Psychiatry 'bible' structure overhauled
May 4th, 2011
05:44 PM ET

Psychiatry 'bible' structure overhauled

Reflecting a new understanding of many mental illnesses, the proposed organization for the newest edition of the "bible" of psychiatry is now open for public comment at dsm5.org.

The American Psychiatric Association this week released its vision for the next Diagnostic and Statistical Manual of Mental Disorders (DSM V). The updates incorporate insights from research since 1994,  the last time the manual was issued with substantial changes, the organization said. Publication of the DSM V is scheduled for 2013.

An earlier version of proposed information for the DSM V was released in February 2010. Tuesday, the American Psychiatric Association put out a more specific framework for how the new manual would be organized, showing connections between disorders that were previously unlinked. The goals are to call attention to commonalities and underlying vulnerabilities in certain groups of conditions, and to spur further research in those areas, said Dr. Darrel Regier, director of the Division of Research at the American Psychiatric Association.

"This organizational framework is trying to emphasize that we don’t have strict divisions between disorders," Regier said.

For instance, Asperger's syndrome, a high-functioning form of autism, instead of being its own diagnosis, would now fall under the broader “austism spectrum disorders.” This move has some parents unhappy because "autism" sounds scarier than Asperger's, which has taken on its own identity in that community, and because children with Asperger's have specific educational needs that are different from kids with more severe autism.

But the association has heard from other parents frustrated that their children with Asperger's are denied special education benefits reserved for autism, Regier said. And biologically speaking, Asperger's is a form of autism, doctors say.

There are many other notable changes. For instance, binge eating now gets an official diagnosis as an eating disorder. Anorexia has been redefined so that it doesn't necessarily include amenorrhea, since there are some women with this eating disorder who do have some menstrual activity. These revisions and others may help patients previously classified as "eating disorder not otherwise specified" (EDNOS), which had rendered some people ineligible for adequate insurance coverage for proper care.

And "Obsessive-Compulsive and Related Disorders" is now its own category, which includes OCD in addition to separate diagnoses of hoarding, skin-picking disorder, hair-pulling disorder (trichotillomania), and body dysmorphic disorder, among others. The rationale is that these conditions are all related, but are distinct and may require different treatments. For example, people with hoarding won't necessarily respond to the same psychotherapy or medication typically given for OCD, Regier said.

The revisions will be open for comment until June 15. Field trials will take place over the summer to test out the revisions in clinical settings. The American Psychiatric Association hopes to put out its next update on the DSM V after January 1, 2012, Regier said.

soundoff (319 Responses)
  1. bje

    There's a medication for hoarding? Seriously? Is it a sedative? That seems to be the psychiatric answer for everything. It's unfortunate that those who truly suffer from true conditions are being minimized by the psychiatry field's need to diagnose and label everyone and every personality type.

    May 4, 2011 at 20:25 | Report abuse | Reply
    • psychology student

      Actually, in the little research that has been done, no medication has consistant shown to help hoarding behavior. Also, I am deeply offended that you say "Hoarding Disorder" isn't serious. First of all, people with this condition usually have serious psychiatric issues and sometimes cogntive defects as well. Also, their hoarding goes beyond simply being a "pack-rat" or shopaholic; its destroyed their living space and usually poses a serious danger to themselves and the community at large.

      May 5, 2011 at 00:25 | Report abuse |
    • bje

      The drugs being "researched" have destroyed far more lives than the hoarding habit. This should be the concern of the community at large.

      May 5, 2011 at 00:34 | Report abuse |
    • Ituri

      The point of updating our knowledge is to end negative beliefs such as yours.

      Hording IS a psychological symptom. It is very rarely caused by an inability to physically function, or severe trauma (some Depression era adults began hording out of fear of another great time of need), but most have no physical or traumatic reason for hording. Far more often it is a symptom, or the main symptom, of other root psychological causes. To not address those causes means the disorder is unlikely to end, as most who have dealt with horders know too well.

      Medications to control hording are probably more toward controlling anxiety and chemical responses in the brain, such as beta-blockers, which are highly useful for many anxiety caused disorders. This is just one example, and they help far more people than you seem to understand. There is no reeason we cannot expand our knowledge and include hording.

      Also, there is the point that people with these problems are often poor and unable to pay for help or therapy. If hording is considered a true disorder, it is far more likely to be covered by insurance, which is often the ONLY access Americans have to health care at all... if they have that much.

      May 5, 2011 at 02:26 | Report abuse |
    • kyle

      psychotherapy is not just drugs, its "therapy", no doctor EVER just gives a patient drugs and sends them on their way. They tell them to see a psychiatrist.

      May 5, 2011 at 05:02 | Report abuse |
    • jendfly

      @ Kyle:
      Really? MY doc just gives me meds. Years of therapy didn't help because my problems are caused by chemical imbalances. And I'm much better.

      May 5, 2011 at 08:30 | Report abuse |
    • Point made

      Jendfly, you made Kyle's point for him. First you had to go through therapy before it was determined that yours was a chemical issue. You did not just walk in, ask for drugs, and receive a prescription. If your doc just gives you meds because you ask for them without knowing the history, then his license needs to be revoked.

      May 5, 2011 at 12:42 | Report abuse |
    • Just me

      I am an asperger, and I Hoard, Skin-pick, nit-pick, hair-pull (other than head) and binge eat.

      I find cannabis works well, especially for the eating – it smooths it out and stops me cycling through the stages.

      May 7, 2011 at 03:34 | Report abuse |
  2. Bobby

    Label me, I'll label you!

    May 4, 2011 at 21:02 | Report abuse | Reply
    • Just me


      May 7, 2011 at 03:35 | Report abuse |
    • Bob

      haha yes....I can just imagine the new DSM will have even MORE labels for more types of problems....they just love to label people and every personality type (excuse me, disorder)....everything is a disorder to them.....maybe the new DSM ought to have a section on what is required to be "Normal"......I think modern psyciatry is a pile of crap...

      May 30, 2011 at 03:22 | Report abuse |
  3. William Rist

    I question the DSM manual at all levels, because there are no actual diagnostic lab test to confirm a diagnosis in the DSM.
    The DSM is used to help psychiatry and big pharma companies stuff their pockets with money while ignoring the potential side affects of medications which can cause injury or death or other medical conditions. There is a difference between a mental illness and a neurological condition which psychiatry tries to make them look like one-in-the same. The DSM should only be used to diagnose people at the Credit Card Companies, Big Banks , Federal Reserve, IRS, and those running the Big Pharma-Companies for diagnosing and to help prescribe the right medications for managing symptoms ie...,
    hoarding of tax-payer bailouts.

    May 4, 2011 at 21:19 | Report abuse | Reply
    • Ituri

      The difference between a psychiatric issue and a neurological issue are not confused, from what I have seen. Whenever you have some concept based on a large-scale conspiratorial plan, its time to reevaluate your ideas. That "Big Pharma" has been partially responsible for the longest lifespans, and the healthiest longest lifespans, in human history, and are a product of modern medicine on the whole.

      Also, to create new therapies (beyond simply medicating), a profession must seriously consider a diagnosis to begin with. If something is not a serious diagnosis, do you think it will receive funding for study and research in the future? Of course it won't. There are a lot of factors that go into these changes, and "conspiracy" isn't likely one of them.

      May 5, 2011 at 02:29 | Report abuse |
    • Wilson

      I believe everything that Willian says, conspiracy plays a big part of the psychiatry, psychiatry answers to the "pharmaceutical companies" where they get pay for the amount of drug they perscribe and they don't care about patient's safety. The drugs they perscribe are nothing but deadly chemicals and kills brain cells and causes depression. Whenever someone commited suicide on phsyc meds or do violent crime, all psychiatrist say is they're crazy, but the truth is the psych meds is the thing to blame for. Psyc meds are no different than street drugs.

      June 25, 2011 at 15:59 | Report abuse |
    • Thaminu

      that sensory pirsecsong issues are linked to social problems. Shouldn't the focus be on figuring how and why they are linked rather than inventing boxes to put the children in? (3) 16.5% of the children in the referenced study had significant sensory symptoms? 16.5%? At a certain point, isn't it kind of hard to characterize something as a "disorder" if nearly 2 children out of 10 exhibit the "symptoms"? (4) Shouldn't the purpose of diagnosing a person's problems be to help figure out how to help the person with the "diagnosis" - either help them recover or help them cope? Does a diagnosis of ASD today actually lead to good help from the medical establishment? How many of us had any idea what to do to help our child once we got a diagnosis? How many of us had to figure out on our own that our child is nothing like the vast majority of the other children out there with ASD? On the other hand, once you figured out (on your own, probably) that your child had sensory pirsecsong deficiencies, did you then have some clearer idea how to help him or her? I think the idea that SPD has to stand alone to have merit should be reconsidered. Not that anybody's asking me, of course ....

      September 11, 2012 at 06:43 | Report abuse |
  4. myoleman

    Actually the best psychiatric 'bible' is the Real Bible. In it you'll find the cure for all the psychistric diseases. Read it, believe it, and apply it to your life!!! God Bless!

    May 4, 2011 at 21:52 | Report abuse | Reply
    • Keith

      Nonsense. It's obvious you haven't even followed your own advice.

