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

Magaluf bar where British girl was filmed performing sex acts on 24 men is shut down after police investigation into video
2014 07 26
Is this what the youth in Britain and Europe is spending their their energy, money, efforts and innocence on? The young girl, pictured, was lured into performing multiple sex acts after organisers offered a free drink although she thought a holiday was on offer* Council officials launched an official investigation after the video went viral Playhouse bar in Magaluf and entertainment ...
Prejudice is a Form of Common Sense - Hard-Wired Into the Human Brain, Says ASU Study
2014 07 26
Contrary to what most people believe, the tendency to be prejudiced is a form of common sense, hard-wired into the human brain through evolution as an adaptive response to protect our prehistoric ancestors from danger. So suggests a new study published by Arizona State University researchers in the May issue of the "Journal of Personality and Social Psychology," which contends that, ...
The State is a Bully
2014 07 24
In the history of Western philosophy and social theory, no really silly idea has been more successful than the theory of the social contract. It is in fact not a theory of the social contract. It is a theory of the political contract. It is the idea, promoted by Thomas Hobbes, John Locke, and Jean-Jacques Rousseau, that, at some point in ...
NATO Exercise in Ukraine Coincided with MH-17 Shoot-down
2014 07 24
Rapid Trident was omitted from the flurry of coverage on the shoot-down MH-17. From the U.S. Army in Europe website: Rapid Trident supports interoperability among Ukraine, the United States, NATO and Partnership for Peace member nations. The exercise helps prepare participants to operate successfully in a joint, multinational, integrated environment with host-nation support from civil and governmental agencies. ...
Warning of ’imminent’ terror attack in Norway
2014 07 24
Norwegians were warned Thursday of the concrete possibility of a terror attack occurring in that country at the hands of people with connections to an extremist group in Syria. A press conference was called in Oslo, Norway on Thursday where an announcement was made of a "possible concrete threat" to national security in that country from terrorists related to an extremist ...
More News »