorders likely won’t make the cut. After the jump, find out which mental illnesses are going the way of the dodo.

As Charles Zanor of the Times points out, the new Diagnostic and Statistical Manual of Mental Disorders will completely change the way personality disorders are categorized. For one thing the number of personality disorder “types” will be reduced to just five: antisocial/psychopathic, avoidant, borderline, and schizotypal. Five others, currently in the DSM-IV, are getting the axe. They are:

Paranoid personality disorder.

In the DSM-IV, “a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.”

Schizoid personality disorder.

“A pattern of detachment from social relationships and a restricted range of emotional expression.”

Histrionic personality disorder.

“A pattern of excessive emotionality and attention seeking.”

Narcissistic personality disorder.

“A pattern of grandiosity, need for admiration, and lack of empathy.”

Dependent personality disorder.

“A pattern of submissive and clinging behavior related to an excessive need to be taken care of.”

People currently displaying these symptoms won’t be magically declared “well” — rather, their problems will “be represented and diagnosed by a combination of core impairment in personality functioning and specific pathological personality traits, rather than as a specific type.” For instance, people who currently have paranoid personality disorder will be reclassified as having the traits “Suspiciousness, Intimacy avoidance, Hostility, [and] Unusual Beliefs.” From what’s been made available to the public, though, it’s not completely clear why some types made the cut and some didn’t — and understandably, people are pissed.

Psychologist Jonathan Shedler to the Times, “clinicians are accustomed to thinking in terms of syndromes, not deconstructed trait ratings” — and at least to this layperson, it now seems like they’re being asked to think in terms of both. Add to that the implication that some personality disorders are now less real or less important than others, and you have a manual that seems destined to cause problems for doctors and for patients (who will now have to get their insurance companies to pay for treatment for their “Suspiciousness, Intimacy avoidance, Hostility, [and] Unusual Beliefs”). And of course, the fact that a serious disorder can suddenly become obsolete illustrates that when it comes to the brain, even expert opinions can be distressingly arbitrary.

A Fate That Narcissists Will Hate: Being Ignored [NYT]
Personality And Personality Disorders [DSM5.org]