      May 5, 2011 at 00:26 | Report abuse |
    • kyle

      Sure, if you want split personality disorder. Kill these people, Don't Hate, Stone your daughters, He who is without sin cast the first stone......the bible is completely retarded.

      May 5, 2011 at 05:05 | Report abuse |
    • Paige

      Yes! Unfortunately, the use of the human mind by itself leads to confusion and judgment with some knowledge but not true wisdom. Thank you for the reminder. I need to read the Bible today. Everything is better when I do that and try to think of others and how I can be of service to them. True 'self-esteem' is actually created when one does positive actions that are not selfish I believe.

      I may differ a little in that I believe that we were given brains to use and we have a spark of the Divine in us. Therefore, doctors can be used as positive instruments in His plan. However, I do know that the power of God makes all things possible and that healing happens every day. Some of the most incredible surgeons pray before every operation.

      May 6, 2011 at 04:16 | Report abuse |
    • Paige

      In response to Kyle's statements, I used to believe the same thing. Even though I always believed that Jesus Christ came and gave His life for us, I didn't think the old testament and some areas in the new could go together. That was before I actually pursued reading it and not just going by what I had heard or reading bits and pieces or taking out of context. When viewed as a whole is when I found understanding and when reading the study parts of the NIV along with it. Now I can see that the people as a nation have swayed to and from God and his laws. There are natural laws in place, just like in physics. If a person or a group chooses a certain action or overall plan, there will be a consequence, either positive or negative. There are predictions from the old that come true in the new that defy probability to the nth degree. And finally, Christ came to clear up any questions. From how I read the New Testament, He came to inform that we are to love others as ourselves and seek God and His will for us. That's all. Pretty clear.

      The Old, I believe is more of a description of how a fallen world will struggle to keep within the boundaries of law. The New, a resolve based on love with the Truth being Jesus Chris is the Way, Truth, & Life.

      Here's stepping out there a bit. I will ask you to try this. Every day for 2 weeks, simply ask Christ to reveal Himself to you. Just a small prayer. If you keep an open mind and find you still don't believe that the Bible is God breathed, so be it. But I do dare you to try this.

      May 6, 2011 at 04:31 | Report abuse |
    • Geoff

      Except for one problem. An adult belief in god is in and of itself a mental disorder just as much as an adult belief in santa claus. A belief in god is indeed a psychiatric disorder. Deny it all you want but that will not make it untrue.

      May 8, 2011 at 22:05 | Report abuse |
    • myoleman

      Geoff needs to watch that movie "Miracle on 34th Street" I don't believe any reputable psychiatrist would say anything like that.

      May 9, 2011 at 19:33 | Report abuse |
  5. Ryan

    When used appropriately, diagnostic criteria are helpful in providing support to individuals dealing with disorders of a psychological nature. There's a sect of the clinical field that doesn't believe in throwing medicine at everything and everyone; certainly, neuropharmocology has its place, but individuals often need therapy more than drugs to work through difficulties. As such, the diagnostic criteria in the DSM-IV helps to guide clinicians towards appropriate treatments.

    May 4, 2011 at 22:22 | Report abuse | Reply
    • bje

      Unfortunately the majority of the psychiatry field has gone the drug everyone path. People are intelligent and this strategy will quickly backfire. There's a growing movement of people speaking out against this unnecessary drugging and if the "experts" don't get in front of the curve, they'll quickly lose respect.

      May 5, 2011 at 00:11 | Report abuse |
    • psychology student

      I agree. Psychiatrists treat mental illness with drugs, sometimes only with drugs, but they are just one type of mental health providers. Clincial Psychologists, clinical social workers, and researchers also use the DSM and they usually don't use medication. Instead they use psychotherapy among other interventions. (sometimes you see it in psychology research, but not that often). Furthermore, many patients need medication to function properly.

      For the record, if you actually read the proposed DSM, you will see that they have included a section clearly defining "mental health disorder" to combat this notion that "everyone has a mental disorder."

      May 5, 2011 at 00:31 | Report abuse |
    • Elizabeth

      My daughter had some problems that needed talking therapy to overcome, but at the same time she admitted that she is telepathic, so she was given risperdol. She gained weight, and her thinking became less clear (already having learning disabilities, which the psychiatrist did not take into account). After a few months, she dropped the medication, but her weight gain lasted for years, and she still claims that she cannot think clearly. When is the psychiatric field going to stop attacking people for religious or personal beliefs or abilities? My whole family is telepathic; the sort of thing where we can predict the next card in a deck, or think about somebody who calls the next day, etc.; it doesn't hurt anybody, and is not at all a part of what is ailing my daughter. She is receiving talking therapy, which helps a great deal, but she won't take drugs, and I do not blame her. The power of talking therapy is that a person learns to sort out thoughts and feelings, learns to direct themselves, and gains self-respect. Drugs needs to be monitored; they don't cost less. Drugs can destroy health and ruin thought processes so that it is harder, not easier, to find answers in life. Worst of all: drugs take the few positive abilities of a person and turn them off. Telepathy is not hallucination. Even in the case of a person who is having hallucinations, the use of drugs should be weighed against the side-effects case by case.

