Home' Trinidad and Tobago Guardian : May 22nd 2013 Contents B36
body & soul
Guardian www.guardian.co.tt Wednesday, May 22, 2013
An update to one of the most important manuals
in mental health---known as the bible of psychia-
try---has been unveiled.
Controversy and criticism have surrounded work
on the fifth version of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-5).
Critics say the rulebook turns normal behaviour,
like grief or childhood temper tantrums, into mental
It is used mainly in the US, but is influential around
This is the first update to the volume since 1994.
Experts in mental health have been taking account
of the latest scientific developments to update ways
of diagnosing mental disorders.
The changes were presented at a meeting of the
American Psychiatric Association (APA).
There are new categories including binge eating
disorder, disruptive mood dysregulation disorder
(previously known as
childhood bipolar disorder)
and hoarding disorder.
Meanwhile Asperger s
syndrome is one of four
previously separate condi-
tions that have now
become part of a single
condition called autism
spectrum disorder (ASD).
ASD now encompasses
autism as known previ-
ously, Asperger s disorder,
disorder, and pervasive
which has not been specified.
The main symptoms of ASD are deficits in social
communication and social interaction and restricted
repetitive behaviours, interests, and activities.
The publication will have no effect on how people
are diagnosed in the UK and other countries which
use guidelines from the World Health Organization.
Attention deficit hyperactivity disorder (ADHD)
has been modified to emphasise that this disorder
can continue into adulthood.
Making normal ill
Ahead of the update, Prof Peter Kinderman, head
of the Institute of Psychology at the University of
Liverpool, argued on the BBC s Scrubbing Up column
that: "(DSM-5) will lower many diagnostic thresholds
and increase the number of people in the general
population seen as having a mental illness."
He said "normal grief" would now be classed as
a major depressive disorder and childhood temper
tantrums would be a symptom of disruptive mood
Also: "A wide range of unfortunate human behav-
iours, the subject of many new year s resolutions,
will become mental illnesses---excessive eating will
become binge eating disorder
, and the category of
behavioural addictions will widen significantly to
include such disorders as Internet addiction and
sex addiction ."
There is also criticism of the way DSM-5 classifies
diseases based on symptoms. There are efforts to
harness advances in genetics and neuroscience to
diagnose people based on the cause rather than the
symptoms of the illness.
The director of the US government s National Insti-
tute of Mental Health said the DSM had a "lack of
Dr Thomas Insel posted a blog saying: "Unlike our
definitions of ischemic heart disease, lymphoma, or
Aids, the DSM diagnoses are based on a consensus
about clusters of clinical symptoms, not any objective
"In the rest of medicine, this would be equivalent
to creating diagnostic systems based on the nature
of chest pain or the quality of fever."
In some areas the distinction between
disorders is narrowing. Autism, attention
deficit-hyperactivity disorder, bipolar dis-
order, major depressive disorder and schiz-
ophrenia are all classed as separate dis-
orders based on their symptoms.
However, research published in the
Lancet medical journal in February showed
Mental health 'bible' updated
Experts in mental health have been taking account of
the latest scientific developments to update ways of
diagnosing mental disorders.
PHOTO COURTESY MINDDISORDERS.COM
YOUR DAILY HEALTH
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"The changes to
the manual will
the continuity of
---Dr David Kupfer,
DSM-5 task force
all five disorders shared several genet-
ic risk factors.
Dr David Kupfer, the chair of the
DSM-5 task force, said: "The changes
to the manual will help clinicians
more precisely identify mental dis-
orders and improve diagnosis while
maintaining the continuity of care.
"We expect these changes to help
clinicians better serve patients and
to deepen our understanding of these
disorders based on new research."
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