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Thursday, February 16, 2012

Critics attack DSM-5 for overmedicalising normal human behaviour

By Geoff Watts
British Journal of Medicine
Originally published on February 10, 2012

Although not due to be published until May 2013, the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is already provoking dissent among psychiatrists and psychologists in Britain.

Critics claim it will make an already problematic diagnostic system worse and result in more people being labelled mentally ill.


"The new categories are based on lists of symptoms that don't necessarily map well on to the underlying biological and psychological processes involved in emotion, behaviour, and cognition," said Nick Craddock, professor of psychiatry at Cardiff University.

Speaking at a critical briefing on the current plans for the DSM-5 he claimed that more aspects of emotion, behaviour, and cognition are going to be labelled as diagnoses.

This will medicalise more of what most people view as normal human behaviour.

He offered the example of someone having an episode of severe low mood that met the accepted diagnostic criteria of depression.

"Currently, if this follows bereavement, it would be excluded. It would be regarded as normal. But in DSM-5 the plan is to remove the bereavement exclusion. What most would view as a normal reaction to the death of a loved one would be labelled as a depressive illness," said Professor Craddock.

Peter Kinderman, professor of clinical psychology at the University of Liverpool and also speaking at the briefing said, "DSM-5 is making the process of describing and explaining situations worse."

 He gave as an example the diagnosis of gambling disorder.

"For individuals and for society gambling is a problem.  I think it's unhelpful to regard it as an illness," he said.

"The proposed revision will include a vast number of social, psychological, and behaviour problems in the category of mental disorder, so pathologising mild eccentricity, loneliness, shyness, sadness, and much else.  One worries about what this will mean for the person who receives the label."

To be categorised as mentally ill has all sorts of consequences, he added.

Professor Kinderman suggested that "the American Psychiatric Association call a halt and convene a representative international expert panel to discuss the proposals."

The article can be found here.
Thanks to Ken Pope for this information.