The DSM-V is coming!

The 5th version of the Diagnostic and Statistical Manual of Mental Disorders or DSM of the American Psychiatric Association is currently in development and is scheduled to be released some time in 2013. From the looks of things right now, it seems that they are pretty close to having it done and right now they are working on the finishing touches. One interesting thing is that the APA is trying to get feedback about the new changes, not only from the medical community but from patient support groups and the general public as well. This certainly seems to be a shift in philosophy compared to the “Doctor knows best” thinking of the mid 20th century. Although I certainly do embrace this new paradigm, it has opened up the proverbial can of worms. There seem to be many people voicing their objections to some of the proposed changes. For example, one of the proposed changes is to eliminate the diagnosis of Asperger’s Syndrome (A very mild form of autism) and just roll it up into the diagnosis of autism. There has been a change in the DSM-V for the diagnosis of autism which now makes the diagnosis of Asperger’s Syndrome redundant. This seems like a very minor and technical change but according to NPR, there is a community of people with Asperger’s Syndrome that has developed over the years and who have developed a sense of pride in who they are and their condition. This new change would certainly be a threat to the identity of this community. Is that reason enough to not eliminate Asperger’s Syndrome? I honestly don’t know. The addition of new disorders is also bringing criticism. Jerome Burne of dailymail.com has pointed out that some of the new proposed disorders include hoarding and bing-eating and alludes to his opinion that the DSM is already too bloated and the addition of these new disorders is the result of the fact that psychiatrists like making up new classifications and medicating people for anything that might be slightly wrong with them. There has even been criticism of the use of NOS (not otherwise specified). This is a modifier for some families of disorders so that individual cases that don’t meet the criteria for a specific diagnosis don’t fall through the cracks. For example, a patient may have the symptoms of depression but not meet the criteria for a diagnosis of a specific type of depression (major depression, dysthymic depression … ). There are those on the internet that interpret NOS as a way for doctors and others to “give problems” to people who really don’t have any. I did study psychology in college but I’m not a therapist or a doctor so I can’t comment on the technical details of the new changes to the DSM. It does seem to me however that a lot of this criticism seems to be churning from the “perpetual emotion machine” that is our media industry. I’m sure there are lots of legitimate concerns about the proposed changes but most of what I’m seeing seems to be the normal “catastrophizing “ of current events.