Psychiatry divided as mental health ’bible’ denounced
2013 05 07

By Andy Coghlan and Sara Reardon | NewScientist

The world’s biggest mental health research institute is abandoning the new version of psychiatry’s "bible" – the Diagnostic and Statistical Manual of Mental Disorders, questioning its validity and stating that "patients with mental disorders deserve better". This bombshell comes just weeks before the publication of the fifth revision of the manual, called DSM-5.

On 29 April, Thomas Insel, director of the US National Institute of Mental Health (NIMH), advocated a major shift away from categorising diseases such as bipolar disorder and schizophrenia according to a person’s symptoms. Instead, Insel wants mental disorders to be diagnosed more objectively using genetics, brain scans that show abnormal patterns of activity and cognitive testing.

This would mean abandoning the manual published by the American Psychiatric Association that has been the mainstay of psychiatric research for 60 years.

The DSM has been embroiled in controversy for a number of years. Critics have said that it has outlasted its usefulness, has turned complaints that are not truly illnesses into medical conditions, and has been unduly influenced by pharmaceutical companies looking for new markets for their drugs.

There have also been complaints that widened definitions of several disorder have led to over-diagnosis of conditions such as bipolar disorder and attention deficit hyperactivity disorder.

Now, Insel has said in a blog post published by the NIMH that he wants a complete shift to diagnoses based on science not symptoms.

"Unlike our definitions of ischaemic heart disease, lymphoma or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure," Insel says. "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."

Insel says that elsewhere in medicine this type of symptom-based diagnosis been abandoned over the past half-century as scientists have learned that symptoms alone seldom indicate the best choice of treatment.

To accelerate the shift to biologically based diagnosis, Insel favours an approach embodied by a programme launched 18 months ago at the NIMH called the Research Domain Criteria project.

The approach is based on the idea that mental disorders are biological problems involving brain circuits that dictate specific patterns of cognition, emotion and behaviour. Concentrating on treating these problems, rather than symptoms is hoped to provide a better outlook for patients.

"We cannot succeed if we use DSM categories as the gold standard," says Insel. "That is why NIMH will be reorienting its research away from DSM categories," says Insel.

[...]

Read the full article at: newscientist.com



Related Articles
Firestorm Over New Psychiatry Bible
The Psychiatric Drugging of America’s Foster Children
One in five Afghan children suffers psychiatric disorder
Dr Thomas Szasz on Psychiatry


Latest News from our Front Page

Your Smartphone Broadcasts Your Entire Life To The Secret Service
2014 09 23
Intelligence services collect metadata on the communication of all citizens. Politicians would have us believe that this data doesn’t say all that much. A reader of De Correspondent put this to the test and demonstrated otherwise: metadata reveals a lot more about your life than you think. Ton Siedsma is nervous. He made the decision weeks ago, but keeps postponing it. ...
Scots were tricked into voting ‘No’ – Salmond
2014 09 23
London politicians gulled Scottish voters out of independence by making a false “vow” to grant Glasgow extra powers, First Minister Alex Salmond has said. He also raised the prospect of another referendum, saying the break-up is inevitable. Alex Salmond, leader of the ’Yes’ campaign and the outgoing head of the Scottish National Party (SNP), told the BBC’s Sunday Politics program that ...
The Most Terrifying Thing About Ebola
2014 09 23
The disease threatens humanity by preying on humanity. Suspected Ebola patient Finda “Zanabo” prays over her sick family members before being admitted to the Doctors Without Borders Ebola treatment center on Aug. 21, 2014, near Monrovia, Liberia. Photo by John Moore/Getty Images As the Ebola epidemic in West Africa has spiraled out of control, affecting thousands of Liberians, Sierra Leonians, and Guineans, ...
Man bitten by Ebola patient flown to Switzerland
2014 09 22
Swiss authorities say a male nurse who was bitten by an Ebola patient while working in West Africa has been flown to Switzerland as a precaution. The health ministry says the unidentified man was working for an international organization in Sierra Leone when he was bitten by a child infected with Ebola on Saturday. The ministry says the nurse was wearing protective ...
Climate March in New York City Reveals Communists Demanding ’Revolution, Nothing Less’ - Trash the City With Garbage
2014 09 22
Tens-of-thousands of demonstrators took to the streets of New York City Sunday to demand political leaders take action on climate change. While the protest remained peaceful, much of the “People’s Climate March” appeared to be made up of fringe elements of the political left. Dozens of signs denouncing capitalism were spotted at the demonstration, often held by self-proclaimed socialists. “Capitalism is destroying the ...
More News »