February 9, 2012
http://www.reuters.com/article/2012/02/09/mental-illness-diagnosis-idUSL5=
E8D98MX20120209
Reuters | February 9, 2012
Shyness an illness in "dangerous" health book-experts
. Grieving relatives could be classed as ill
. Revisions mean broader diagnoses of mental disorders
. Petition signed by 11,000 health workers calls for halt
By Kate Kelland, Health and Science Correspondent
LONDON, Feb 9 (Reuters) - Millions of healthy people - including shy or =
defiant children, grieving relatives and people with fetishes - may be =
wrongly labelled mentally ill by a new international diagnostic manual, =
specialists said on Thursday.
In a damning analysis of an upcoming revision of the influential =
Diagnostic and Statistical Manual of Mental Disorders (DSM), =
psychologists, psychiatrists and mental health experts said its new =
categories and "tick-box" diagnosis systems were at best "silly" and at =
worst "worrying and dangerous".
Some diagnoses - for conditions like "oppositional defiant disorder" and =
"apathy syndrome" - risk devaluing the seriousness of mental illness and =
medicalising behaviours most people would consider normal or just mildly =
eccentric, the experts said.
At the other end of the spectrum, the new DSM, due out next year, could =
give medical diagnoses for serial rapists and sex abusers - under labels =
like "paraphilic coercive disorder" - and may allow offenders to escape =
prison by providing what could be seen as an excuse for their behaviour, =
they added.
The DSM is published by the American Psychiatric Association (APA) and =
has descriptions, symptoms and other criteria for diagnosing mental =
disorders. It is used internationally and is seen as the diagnostic =
"bible" for mental health medicine.
More than 11,000 health professionals have already signed a petition (at =
http://dsm5-reform.com) calling for the development of the fifth edition =
of the manual to be halted and re-thought.
"The proposed revision to DSM ... will exacerbate the problems that =
result from trying to fit a medical, diagnostic system to problems that =
just don't fit nicely into those boxes," said Peter Kinderman, a =
clinical psychologist and head of Liverpool University's Institute of =
Psychology at a briefing about widespread concerns over the book in =
London.
He said the new edition - known as DSM-5 - "will pathologise a wide =
range of problems which should never be thought of as mental illnesses".
"Many people who are shy, bereaved, eccentric, or have unconventional =
romantic lives will suddenly find themselves labelled as mentally ill," =
he said. "It's not humane, it's not scientific, and it won't help decide =
what help a person needs."
RADICAL, RECKLESS, AND INHUMANE
Simon Wessely of the Institute of Psychiatry, King's College London said =
a look back at history should make health experts ask themselves: "Do we =
need all these labels?"
He said the 1840 Census of the United States included just one category =
for mental disorder, but by 1917 the APA was already recognising 59. =
That rose to 128 in 1959, to 227 in 1980, and again to around 350 =
disorders in the fastest revisions of DSM in 1994 and 2000.
Allen Frances, Emeritus professor at Duke University and chair of the =
committee that oversaw the previous DSM revision, said the proposed =
DSM-5 would "radically and recklessly expand the boundaries of =
psychiatry" and result in the "medicalisation of normality, individual =
difference, and criminality".
As an unintended consequence, he said an emailed comment, many millions =
of people will get inappropriate diagnoses and treatments, and already =
scarce funds would be wasted on giving drugs to people who don't need =
them and may be harmed by them.=20
Nick Craddock of Cardiff University's department of psychological =
medicine and neurology, who also spoke at the London briefing, cited =
depression as a key example of where DSM's broad categories were going =
wrong.
Whereas in previous editions, a person who had recently lost a loved one =
and was suffering low moods would be seen as experiencing a normal human =
reaction to bereavement, the new DSM criteria would ignore the death, =
look only at the symptoms, and class the person as having a depressive =
illness.
Other examples of diagnoses cited by experts as problematic included =
"gambling disorder", "internet addiction disorder" and "oppositional =
defiant disorder" - a condition in which a child "actively refuses to =
comply with majority's requests" and "performs deliberate actions to =
annoy others".
"That basically means children who say 'no' to their parents more than a =
certain number of times," Kinderman said. "On that criteria, many of us =
would have to say our children are mentally ill." (Reporting by Kate =
Kelland; Editing by Andrew Heavens)
-----------------------
Suzy Chapman
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