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The DSM gets a revision and mental illness gets redefined

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The Diagnostic and Statistical Manual of Mental Disorders is being revised. This is the first time since 1994 and you can be everyone is anxious to include the latest in psychiatric diagnosis.

Suggested changes include the definition of autism spectrum disorders and depression. While these might cause concern, there is even larger attention being paid to the DSM as a whole.

“Almost no one likes the DSM, but no one knows what to do about it,” said University of Michigan psychiatrist Randolph Nesse of the diagnostic tool first published in 1952.

“A huge debate over when depression is abnormal seems likely to be resolved by removing the so-called ‘grief exclusion’,” Nesse said. “At the moment, depression is not diagnosed in the two months after loss of a loved one. The result of this proposed change would be that people experiencing normal grief will receive a diagnosis of major depression. Doing this would increase consistency in diagnosing depression, but at the cost of common sense. It’s clear that bereavement is not a mental disorder.”

The new DSM will likely upset as many people as it pleases. “The problem is not the DSM criteria,” said Nesse. “The problem is that the untidy nature of mental disorders is at odds with our wish for a neat, clean classification system.”

He continued, “It’s vital to recognize that emotions serve functions in the same way that pain, cough and fever do, and that strong negative emotions can be normal responses to challenging or anxiety-provoking situations.”

Everyone should remain realistic in their expectations for the revision. Remember, it’s a work in progress.

Source: ScienceDaily, BMC Medicine

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