Thursday, July 09, 2009

Dr. Carlat Wants To Talk About The DSM-V


Dr. Daniel Carlat has his own psychiatry blog and he wants to talk about what's going to happen with the new Diagnostic and Statistical Manual (DSM-V). Funny they call it a statistical manual when there are no statistics (there are diagnoses!).

I'm sending you over there to join the discussion:

http://carlatpsychiatry.blogspot.com/

2 comments:

Quiact said...

The Diagnostics and Statistical Manual (DSM), the Shrink's bible, has been around for over 50 years. Within this manual, there are now possibly nearly 300 mental disorders.

As a dictionary of suspected mental illnesses, many redefined diagnoses are added to this manual with each edition, and how such disorders are classified and assessed.

On occasion, a mental disorder is deleted from the DSM, such as homosexuality in the early 1970s. Its purpose, this manual, is to assist mental health professionals to diagnose and classify mental disorders.

How a group sponsored by for profit pharmaceutical industry corporations that promote psychotropic drugs for various mental issues that may or may not fully exist make the determinations that they do while maintaining objectivity is a phenomenon.

Published and designed by the American Psychiatric Association (APA), the DSM is also used, I understand, for seeking mental diagnostic criteria to assure reimbursement.

The DSM is organized in part by the following:

I- Mental disorders
II- mental conditions
III- Physical disorders/syndromes, medical conditions (co-morbidity)
IV- Mental disorder suspected etiology
V- Pediatric assessments

The APA has historically directed the creation of each edition of the DSM, and assigns selected task force members to create this manual. This situation has proven to be controversial.

The next DSM involves 27 people. About 80 percent of these individuals are male, and only 4 members are not medical doctors. Most have had relationships with the NIH, and about 25 percent of these task force members have had relationships with the WHO.

Historically, at least a third of task force members have had, or do, have often monetary pharmaceutical industry ties in some way.

This makes sense, as about one third of the APAs total financing is from the pharmaceutical industry.

The APA required this task force for the next DSM edition to sign non-disclosure agreements- which is rather absurd and pointless. Lack of transparency equals lack of credibility because of these agreements of the content of the next DSM. It opposes any recovery model necessary regarding such disorders, I believe.

The DSM should be evaluated by another unrelated task force or a peer review of sorts to assure objectivity. This is particularly of concern presently, as many more are diagnosed with mental dysfunctions presently at a concerning rate- with very young children in particular.

Dan Abshear

Anonymous said...

Statistics makes it sound all sciency and fact based! Docs thrive on the fallacy from authority, or whatever it's called! (No disrespect intended, you know many do.) Some of the stuff the AMA did in the 60s, not cool, and not following the oath.