DSM V: Diagnostic Sausage Making

Ah, the DSM, the Diagnostic and Statistical Manual, the focus of much consternation and jockeying for position in the world of insurance reimbursements for treatments for “mental illnesses.” A new edition is being struggled over at this very moment and it is not exactly the scientific process our average citizen would imagine.

The good folks at Miller-McCune Online have been kind enough to develop a three article series on the dynamics of this process of psychiatric “sausage making.” This is important stuff as the DSM provides the framework for deciding who gets what drugs and who gets government aid, and which children get weighted down with a disease label they will probably carry for their entire lives.

Anyway, here is a small snippet from the first of the articles. I encourage you to read all three articles in their entirety.

from Infallibility and Psychiatry’s Bible

…the path to wellness would be near impossible were it not for theDiagnostic and Statistical Manual of Mental Disorders. This encyclopedia of mental illness, published by the American Psychiatric Association, offers the final word on everything from kleptomania to schizophrenia. No wonder it’s regularly consulted by clinicians, health insurance companies, the pharmaceutical industry and policymakers throughout the United States and, in varying degrees, the rest of the world.

The latest battle became public last summer when the authors of the currentDSM-IV, Allen Frances and Robert Spitzer, sent a letter to the APA’s Board of Trustees warning of serious problems with both the process and content of the DSM-V, currently being revised for publication in 2013. Their missive followed a back-and-forth between Frances and the APA in the pages of thePsychiatric Times.

In their July 6, 2009 letter, Frances and Spitzer assailed the DSM-V task force for its lack of transparency: “The DSM-V leadership has lost contact with the field by restricting the necessary free communication of its workgroups and by sealing itself off from advice and criticism.” Unless the internal review process improved, the authors warned that questions would be raised about the “legitimacy” of the APA’s role in producing this and future manuals…

much more via Miller-McCune

Part II: Who Benefits? DSM Conflict of Interests (June 3)
Part III: Are You Normal or Finally Diagnosed (June 8 )


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