The new psychiatric bible

The San Fran Chronicle reports:

The "bible" of American psychiatry - a manual of mental health used around the world by doctors, consumers and insurance providers - has come under fire from a growing group of psychologists who worry that proposed revisions will feed into a culture of overdiagnosing, and overtreating, otherwise healthy people.

The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is undergoing its fifth major revision in the more than 60 years since it was first published by the American Psychiatric Association. The last update was in 1994, and the new manual is expected to be released in spring 2013.

Revisions to the DSM are often hotly debated, but after two decades of major, and frequently controversial, shifts in how mental health problems are diagnosed and treated in the United States, this latest update has become especially contentious, many mental health providers say.

Last month a group of psychologists with the Society for Humanistic Psychology posted a petition against many of the suggested DSM revisions, citing what they see as a broadening of the definition of mental health disorders, which, in turn, would lead to overtreatment with drugs. ...

Since the last diagnostic manual update, research has increasingly pointed to biological causes for a wide variety of mental health conditions and, in response, treatment has turned toward pharmacological answers, some psychologists say. Drugs are being used to solve mental health problems that aren't problems at all, they add.

In 2010, 1 in 5 American adults was using some type of mental health medication, a 22 percent increase over the past decade, according to a report released last week by Medco Health Solutions, a pharmacy-benefits management company. ...

Grief after the death of a loved one, for example, may be included under the diagnosis of major depressive disorder. That means a person's grief could be labeled a pathological disorder, and not a normal human experience, said psychologist Brent Robbins, a professor at Point Park University in Pittsburgh and an author of the petition.

"Another diagnosis, dysphoric mood dysregulation disorder, is basically temper tantrums," Robbins said. "Next thing you know, you could have 2-year-olds on psychotropic medications."

If you feel depressed after the death of a loved one, that is not a pathological condition. That is a normal human response. But more and more, people are getting psychotropic pills from non-psychiatrist physicians in order to feel better, without a diagnosis. And the psychologists and other counselors are upset because they cannot prescribe the pills. Only physicians (including psychiatrists) can.

All this talk of "biological causes" is exaggerated. People like to talk about chemical imbalances and brain mis-wiring, but these psychiatric disorders cannot be diagnosed with brain scans or blood tests or anything objective like that.

You can get the DSM-IV diagnostic criteria from Morrison's simplified version. The psychologists made him shut down his website, but the info is available on a Canadian and a Russian website. I will put my own up, if these are lost for any reason.

My guess is that the DSM-5 will invent a bunch of new excuses for prescribing pill, getting counseling, and otherwise promoting the rise of therapism.