Thursday, May 23, 2013

DSM-5 and The Critics—God Help Us All!

The new DSM-5 guide is being released this month, it’s the first major revision in 20 years. For those unfamiliar, it’s basically considered the bible for psychiatric disorders, it’s where labels of mental illnesses are defined. It’s used by doctors to diagnose their patients, by researchers and by insurance companies for billing purposes. So it’s a pretty big deal.

For some time now, there’s been a lot of controversy over the new revised guide from labels being removed to new labels being added. For example, the Aspergers label has been removed and those with these symptoms should now fall under the new Autism Spectrum Disorder label. According to Slate.com, a study by Fred Volkmar, director of the Child Study Center at the Yale School of Medicine has already predicted that up to 75% of those previously diagnosed with Aspergers would not qualify for the more restrictive label of Autism. So families fear that those kids will now lose services or if newly assessed, like my son, may receive none at all.

Then there’s the new label for kids with anger issues who were once previously diagnosed with Bipolar Disorder, they will now receive the new label of Disruptive Mood Dysregulation Disorder (DMDD). The media identifies this with kids having severe temper tantrums. People now worry that kids will get unnecessary labels and those kids previous labeled with Bipolar Disorder will now be lumped into this category. How will insurance companies decide to cover their meds and necessary therapies? Not to mention how schools will address it.

This is just a sneak peek of what the controversy has been about. But now as the DSM-5 is released this month, there’s a growing backlash. One of the most notable is the National Institute of Mental Health (NIMH), the world’s largest funding agency for research into mental health, has indicated that it is withdrawing support for the manual. This is serious stuff folks!

In salon.com, Temple Grandin proclaims that the DSM-5 sounds like diagnosis by committee. She concludes:
Twenty years from now, I think we’re going to look back on a lot of this diagnostic stuff and say, “That was garbage.” So as I see it, we have a choice. We can wait twenty years and several more editions of the DSM before we start to clean up this mess. Or we can take advantage of the technological resources that are beginning to become available and start phase three right now.
 I choose phase three.
And the critics go on and on...

So what does that mean for us? For our kids? How will this affect my son’s assessment that he’s currently participating in? Will we look back and think this was all garbage? Will we still be confused years later? I’d like to think that we’re doing the best we can with what we know today, but it doesn’t help when the professionals don’t agree. Who do we trust?

The more I read about symptoms in children, the more things seem similar. Sometimes I laugh when I read blogs on one illness because I’d swear it was written for another illness.

It makes me wonder how wide is that spectrum? Could bipolar, schizophrenia, autism, ADHD, ODD, PDD, Anxiety, Depression etc. all be on one large spectrum? It seems there’s a lot of the same medications used to treat these different illnesses and new research is showing some connections between them. 

It makes me wonder, what will we think when we look back on this 20 years from now?

Our precious children are depending on us to make the best decisions. 

God help us all.


* * *

The NIMH Withdraws Support for DSM-5

Temple Grandin on DSM-5: “Sounds like diagnosis by committee”

The DSM-5 is here: What the controversial new changes mean for mental health care

You Do Not Have Asperger’s
What psychiatry’s new diagnostic manual means for people on the autism spectrum.

2 comments:

  1. (way late in commenting) But I agree with you. I think a lot of these illnesses have a lot more in common than the DSM V allows for. And for years I've felt my son was in a diagnostic Bermuda Triangle: a little bit of ADHD, a little more bipolar, some autistic traits. And at times his behavior looked exactly like the behavior of the boy down the street with epilepsy. I hope that we can make some strides in figuring out how to make our kids lives better in the next few years rather than quibbling about what we call it.

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    1. It’s good to know I’m not the only one that feels this way!

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