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

Water rationing hits California: limit of 50 gallons per person per day or face fines of $500
2014 09 29
Millions of Californians are about to be hit with strict water rationing -- daily "allocation" numbers that represent the maximum amount of water you’re allowed to use for any purpose. Households that exceed the allocation limit will face stiff fines of hundreds of dollars per violation. "In July, the State Water Resources Control Board passed stage one emergency regulations, giving powers ...
Much of Earth’s Water is Older than the Sun
2014 09 29
Much of the water on Earth and elsewhere in the solar system likely predates the birth of the sun, a new study reports. The finding suggests that water is commonly incorporated into newly forming planets throughout the Milky Way galaxy and beyond, researchers said — good news for anyone hoping that Earth isn’t the only world to host life. “The implications of ...
Did the Vikings Get a Bum Rap?
2014 09 29
A Yale historian wants us to rethink the terrible tales about the Norse. This illustration shows the stereotype of Viking marauders wreaking mayhem, even on clergy. The scene depicts the monastery at Clonmacnoise, Ireland. The Vikings gave no quarter when they stormed the city of Nantes, in what is now western France, in June 843—not even to the monks barricaded in the ...
David Cameron Says Non-Violent Conspiracy Theorists Are Just As Dangerous As ISIS
2014 09 29
David Cameron told the U.N. that "non-violent extremism" is just as dangerous as terrorism and must be eradicated using all means at the government’s disposal. He references 9/11 and 7/7 Truthers as examples of the type of extremism that must be dealt in a similar fashion to ISIS. If you thought Obama’s War is Peace speech to the U.N. was creepy, ...
NY Times: Europe’s Anti-Semitism Comes Out of the Shadows
2014 09 28
NY Times Whines about European "Anti-Semitism" In the wake of the conflict in Gaza, three communities became flash points of violence and began contending with hatred they thought was buried in the past. Read the NY Times hit piece on Europe here Below is a rebuttal from Mike King’s The Anti-New York Times at tomatobubble.com: Strike up the violins and break out the barf ...
More News »