Monday, November 17, 2008

The DSM-5 Debate


Christopher Lane over at the LA Times has an Opinion published in yesterday's issue exposing the debate within the APA (now spilling out) about how transparent to make the process for developing the upcoming DSM-V.

...The bone of contention: whether the next revision of America's psychiatric bible, the "Diagnostic and Statistical Manual of Mental Disorders," should be done openly and transparently so mental health professionals and the public could follow along, or whether the debates should be held in secret.

One of the psychiatrists (former editor Robert Spitzer) wanted transparency; several others, including the president of the American Psychiatric Assn. and the man charged with overseeing the revisions (Darrel Regier), held out for secrecy. Hanging in the balance is whether, four years from now, a set of questionable behaviors with names such as "Apathy Disorder," "Parental Alienation Syndrome," "Premenstrual Dysphoric Disorder," "Compulsive Buying Disorder," "Internet Addiction" and "Relational Disorder" will be considered full-fledged psychiatric illnesses.
Perhaps some think that this is another thing, like making sausage or legislation, that one doesn't want to know how it is made or what goes into it.  Let's hope not.  In fact, Robert Spitzer, who chaired the group which created the third edition of the DSM (the so-called Diagnostic & Statistical Manual contains the gold standard definitions of various mental illnesses and other conditions), sent out an open letter a few months ago calling on the APA to open up the process.  In response, the APA is now publishing Work Group reports and is planning to publish the minutes from the meetings, as well.

The DSMV is expected in 2012.