      May 5, 2011 at 01:21 | Report abuse |
    • Wilson

      The DSM is not the book to help people, it's the every since deadly drugs they can use to drug people and kill. It's not about appropriate treatment, they don't even know what the drug effect is, many people have died and become physically and mentally disabled because of they tried drugs on patiens as one phyciatrist said, "it's all try and error". The perscribe drug just to get paid!
      And the medication is not just use sometimes reply to the psycology student, the USE IT ALL THE TIME, and the book that your studying is PAID by the pharmaceutical company to manipulate what the want the students to believe, Don't get brain washed!

      June 25, 2011 at 16:07 | Report abuse |
  6. Dr.Dr.What's wrong with me.

    We have to procedural code everything for health insurance companies to figure
    out if they wish to pay or deny payments for Psychiatric illness or a cyst removal.
    It's a new world where everything Human must now be assessed mechanicly.

    May 4, 2011 at 22:58 | Report abuse | Reply
  7. JehseaLynn

    I have a problem accepting, on its face, the entire premise of "talk therapy," as it depends on a classical "sick" model. That is to say, in therapy, two people sit in a room, and by virtue of a degree, one is deemed "healthier" than the other who by default is the "sick" person. The sick person can only get "well" again by taking pills the powerful one says to take, and, furthermore, must essentially "rent as a close personal friend" the person who is deemed to be the healthier of the two, for regular heart-to-heart talks that will be recorded forever and associated with you ever after. If you think the "rent a friend / pill-popping system is not working, and leave, your file is marked "left before issues were resolved." (BAD!) For a system that claims to care, it is incredibly cold, controlling, inflexible, unilateral in decision-making, and completely indifferent to the "sick" person's needs, desires and feelings.

    May 5, 2011 at 00:37 | Report abuse | Reply
    • bje

      Wow, couldn't have said it better myself. I wholeheartedly agree. Talk therapy can be beneficial, but to consider this field in the medical arena is inappropriate.

      May 5, 2011 at 00:43 | Report abuse |
    • Elizabeth

      If you do not like a therapist, get a different therapist. The therapist doesn't tell you what to do or think, they help you to figure that out yourself. If they are bossing you around, then they are not properly trained. Don't blame talk therapy. Good talk therapy lets you talk about anything you want to, and the other person just keeps you on the subject of what is bothering you, and lets you see your own contradictions, not their personal beliefs. I would much sooner trust talking to another human than taking some king of chemical. I'm speaking not as a professional, but as a family member of a patient.

      May 5, 2011 at 01:28 | Report abuse |
    • Disagree

      There is so much distortion in this post it's hard to know where to begin. If this is what your experience was with talk therapy then you should have bolted from that therapist's office and reported him/her immediately. This is NOT how most therapists work. A therapist is there to be a guide on the journey who illuminates the path for you. They show you the contradictions in your thinking and help you to see areas of pain in your life more clearly and realistically. They should not be telling you what to do, what to think, what to feel, or what to say. The patient is always in charge and every decision (assuming that it is not life-threatening) is their own.

      The therapist is there to allow you to transfer your feelings onto them so that you may deal with them safely and thus better prepare you to deal with them in the real life situation. The one thing that therapy is not is incredibly cold, controlling, inflexible, unilateral in decision-making, and completely indifferent to the "sick" person's needs, desires and feelings. Therapy is exactly the complete opposite of these descriptions. You either had the worst therapist on the planet, or as is my guess, you have never stepped foot in a therapist's office.

      May 5, 2011 at 04:21 | Report abuse |
    • Opposed

      Frankly, you are wrong. Like all issues and instances, there are extremist opinions and actions. Not all mental health workers work the way you are discussing. Talk therapy is not about "one sick person" and "one healthy person." It is about one person seeking to be able to evaluate and assess his or her or ze way of being, and then to make adjustments as they, the client, sees fit. A counselor does not make decisions or promises for people–they work as a metaphorical mirror that helps the individual seeking treatment get a better grasp on individual wants, needs and meanings in life. Then the client can be assisted with learning new ways and tools for seeking potential changes. It does not work in all cases–nothing does, not surgery or any medical processes–but for many people therapy is life-changing and life-saving.

