Last Chance To Comment on Psychiatric Disorders in the DSM-5

Image courtesy of Wikimedia Commons

Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters.


If you’ve got a pressing need to tell psychiatrists what you think about “disruptive mood dysregulation disorder” (translation: kids with temper tantrums), “night eating syndrome” (people who, well, eat a lot at night), and “callous and unemotional specifier for conduct disorder” (cold-fish types), now’s the time to do it. Friday is the deadline for public comment on the final draft of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual, a volume often referred to as “the bible of psychiatry.”

Actually, ‘bible’ is an absurd term for a text that’s been rewritten—and greatly expanded—multiple times since the first edition was published in 1952. That early version was a modest effort: 132 pages with about a hundred disorders. DSM-IV, published in 1994, features almost three times the number of disorders in 886 pages—longer than my copy of The Brothers Karamazov.

I suppose one could praise the APA’s commitment to updating its views and incorporating new science, although much of that new science is funded by drug companies seeking to expand their product sales. The problem is that the rest of us—patients, clinicians, hospitals, insurers, etc.—tend to view these diagnoses as a true reflection of reality, and we allow them to govern major aspects of our lives and self-identities. But psychiatric diagnoses are often, at best, clumsy human framings of complex mood states that elude easy understanding and description.

The current revision is taking place amid much greater public and media attention. Academics and jounalists in recent years have detailed the influence of drug-company money on medical research and clinical practice. They have focused on what has been called disease-mongering—the effort to expand illness boundaries in ways that tend to increase industry profits. In the case of DSM-5, researchers have doumented widespread industry ties among panel members debating the diagnostic changes. Although the APA itself has tightened its conflict-of-interest policies for DSM panel members, critics say the changes have not gone far enough.

Controversies have also erupted over efforts to redefine common disorders, including depression, addiction, autism, sexual problems and a host of other conditions—often in ways that appeared to increase the numbers likely to be diagnosed, and therefore likely to be treated with medication. After public criticism, the APA has backed away from some controversial proposals, like “attenuated psychosis syndrome” for people deemed at risk of becoming psychotic, and “persistent complex bereavement-related disorder,” which critics said transformed ordinary grief into a pathological condition.

Public interest in the changes has been widespread. The open comment periods for two earlier drafts of DSM-V, in 2010 and 2011, generated almost 11,000 responses altogether. The volume is expected to be published next year.

AN IMPORTANT UPDATE

We’re falling behind our online fundraising goals and we can’t sustain coming up short on donations month after month. Perhaps you’ve heard? It is impossibly hard in the news business right now, with layoffs intensifying and fancy new startups and funding going kaput.

The crisis facing journalism and democracy isn’t going away anytime soon. And neither is Mother Jones, our readers, or our unique way of doing in-depth reporting that exists to bring about change.

Which is exactly why, despite the challenges we face, we just took a big gulp and joined forces with the Center for Investigative Reporting, a team of ace journalists who create the amazing podcast and public radio show Reveal.

If you can part with even just a few bucks, please help us pick up the pace of donations. We simply can’t afford to keep falling behind on our fundraising targets month after month.

Editor-in-Chief Clara Jeffery said it well to our team recently, and that team 100 percent includes readers like you who make it all possible: “This is a year to prove that we can pull off this merger, grow our audiences and impact, attract more funding and keep growing. More broadly, it’s a year when the very future of both journalism and democracy is on the line. We have to go for every important story, every reader/listener/viewer, and leave it all on the field. I’m very proud of all the hard work that’s gotten us to this moment, and confident that we can meet it.”

Let’s do this. If you can right now, please support Mother Jones and investigative journalism with an urgently needed donation today.

payment methods

AN IMPORTANT UPDATE

We’re falling behind our online fundraising goals and we can’t sustain coming up short on donations month after month. Perhaps you’ve heard? It is impossibly hard in the news business right now, with layoffs intensifying and fancy new startups and funding going kaput.

The crisis facing journalism and democracy isn’t going away anytime soon. And neither is Mother Jones, our readers, or our unique way of doing in-depth reporting that exists to bring about change.

Which is exactly why, despite the challenges we face, we just took a big gulp and joined forces with the Center for Investigative Reporting, a team of ace journalists who create the amazing podcast and public radio show Reveal.

If you can part with even just a few bucks, please help us pick up the pace of donations. We simply can’t afford to keep falling behind on our fundraising targets month after month.

Editor-in-Chief Clara Jeffery said it well to our team recently, and that team 100 percent includes readers like you who make it all possible: “This is a year to prove that we can pull off this merger, grow our audiences and impact, attract more funding and keep growing. More broadly, it’s a year when the very future of both journalism and democracy is on the line. We have to go for every important story, every reader/listener/viewer, and leave it all on the field. I’m very proud of all the hard work that’s gotten us to this moment, and confident that we can meet it.”

Let’s do this. If you can right now, please support Mother Jones and investigative journalism with an urgently needed donation today.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate