Mental health 'bible' starts revamp with new terminology, diagnoses

Feb 11 2010

The Wall Street Journal: "Mental-health experts wrestling with how to fit temper tantrums, hoarding and even Internet addiction into the current understanding of mental illness are proposing changes to the field's primary reference for diagnoses for the first time in 16 years. The draft revisions of the Diagnostic and Statistical Manual of Mental Disorders—the bible for mental health clinicians and researchers—unveiled Wednesday could have effects that ripple through mental health care."

Researchers, clinicians and insurance companies use the DSM to make diagnostic, treatment and coverage decisions. For drug companies, changes could open up opportunities for new drugs or expand the uses of existing ones"  (Wang, 2/10). 

NPR: "Doctors use the DSM to diagnose patients, and insurance companies use it to decide on reimbursement, so it's incredibly important in the profession of psychiatry."

NPR reports on a change for children currently being diagnosed with bipolar disorder (also known as manic-depression): "The condition will be called temper dysregulation disorder, and it will be seen as a brain or biological dysfunction, but not as a necessarily lifelong condition like bipolar. ... By adding this new entry, the American Psychiatric Association is trying to use the considerable institutional power of the DSM to curb use of the pediatric bipolar label" (Spiegel, 2/10).

The Associated Press: The American Psychiatric Association "is seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them. ... Sure to generate debate, the draft also proposes diagnosing people as being at high risk of developing some serious mental disorders -- such as dementia or schizophrenia -- based on early symptoms, even though there's no way to know who will worsen into full-blown illness" (Neergaard, 2/10).

USA Today reports on efforts to classify illness like autism as broader illnesses rather than a specific subtype: "DSM-5 proposes replacing diagnoses for autism, Asperger's, childhood disintegrative and pervasive developmental disorders with a single diagnosis, 'autism spectrum disorders,' based on deficits in social interaction and communication and the presence of repetitive behaviors and interests" (Rubin, 2/9).