• Grief is being rediagnosed by US psychiatrists as “Major Depressive Disorder”.
by the book
HOARDING, temper tantrums and skin picking are in. Sex addiction is out.
The American Psychiatric Association has redefined a number of mental disorders as part of its fifth review of its psychiatric “bible”—the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
A decade in the making, the new edition is due to be published in May.
But the revision is embroiled in controversy, described as flawed and dangerous by outspoken critic and chair of the taskforce that developed DSM-IV, Allen J Frances.
Dr Frances says new diagnoses are dangerous because they influence whether millions of people are placed on drugs—often by GPs after brief visits.
The APA says more than 1500 experts in all fields of psychiatry and psychology from 39 countries contributed to the new version.
Under the changes:
1. Temper tantrums and persistent irritability become Disruptive Mood Dysregulation Disorder—raising concerns over excessive and inappropriate use of medication in young children and adults who lose it three or more times a week for more than a year. The change is seen as creating a new “fad” similar to others including attention deficit disorder.
2. Grief becomes Major Depressive Disorder—a move described as “medicalising and trivialising” the expected and necessary emotional reactions to the loss of a loved one and “substituting pills and superficial medical rituals for the deep consolations of family, friends, religion and the resiliency that comes with time”. Grief used to be considered normal in people with symptoms of depression lasting less than two months.
3. Excessive eating 12 times in three months becomes Binge Eating Disorder.
4. First-time substance abusers will be lumped in with hard-core addicts under Substance Related and Addictive Disorders. Gambling falls under this category where previously it was an impulse control disorder. Sex addiction also has been dropped.
5. Everyday stress becomes Generalized Anxiety Disorder—raising fears the change will create millions of anxious new patients and expand the already widespread practice of inappropriately prescribing addictive anti-anxiety medications.
6. Asperger’s disorder, childhood disintegrative disorder and pervasive development disorder will no longer be specific diagnoses. Instead, children with these conditions will receive diagnoses of autism spectrum disorder.
7. Hoarding becomes a disorder in its own right, previously regarded as a symptom of obsessive-compulsive disorder in, “people with persistent difficulty discarding or parting with possessions, regardless of their actual value”.
8. Skin picking becomes a new disorder related to obsessive-compulsive disorders.
by CARMELO AMALFI