Today, the American Psychiatric Association (APA) released the proposed revisions to the most influential book in psychiatry: the and diagnostic manual statistical of mental disorders ( DSM ). These draft criteria for diagnosing mental disorders are the result of a decade of work by dozens of researchers and clinicians. After collecting comments on the draft criteria and conducting field trials to test them, APA plans to publish a new fifth edition of DSM in 2013.
By ranking mental disorders and give them names, DSM not only influences the way doctors diagnose and treat their patients. It also undulates how insurance companies decide what conditions to cover, how pharmaceutical companies design clinical trials, and how the funding agencies to decide what research to fund. Make changes to a document widely used was linked to controversy, and it was. "It's like repairing an airplane while still in flight," says psychiatrist Steven Hyman, provost of Harvard University and member of the Executive Committee DSM-V revisions.
researchers and clinicians DSM-V had more ambitious goals, including using new discoveries in neuroscience and genetics to make diagnoses, reducing large dead zones diagnosis of abnormal behavior that fall into the cracks of the current criteria, and introducing the idea of "dimensions" to reflect the degree of severity of symptoms and the overlap between the various disorders.
Some critics, including two psychiatrists who conducted the two previous major revisions DSM , argued that an ambitious overhaul should not have been attempted until more is known of the biological basis mental illness.
Duke University psychiatrist Allen Frances, who led the DSM-IV revisions, wrote a widely read and last year warning debated editorial that drastic changes in mental disorders diagnostic criteria may have unintended consequences, including "epidemics" false "mental illness.
in the working groups focusing on the different types of disabilities, members were confronted with scientific dilemmas and some cases, pressure from patient groups. Among a number of new proposals that seem likely to cause a stir are diagnosed with "pre-psychotic risk syndrome" applies to young people and a redefinition of autism spectrum disorders that would eliminate Asperger syndrome, which many consider a mild form of autism.
See No. tomorrow science for a more complete overview of the draft criteria DSM-V. In the coming weeks Science will explore several new proposals - and researchers and clinicians from the reaction to them - in more detail.
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