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SALT LAKE CITY — The "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition" (referred to as the DSM-IV) is published by The American Psychiatric Association for defining treatment for psychiatric disorders in the United States and widely used as a standard here and in some other parts of the world. Next year, the fifth edition will be published.
Each diagnosis/treatment is coded. The codes must be completed on reimbursement documents to allow payment when psychiatric services are rendered. The codes are then used by health insurers in deciding which disorders are reimbursed.
The implications reach well beyond the psychiatric community, and the problems associated with the manual appear to be never-ending. This new edition will be the worst yet, according to some.
The new DSM-5 manual has been posted online for quite a few years but officially will not be published until 2013. The APA says the purpose of the pre-publication was to build a “consensus and to gain valuable feedback.” The final commenting period on the draft DSM-5 closed June 15.
Unfortunately, the latest version of the DSM-5 in some areas, like gambling and binge eating, seems to read more like a checklist of arbitrary characteristics, but sex and Internet overuse are ignored.
Another example is the new diagnosis for Asperger’s syndrome (describing someone as socially uneasy with an obsessive interest in arcane subjects) falls into the category of “autism spectrum disorders,” which for many parents, is offensive and they would not want their children ever diagnosed as autistic.
A further example is the “gender incongruence” replacing “gender identity disorder” used to describe children who are uncomfortable with their gender. “Mental retardation” has also been replaced with “intellectual disability.” It seems that some of the “labels” serve only to stigmatize.
Moreover, some critics also believe the manual trivializes serious conditions, foments hurtful stereotypes and is too politically correct.
How the manual will be received and what the effects on the psychology world will be remains to be seen. But it has certainly generated myuch more controversy than previous revisions.
Mel Borup Chandler writes about science-related topics, technological breakthroughs and medicine. He was previously a caseworker working with dual diagnosed developmentally disabled clients.His email address is mbccomentator@roadrunner.com.