      May 5, 2011 at 10:11 | Report abuse |
    • Opposed

      Perfect timing "disagree." Glad this entire post is not just an unrealistic and false account of such a wonderful opportunity for people to receive help and/or find growth in what can be a difficult, scary and confusing life.

      May 5, 2011 at 10:15 | Report abuse |
    • AGREED!!!

      You people who do not agree it's either you are too blind to see the problem or you are the therapist him or her self! most people who has gone to the therapy will tell you it's useless and all they do is talk like they are helping you but really, they're there to use to to make money from the phamaceutical company! because they're are part of the phychiatry consparacy! Do not trust their words!

      June 25, 2011 at 16:11 | Report abuse |
  8. HadIt

    Hopefully the new version will address the once growing and now ever-present trent of medical doctors to prescribe "antidepressants" as though such medication was actually appropriate for each and every medical complaint they hear daily. Broken finger? Here, take antidepressants? Headache pain, migraines, sinus problems? Here, take antidepressants. Honestly, this BS of 'off label prescribing' of antidepressants for everything from hangnails to situational/reactional depression, to muscle aches, to you name it – NEEDS TO STOP.

    May 5, 2011 at 01:06 | Report abuse | Reply
    • mikel84

      Actually increasing serotonin (which is done by ssris) can solve many problems. It isnt just used if you are feeling down or unhappy. I would also like to say that ssris have MANY side effects and they can be harmful. There are other options out there that give the benefits without the negatives such as OTC 5 htp, tryptophan and others

      May 5, 2011 at 01:18 | Report abuse |
    • Elizabeth

      Yes, the whole world seems paisley sometimes, does anybody have anything for an acid stomach? (Just quoting Firesign Theater, which was making fun of a famous seratonin drug.)
      Seriously, such anti-depressants can keep a person in a buffered zone where they are unable to recall what is actually bothering them, so that they can't address it. Another family member went to the hospital for a physical ailment, and couldn't take oral medication for two weeks (anti-depressants are ONLY oral, another problem). After the enforced withdrawl, and considering that he should have been much MORE depressed because of his physical ailment, he actually felt much better, because at last he could address his feelings. A lot of doctors who are just family doctors give out anti-depressants without any other therapy; it's harder to think about feelings on them, and the feelings are never addressed. In the past, insurance didn't pay for talk therapy; it's high time that such therapy became available to many more people.

      May 5, 2011 at 01:36 | Report abuse |
  9. JehseaLynn

    @bje – The medical field is married to talk therapy. A person in therapy with a psychologist or other provider, who is recommended for a prescription drug as an adjunct to talk therapy, MUST see the facility's psychiatrist. A psychiatrist is a medical doctor (MD) who specialized in neuropharmocology and psychotrophic drugs and their actions on brain chemistry, etc. So, the medical field IS PART & PARCEL of the DSM V, and the diagnosis and treatment of mental illnesses / disorders.

    May 5, 2011 at 01:19 | Report abuse | Reply
    • Rai

      Top Video. how do protect are selfs? there snikrimg on every illness. already I know its crooked. this is like nazi's. .DSM -5 have refine it so much that if you wont do the survey now you have an illness. ( clinical practice (Part 3/4) video). Also MENTAL HEATH uses DSM not just clinics. Be careful. Why is public not waking up. Look Parents getting your child to be ADHD is traded on the stockmarket. it gambled on. orthodox psychiatrist jockmclaren47 does good video so to this plus others.

      September 11, 2012 at 09:06 | Report abuse |
    • Willian

      That's a really good quesoitn. I think it has to do with the fact that sensory processing falls within the domain of occupational therapy. The therapists themselves are mostly not doctors. Kranowitz, the author of The Out of Sync Child, is a former preschool teacher. I think the movement needs some heft to impress the elitists.

      September 14, 2012 at 01:04 | Report abuse |
  10. Dr Bill Toth

    A cure occurs the moment a decision is made – either the doctor decides the patient is cured, or the patient decides they are cured, or the insurer decides the patient is cured. Live With Intention, DrBillToth.com/blog

    May 5, 2011 at 06:55 | Report abuse | Reply
    • Daniel


      May 5, 2011 at 14:06 | Report abuse |
    • Daniel

      I meant worthless , totally worthless

      May 5, 2011 at 14:07 | Report abuse |
  11. someoneelse

    Psychaitry and psychology, while based on science, is basically observing how things interact and their results. It's really no different than alchemy was before the discovery of chemistry (and the atom, i.e. how chemical interactions actually work). These fields are really just neuroscience that we don't understand yet. It's useful to a point, but is accepted too easily as 'Holy Writ' and has caused just as much damage as it has helped (though on a societal level that these people can't see).

