Wednesday, January 14, 2009


Ok, I’ve known for some time that the DSM-V was in progress, but what I didn’t know about was that the process was supposedly a closed-doors, hush-hush thing. And that made me ask, ‘WTF?’

Pardon the language, but seriously, what is it the people working on the new DSM feel the need to hide? I don’t have anything against the DSM per se, it’s generally useful as a general guide for at least knowing which medications to prescribe, but it’s certainly not a psychiatric rule book that begs absolute obedience. And the categories and labels have changed so significantly since the manual’s conception (homosexuality used to be a psychiatric condition and the number of disorders has greatly increased) that the manual is more of a dictionary educating physicians on which words to use to communicate with each other for the next few years. And clarity is a good thing. And revisions as we learn more about psychiatric illness are a good thing. Certainly labels are helpful in certain official situations, like court where the difference between sociopathy and psychopathy might be relevant, but who really cares if they are in separate categories in the DSM or are chaptered under the umbrella of antisocial personality disorders?

I think it would be funny if the DSM task force put a bunch of symptoms into one hat and a bunch of diagnoses into another and picked the categories at random. Which is probably the most dramatic (or maybe not) change that would be made to the current edition. My point: it’s just the DSM. For those working in psychiatry, it’s not like a new diagnosis is going to suddenly appear and completely change the world. There is no conspiracy…probably.


- Wall Street Journal blog post

- I think the link title is descriptive enough

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