New diagnostic book for mental disorders too broad: critics

VANCOUVER (NEWS1130) – Do you bite your nails? Maybe you have pathological grooming habits.

Having a “senior moment?” It might be a minor neuro-cognitive disorder.

It’s not even out yet, but the newest version of the “psychiatrist’s bible” is already attracting a firestorm of controversy.

Thousands of doctors and psychiatrists around the world believe the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5) broadens the definition of many mental disorders to the point where almost everyone is on the brink of being diagnosed some kind of mental disorder.

The worry from many psychiatrists, psychologists, and other mental health practitioners is that even more people will be over-medicated for “conditions” that many consider normal, everyday behaviour.

“It will, in fact, translate into more medication and a blurring of everyday behaviour, in terms of being seen as mentally ill,” says Anne Kingston, senior writer with Maclean’s Magazine.

This week’s Maclean’s offers an in-depth look at the criticism surrounding the new DSM-5, due out in May.

“There is huge division right now and it’s caused a lot of outrage,” she suggests.

If your child has more than three temper tantrums in a week, he or she could be diagnosed as having “disruptive mood dysregulation disorder,” under guidelines in the DSM-5.

“It’s a little bit different than bi-polar,” explains Kingston. “The thinking behind this was that they wanted to get away from bi-polar diagnoses, which just exploded when it was introduced the last time this manual came out. But by doing this, it created a situation where parents might not be sure if normal irritability or a child who has an irritable personality to begin with does, in fact, have deeper, darker problems.”

There’s a push from some camps to shift away from the DSM as the “bible” of mental disorder diagnoses.

“There are other standards. The World Health Organization also has a categorization of disease types that is in keeping with the DSM. But there is thinking now, within in organizations like the American Psychological Association, that the standard will shift to the WHO because there is such a worry about this blurring of everyday life in terms of the DSM and over-diagnosis,” explains Kingston.

But she points out there is one upside to the controversy over the reference manual: Some experts feel it is a perfect opportunity to begin constructive conversations about the future of psychiatric diagnosis.