    May 5, 2011 at 07:13 | Report abuse | Reply
  12. someoneelse

    Also, Sociology and Psychology are what people fail into when they can't do anything smarter (except Art History and General Arts, which are the lowest of the low in the realm of acadmeia). Psychiatrists are usually failed doctors.

    May 5, 2011 at 07:14 | Report abuse | Reply
    • Psychiatrist

      Ha! and what do you do for a living, aside from make blanket generalizations about a field you seem to know nothing about.

      May 5, 2011 at 12:52 | Report abuse |
    • Michael

      someoneelse: your remark is a perfect demonstration of the kind of drivel that results when ignorant people feel compelled to post comments endlessly on topics about which they are clueless. Why don't you try earning a doctorate before you make claims about other people failing as doctors?

      May 6, 2011 at 11:55 | Report abuse |
    • Anti-psychiatry

      Psychiatrist are NOT DOCTORS at all!! Look at what psychiatry have done in the history, they have no power of cure but playing a little treatment game with you as if they're trying to help you. It's all about $$$$$$$$

      June 25, 2011 at 16:15 | Report abuse |
  13. GracieZG

    This is all about creating markets for drugs which are worthless at best (having little more than a placebo effect, as shown by studies), and harmful at worst (potentially producing agitation, mania, outward violence, suicide). What a bunch of frauds. Leave our children alone.

    May 5, 2011 at 08:14 | Report abuse | Reply
    • kidnp

      The betterment of healthcare is not about a "market" for anything. I am a healthcare provider with every intention of healing without harm. Have you considered why medicine, psychiatry, dentistry, etc are practices? It's because we have not perfected them yet, but don't fool yourself, or so easily fall victim to new-age, conspiracay theorist propaganda that claims healthcare is all bad and concerned with nothing but money. There are those of us out here who truly want to decrease pain and suffering, and believe me, if it were about money, I would have changed professions long ago!!

      May 5, 2011 at 09:19 | Report abuse |
    • poster

      Kidnp, I think you're misinterpreting Grazie's post as a personal attack. Nobody is attacking individual healthcare providers such as yourself. It's a systemic problem. Healthcare is a business. The problem is on a macro level, but you're defending yourself on a micro level. This is one reason why these problems are not being addressed. Economics is not a conspiracy theory. It's a science.
      While individual doctor may mean well, their is an entire system behind healthcare. Hospital administrators of for-profit hospitals, insurance companies, and pharmaceutical companies all answer to stock holders or management first. You call this a new-age conspiracy theory. It's not new-age, it's not conspiracy, and nobody denies it's existence. Doctors are only a small part of the system even though they are on the front line and often the face of medicine to people.

      May 5, 2011 at 11:22 | Report abuse |
    • abby

      psychiatry is about helping people - really it is - don't give up on the people who do their utmost to improve other people's lives - they're not perfect and, yes, there are flaws in the "system" but consider what life would be like for those who need help without psychiatric intervention.

      May 5, 2011 at 13:34 | Report abuse |
    • kidnp

      I don't feel attacked at all, actually I'm quite confident in who I am. I just get so tired of people who have absolutely no experience with "the other side of the system", speaking about it like the understand every caveat. Yet, they access the system when they need help. This is not an arguement that can be won or lost, because the bottom line is the patient!!! And when people fail to seek needed healthcare because of people making uneducated statement as the ones here, that's the true loss.

      May 6, 2011 at 12:08 | Report abuse |
  14. Marti58

    I wish we admitted we don't understand much of how the brain works. As far as I'm concerned psychology is nowhere. Other than the very obvious disorders (clincal depression, autism, schizophrenia etc) therapists and psychiatrists alike are just guessing and medicating. It's a very lucrative business. Thank you

    May 5, 2011 at 08:16 | Report abuse | Reply
  15. Conrad Shull

    Most re-classifications in the DSM V seem to be aimed at increasing the amount of money individuals and society pay to "Big Therapy".

    May 5, 2011 at 08:54 | Report abuse | Reply
  16. SoulCatcher

    And I thought the psionics bible was written into 2nd Ed AD&D Psionics by Gary Gygax.

    Some say too that Psychiatry is based on Alchemy... that's in there also.

    May 5, 2011 at 10:06 | Report abuse | Reply
  17. phoenix

    heathen quacks make a killing on their heathen research subjects. try the holy bible.

    May 5, 2011 at 11:04 | Report abuse | Reply
    • Michael

      Yes, the earth is flat; science is an illusion of the devil; literacy is dangerous and probably sinful; Copernicus was wrong; here comes the Inquisition.

