Don Bigelow, D.D.S.
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Psychiatry Evolves

Psychiatry Evolves with New Official Manual: What It Means for You and Your Children

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Asperger’s syndrome doesn’t exist, gambling addiction recognized, and new severity tests for diagnosis. For the first time in thirty years, substantial changes are being made to the central reference book for all psychiatrists. The changes include recognition of new mental disorders, the potential scrubbing out of some old ones, and modifying of how diagnosis takes place, all of which will change the course of mental health treatment forever.

What is this reference book?

Called the “bible” of psychiatry by some, the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), plays a huge role in the type of diagnosis a clinician makes for a patient. Between 1969 and 1972, a group of healthy individuals, led by a psychology professor, entered different mental institutions claiming to hear voices in their heads, and wrote a paper called, “On Being Sane in Insane Places.” The experiment was ground breaking and concluded that psychiatrists did not have a valid way to diagnose mental illness.

This led to the revamping of the DSM. The new version paired ailments with checklists of symptoms.

Now, according to Scientific American, insurance companies often demand an official DSM diagnosis before they pay for mental illness treatment. Furthermore, many schools and social services require a DSM diagnosis before kids with special needs due to mental problems are admitted into programs.

Why is it being revamped?

A recent article in Scientific American said that changes were needed for a number of reasons.
One reason mentioned was that “health professionals rely so heavily on catchall diagnoses because the current DSM has some serious gaps in its diagnostic offerings and has some superfluous entries.”

Another reason is that because checklists of symptoms are so similar for different disorders, patients are often wrongfully given multiple diagnosis.

Changes that matter:

Changes will take effect next year, in May of 2013.

According to Scientific American, the revisions will probably scrub out commonly known mental disorders, namely Asperger’s syndrome and paranoid personality disorder. A number of new diagnoses will be recognized, namely:

  • An ailment in children characterized by severe temper tantrums.
  • A type of sex addiction in adults.
  • Binge eating.
  • Addiction to gambling.

Changes in how we are diagnosed

The last DSM version, DSM-IV, grouped every disorder in one of three categories: Clinical disorders, personality and developmental disorders, and medical problems playing a role in mental illness. DSM-5 throws out these three categories, and instead places different disorders chronologically, starting with disorders that most often occur in infancy, moving through adulthood.

The revisions in DSM-5 will have doctors grade the severity of the patient’s symptoms. For example, if a patient has depression, he or she will be rated for milder symptoms like insomnia and more severe symptoms like thoughts of suicide. Such ratings will be standardized so that different doctors can reach similar conclusions, according to Scientific American.

One possible concern with grading symptoms is that some patients might be ruled out of insurance help because their rating is too low.


The changes have been subject to much criticism and debate. In fact, the website that posts the proposed changes has received 50 million hits from 500,000 people. You can see more proposed changes here.
The interest comes, no doubt, because the changes will reshape how we look at mental health as a society.

Source: Scientific American

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Article Reviewed: June 1, 2014
Copyright © 2015 Healthy Magazine

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