The DSM-5 arrives in cloud of controversy

By Steve Ferguson,  Director of Consumer Activities


Dr. Richard Friedman recently wrote an article in the NY Times  giving his view on the new 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, commonly referred to DSM-5.  The DSM is published by the American Psychiatric Association and it provides set criteria for the classification of mental disorders.

As science progresses and evolves, it is common sense to go back and revise earlier criteria amid new evidence.  However, there has been little ground-breaking new evidence since the publication of the 4th edition (DSM-4).  Many psychiatrists feel the release of DSM-5 is premature and potentially dangerous to those with a mental health diagnosis and also those who are seeking help for the first time.

In the article Dr. Friedman gives an example of how DSM-5 could be potentially dangerous and unethical.  DSM-4 clearly differentiates normal/expected grief a person suffers from after a loss (ex: death of a loved one or good friend) from severe clinical depression.  However, the new DSM-5 encourages clinicians to diagnose major depression in parents who are grieving the loss of a child only after two weeks of mild depressive symptoms.   This is dangerous for the devastated parents who will be prescribed medications they may not need. Basically, it shows a rush to medicate when perhaps the parents should have time to work with a grief counselor to start the healing process.

This rush to prescribe anti-depressants without proper therapeutic treatment is an ongoing problem because it mislabels healthy people with a psychiatric diagnosis, although it does benefit pharmaceutical corporations with an increase in sales of anti-depressants and mood stabilizers.

However, keeping all that in mind, I believe that DSM has been a valuable tool for psychiatrists, psychologists, physicians, therapists, and many other practitioners.   One of its important benefits is that it can still provide a common language for clinicians to use in order to discuss and treat mental illnesses. While the latest edition of DSM comes with its share of issues and limitations, perhaps it can still be a useful tool when used with caution. And like anything that is in the realm of science, the DSM will continue to evolve and progress as new evidence and truths regarding mental disorders are unveiled.

(The views expressed in this blog do not necessarily represent the views of the Mental Health Association in Niagara County, Inc.)


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