Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=156382
Story Retrieval Date: 5/24/2013 11:49:11 PM CST

Top Stories
Features

First update to psychiatrists’ manual in 16 years provoking strong debate

by Lauren Sullivan
Feb 11, 2010


The American Psychiatric Association is revising what is considered the psychiatrists’ bible for the first time in 16 years, leaving medical officials and academics at odds over the direction of mental health perception and treatment in this country. 

The first draft of the modified Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, was introduced Wednesday. The manual has provided medical professionals, researchers, pharmaceutical companies and insurance groups with diagnostic material since its inception in 1952. 

 Some medical professionals praise the new recognition of addictive disorders like gambling and binge eating in the handbook. 

 “Many times these addictions are paired with a major depressive disorder,” said Dr. Kim Dennis, the medical director of Timberline Knolls, a women’s residential treatment center in Lemont.  

“Gambling addiction has one of the highest suicide rates. Many times individuals are treated with higher doses of anti-depression medications because the co-existing addictive disorder, like gambling, hasn’t been addressed,” Dennis said. 

This year’s reclassification of certain psychiatric disorders and creation of dozens of others will change the way people think of mental illness.  

“This is a big project put together by researchers and people studying outcome measures and psychotherapy,” said Dr. Terrence Koller, executive director of the Illinois Psychological Association. “This change and update – to measure outcome, whether a treatment is most effective and if the diagnosis lets people see change – is a good thing.” 

The updated manual also means a revamp in the treatments prescribed by mental health professionals. 

“Getting clients reimbursed for services is one of the major issues that professionals in mental health face,” Koller said. “If a diagnosis meets a necessity criteria – clarified in DSM 5 – you will be reimbursed.” 

But the latest draft has met criticism.  

Reclassifying certain disorders has left advocacy distraught. For instance, the DSM-5 eliminates Asperger’s syndrome and introduces what is being classified as the autism spectrum as a new umbrella term for everyone who has the disorder.
“It’s a mistake most importantly because we use the classifications to try gauge the real prevalence, said J.B. Handley, co-founder of Generation Rescue, a California-based autism awareness group. “When you change them, you muddy the waters relative to history. We find that frustrating.” 

 Others understand the adjustment in terminology. 

 “We’ve been talking about spectrum disorders for some time now,” Koller said. “Disorders could fall into a category that doesn’t accurately describe the symptoms. It’s better to consider it a spectrum diagnosis. Diagnosis is not a black or white term. It makes it clearer where you fall.” 

 The current draft is available online for review and public commenting until April 20. Publication of the revised manual is expected in May 2013.