      May 6, 2011 at 11:58 | Report abuse |
  18. William Rist

    DSM + Big Pharma = $$$. Most people who are taking these medications really do not understand what they are made of except for witnessing the side affects. Over time toxicty in the blood builds up causing other medical problems which mean more medications to treat other problems. If people were to look at the print out of side-affects of medications it is a long list, physicians are not even sure what will happen when you take them, and the side affects are listed to help protect against liability issues ie..., medical malpractice lawsuits. Physicians are required to be insured in case something does go wrong (risk are involved). Medications will only mask the symptoms but will never fix the underlying cause. People should look into other alternatives to help manage symptoms.

    May 5, 2011 at 11:17 | Report abuse | Reply
  19. Kim

    The comments here are so entertaining. We go from the one extreme of people who know a lot about this subject to the other extreme of dingbats who make uneducated sweeping generalizations about the entire field of psychology/psychiatry. I especially love the telepathic lady. Thanks everyone! Keep it up!

    May 5, 2011 at 12:02 | Report abuse | Reply
  20. MissyK

    I have been seeing a psychiatrist and/or therapist for around a decade. Finding the right medications has stabilized my bipolar disorder so I can work and be a good parent. Not just in and out of the hospital. I read studies and talk to the Dr.s about what is out there. Noone forces me to take a certain med and if they do I find a new provider. Some do get pushy about certain treatments they favor. Some do want to write you up as "uncooperative" and "noncompliant" if you don't do exactly what they, "the expert," says They don't get my business. End of story. Overall my general experience with the mental health system has been positive and productive.

    May 5, 2011 at 12:48 | Report abuse | Reply
    • abby

      wishing you the best -

      May 5, 2011 at 13:31 | Report abuse |
  21. Daniel

    The DSM , the so called bible psychiatric is proof that psychiatrist's don't actually know what they are doing ..
    They figure if they can come up with enough lables to fill a book , then, that gives their worthless profession credit.
    Every lable in the DSM is voted on , Voted on by psychiatrist's and backed by big pharma .
    I was once told that psychiatrist's don't actually help people , that just gather information so they can help others.
    I never heard such word play and mis-use of trust as in the psychiatric field .

    May 5, 2011 at 13:28 | Report abuse | Reply
  22. abby

    after reading some of the comments it seems to me that there are still too many people who do not realize that a psychiatric disorder is an illness - like diabetes or cancer is an illness - some of the disorders require medication, some require therapy, some require both. please be a little compassionate.

    May 5, 2011 at 13:30 | Report abuse | Reply
  23. Dukes

    Psychiatry has been co-opted by big pharma and is doing more harm than good. Their whole problem stems from trying to medicalize human emotions and disturbances. The chemical imbalance theory to mental illness is questionable at best. Even if it was true, they don't give you a blood tests or an MRI before putting you on medication. If you have 5/9 symptoms in the DSM for two weeks, to them you have a brain DISEASE. There is no context given to these symptoms like your going through a divorce, or someone in the family died. Conditions like depression, anxiety, schizophrenia, are very complex and are not as simple as neurotransmitters in your brain are miss-firing. I mean for god sakes, they used to think lobotomies worked. Psychiatry is medicating itself off a cliff with more people starting to wake up to this disturbing trend.

    May 5, 2011 at 14:25 | Report abuse | Reply
    • MissyK

      Please realize not all psychiatrists are going to push a diagnosis on you. After I told my current doc what's happening in my life he said "Do you realize most of your current symptoms are likely situational stress, not your illness (I'm bipolar)?" He then suggested some things I could do to relieve/deal with the stress. NO MEDS! Can you believe it?!

      May 5, 2011 at 15:58 | Report abuse |
  24. Good luck

    I hope you will redo the AD/HD classification... I was diagnosed with ADD two months ago and the current symptoms (in my opinion) for ADD don't seem to describe it well at all. There's no mention of hyperfocus... being so concentrated on one thing that it is really physically difficult to get up to use the bathroom or eat.. all the research that shows its correlation/causation with poor social skills. And the description of ADD only pertaining to the classroom.. ADD doesn't affect just your school but your whole life! They should put down what happens when a person w/ ADD lives w/ no structure.. routine hygiene not being kept up with.. house a constant tornado even if you hate mess.. credit in the toilet/constant eviction threats even though you have plenty of money to pay all your bills..
    I know it's listed as a childhood disorder and children don't have a lot of these problems.. but like I said it's current symptoms and school-focused explanations don't do a good job of describing it at all.. especially compared with the other disorders. I know when I was a child I had trouble even keeping up with hygiene (constantly not taking showers, shaving, brushing teeth – not b/c I didn't want to.. I knew classmates would make fun of me but because I would forget) I had poor social skills. I had the hyperfocus. My friends would always call me slow or comment on how I was so intelligent and could make good grades w/o even trying but yet processing information was so difficult for me. Excessive worrying. I can go on...
    (This is all my opinion of course – from one person who has it and has only taken a college intro psych course.)

