1 Boring Old Man

Weekend Vote Will Bring Controversial Changes To Psychiatrists’ Bible
NPR: All things Considered
by Alix Spiegel
November 30, 2012

^{This weekend, 20 people from around the country will meet in a nondescript hotel room in Arlington, Va., and take a vote. A passing stranger who stumbled on this group wouldn’t see much of anything, just a bunch of graying academic types sitting around a table. But millions of people will be touched by that vote because the graying academic types are voting to approve the 5th edition of the Diagnostic and Statistical Manual — the bible of psychiatry…}

^{There will likely be a new childhood disorder called disruptive mood dysregulation disorder: The people in charge of childhood disorders proposed this diagnosis because they felt very strongly that too many children were being categorized as having bipolar disorder and then prescribed anti-psychotic drugs.}

^{The hope is that psychiatrists will use this new diagnosis for kids, instead of bipolar disorder, and not prescribe as many drugs. Critics say it’s not clear that the change will work out, and that the history of mental health is littered with good intentions like this gone terribly wrong. But the hope is that it will shut down the rise of bipolar diagnoses in children…}

^{There will be a new way to think about sadness in the wake of the death of a loved one: In the last DSM (DSM-4), psychiatrists were warned away from diagnosing major depression in people who had recently lost someone they loved, because grief in the face of loss was seen as a normal — not abnormal — response.}

^{"That’s reasonable thinking, and certainly no one wants to pathologize grief or sadness or call it an illness when it is an absolutely normal human experience," said Dr. Sidney Zizook of the University of California, San Diego. But Zizook was one of the people who argued — probably successfully — to change that because, he says, telling psychiatrists that people who are grieving shouldn’t be diagnosed as depressive "excludes a bereaved person from being diagnosed with depression, if they have a depression, and no one wants to do that, either"…}

^{Chris Lane, author of Shyness: How Normal Behavior Became a Sickness, is a DSM critic. He worries the new version will label people sick when they are not. "I’m very concerned about the number of false positives from this edition," he says. "That is, the number of people who are overdiagnosed." Roger Peele of the APA obviously doesn’t agree, which doesn’t mean that he thinks the DSM-5 is infallible. "It’s important that people not see the DSM as a bible," he says, "that they respect it but don’t worship it"…}