Posts Tagged ‘APA’

The diagnostic bible of the American Psychiatric Association is getting a makeover. A rough draft of version 5 (which is still being debated by the powers that be) is posted at http://www.DSM5.org. And this debate is going to be a dilly.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the manual that doctors, insurers, and scientists use in deciding what is officially considered a mental disorder and how to tell if someone has it. Every now and then they decide to re-evaluate this based on the latest research findings. In a new twist, they were seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them. That ended in April. Now they have a committee (called the DSM-5 work group on their website) reviewing the comments; and between public input, APA member input, and private research, they will have the new version ready for publication by May of 2013.

Why so long? Take a look at their website, especially the timeline. Then check out the list of diagnostic categories on the home page. These are only the general categories. Specific disorders in each category can be seen by clicking on the name of the general category. All things considered, that final list is going to be huge – when they decide what will be on it and why.

Here’s one issue that they have to decide before 2013. Is Gender Identity Disorder a physical problem, a mental problem, or just another way for humans to behave? The LGBT community is already on the edge of their seats waiting for the APA to have an official opinion, and one way or another, that decision will make headlines for weeks.

My personal source of amusement comes from the fact that, at the moment, PMS is lumped in with bipolar disorder in the Mood Disorders category. I have both, I can tell the difference between the two, and I think that putting them in the same diagnostic category is hilarious. PMS is a physical problem with emotional side effects, and doesn’t belong in the DSM at all (although I think several men around the world would loudly disagree with me).

In other categories, the APA is officially considering hoarding, skin-picking, tics, and olfactory reference syndrome (delusional beliefs about one’s own body odor) as formally classified Anxiety Disorders. Binge eating is also being considered for placement with anorexia and bulimia in the Eating Disorders category. There’s an idea. I could get insurance to pay for a doctor to help me stop pigging out.

Seriously, if you are concerned about the diagnostic process when it comes to mental disorders, keep checking back for updates to their website. I hope that they’re carefully considering the comments of the people who have to personally deal with these issues every day, and not just letting the insurance companies tell the APA how to interpret the research.


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Perhaps inspired by President Obama, the American Psychiatric Association announced yesterday that it will no longer accept free meals and “medical education seminars” from pharma-lobbyists (excuse me) prescription drug manufacturers.

This is the best news I’ve heard all week!  Psychiatric medications are one of the worst categories of drugs to prescribe for the wrong reasons.  The side effects of the wrong psych medication can be more debilitating than the original disorder itself, and it can take a patient weeks or months to think straight again.

The APA’s CEO and medical director, Dr. James Scully, issued a statement which acknowledged that people have “a perception that accepting meals provided by pharmaceutical companies may have a subtle influence on doctors’ prescribing habits”.

No kidding.

For years, the APA has been frowning on gifts from these companies and asking that seminars at medical education conferences be given by neutral third parties, not by the manufacturers hoping to sway the doctors’ opinions about the best choices for their patients.  Fortunately, some of the drug manufacturers have already volunteered to stop giving out freebies to the doctors, presumably to avoid the illusion of bribery.

Dr. Scully also said this:  “What was acceptable five years ago isn’t necessarily acceptable today.”

With all due respect, I have news for you, sir.  It wasn’t really acceptable then, either.  You just weren’t getting as much flak about it.  On behalf of everyone affected by this, thank you very much for implementing the necessary policy changes.

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