    May 5, 2011 at 17:14 | Report abuse | Reply
    • Pete

      I can relate to the hyperfocus part and having the ability and/or resources to do anything but being 'stuck' sometimes when in an overwhelmed state get off track and forget to do simple things but end up recalling complicated information easily bouncing between people thinking I'm an airhead one minute and genius the next. I didn't know I had a true disorder until a few years ago even though many people would say things like here comes ADD guy. I have degrees in a few fields but am working in an unrelated field because organization skill keeps me from using what I know. Anyway, I agree that it would be good to have more emphasis put on the adult side of this diagnosis.

      May 6, 2011 at 04:53 | Report abuse |
  25. Tom

    Psychiatry is a JOKE! Name any other branch of scientific medicine where diseases are conjured up by committee vote! Could you imagine a group of oncologists convening and voted to do away with pancreatic cancer as an illness? Or maybe endocrinologists can get rid of diabetes by voting it out of existence?

    May 7, 2011 at 11:04 | Report abuse | Reply
  26. William Rist

    GlaxoSmithKline, another example of trusted fraud cases. $3Billion to settle pharma criminal activity and to settle for damages made to individuals who were affect, by off label uses. " Conficts of Interest " $$$- placed over patient safety once again. As the recession continues in our economy and the U.S. dollar de-values, let's see how many psychiatrist develope mental illnesses, which will require them to use thier own meds.., how is that for consumer confidence.

    July 7, 2012 at 13:28 | Report abuse | Reply
  27. Dziara

    In 1994, I worked as a Service Coordinator for the wpoarraund program, Project Connect. As part of my job, I was sent to a workshop on the review of the new DSM-IV guidelines specifically because we were getting more and more referrals for children who had bipolar disorder. It seemed as though this increase in childhood bipolar disorder diagnosis was happening almost over night.At that workshop, I heard from a mother who spoke about how she struggled her whole childhood from this disorder without any benefit of treatment or understanding. When she noticed similar symptoms in her 9 year old daughter, she was quick to respond and was pleased with the resulting diagnosis and medication regime. She was a powerful speaker who underlined the importance of accurately diagnosing disorders and providing prompt access to treatment.While I agree with the professional reasoning and wisdom behind the recent change in the bipolar diagnosis in children there has most definitely been an explosion in diagnosing children with bipolar disorder, particularly in the Boston area I am ambivalent about the new category and I fear for the unintended consequences this might bring. Specifically, I share the concern that this new category will not be given similar credence or clout as a bipolar diagnosis, which means that families will not get the proper treatment or understanding for their suffering children. I am most afraid that service providers will use the new name, temper dysregulation disorder, as a way to deny services because it could be seen as a behavior issue and not a bone fide disorder.If we are to move forward with this newly named disorder, then we must move forward with a renewed commitment to provide treatment for those who suffer from it. If this new category were to be seen as somehow less debilitating than bipolar and therefore less deserving of services from insurance companies, schools and state agencies, this would be a disgrace and a disservice to everyone families and children alike.Temper dysregularion disorder with dysthymia call it what you like, but treat it for what it is a real, debilitating and potentially devastating condition.

    September 14, 2012 at 01:22 | Report abuse | Reply
  28. michael howell miami

    There are many other notable changes. For instance, binge eating now gets an official diagnosis as an eating disorder. Anorexia has been redefined so that it doesn't necessarily include amenorrhea, since there are some women with this eating disorder who do have some menstrual activity. These revisions and others may help patients previously classified as "eating disorder not otherwise specified" (EDNOS), which had rendered some people ineligible for adequate insurance coverage for proper care.

    And "Obsessive-Compulsive and Related Disorders" is now its own category, which includes OCD in addition to separate diagnoses of hoarding, skin-picking disorder, hair-pulling disorder (trichotillomania), and body dysmorphic disorder, among others. The rationale is that these conditions are all related, but are distinct and may require different treatments. For example, people with hoarding won't necessarily respond to the same psychotherapy or medication typically given for OCD, Regier said.

    The revisions will be open for comment until June 15. Field trials will take place over the summer to test out the revisions in clinical settings. The American Psychiatric Association hopes to put out its next update on the DSM V after January 1, 2012, Regier said.
    Post by: Elizabeth Landau – CNN.com Health Writer/Producer
    Filed under: Mind and body • Psychology

    March 29, 2015 at 06:27 | Report abuse | Reply
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