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Thread: What’s wrong with DSM-V?

  1. #1
    Founder Luc's Avatar
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    What’s wrong with DSM-V?

    Just two weeks before DSM-5 is due to appear, the National Institute of Mental Health, the world's largest mental health research institute, has announced that it is withdrawing support for the manual.

    In a humiliating blow to the American Psychiatric Association, Thomas R. Insel, M.D., Director of the NIMH, made clear the agency would no longer fund research projects that rely exclusively on DSM criteria. Henceforth, the NIMH, which had thrown its weight and funding behind earlier editions of the manual, would be “re-orienting its research away from DSM categories.” "The weakness” of the manual, he explained in a sharply worded statement, “is its lack of validity.” “Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."

    That consensus is now clearly missing. Whether it ever really existed remains in doubt. As one consultant for DSM-III conceded to the New Yorker magazine about the amount of horsetrading driving that supposedly "evidenced-based" edition from 1980: “There was very little systematic research, and much of the research that existed was really a hodgepodge—scattered, inconsistent, ambiguous.”

    According to Insel, too much of that problem remains. As he cautioned of a manual whose precision and reliability has been overstated for decades, “While DSM has been described as a 'Bible' for the field, it is, at best, a dictionary, creating a set of labels and defining each.” And not even a particularly good dictionary, apparently. Of the decision to steer research in mental health away from the manual and its parameters, Insel states: “Patients with mental disorders deserve better.”

    Yet what the NIMH is offering as a solution the DSM’s fumbles and errors is not without major problems of its own, including because of the agency's single-minded focus on biological psychiatry as the represented solution to all such ambiguities and confusions. Among the consequences of that emphasis, interest in symptoms will be radically curtailed: “symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.”

    More at: http://www.psychologytoday.com/blog/...-support-dsm-5
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  2. #2
    Founder Sheila's Avatar
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    Wow!.....Wow! Big news! Big shake-up.
    Meds free since June 2005.

    "An initiation into shamanic healing means a devaluation of all values, an overturning of the profane world, a peeling away of inveterate handed-down notions of the world, liberation from everything preconceived. For that reason, shamanism is closely connected with suffering. One must suffer the disintegration of one's own system of thought in order to perceive a new world in the higher space."
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  3. #3
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    As this poster on one of the websites wrote under the above article; "The matrix is crumbling". Spot-on words. The Great Shift of Consciousness that we talked and dreamt of barely 2-3 years go is here. We're entering the next paradigm. We will be learning of the existence of new technologies (Tesla stuff including) along with medical treatments so far kept hidden and reserved for the few. By 2020, the world will have changed completely. For the better. And, what is incredible, for many of us here, it will be a double awakening and improvement - we're also healing on our personal "SSRIs" level.

    Let us keep growing to reach more and more people and spread the word about ADs even faster.
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  4. #4
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    Cont.

    Chair of DSM-5 Task Force
    Responds to NIMH



    David Kupfer, Chair of the DSM-5 Task Force, while defending the DSM as a useful diagnostic tool in a press release, concedes that ”biological and genetic markers that provide precise diagnoses that can be delivered with complete reliability and validity” are still “disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”


    Full text of the release:

    For Information Contact:
    Eve Herold, 703-907-8640
    [email protected]
    Erin Connors, 703-907-8562
    [email protected]

    Statement by David Kupfer, MD

    Chair of DSM-5 Task Force Discusses Future of Mental Health Research

    The promise of the science of mental disorders is great. In the future, we hope to be able to identify disorders using biological and genetic markers that provide precise diagnoses that can be delivered with complete reliability and validity. Yet this promise, which we have anticipated since the 1970s, remains disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting. In the absence of such major discoveries, it is clinical experience and evidence, as well as growing empirical research, that have advanced our understanding of disorders such as autism spectrum disorder, bipolar disorder, and schizophrenia.

    This progress will soon be recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The new manual, due for release later this month, represents the strongest system currently available for classifying disorders. It reflects the progress that we have made in several important areas.

    A revised chapter organization signals how disorders may relate to each other based on underlying vulnerabilities or symptom characteristics.
    Disorders are framed in the context of age, gender, and cultural expectations, in addition to being organized along a valuable developmental lifespan within each chapter.
    Key disorders were combined or reorganized because the relationships among categories clearly placed them along a single continuum, such as substance use disorder and autism spectrum disorder.
    A new section introduces emerging measures, models and cultural guidance to assist clinicians in their evaluation of patients. For the first time, self-assessment tools are included to directly engage patients in their diagnosis and care.DSM, at its core, is a guidebook to help clinicians describe and diagnose the behaviors and symptoms of their patients. It provides clinicians with a common language to deliver the best patient care possible. And through content such as the new Section III, the next manual also aims to encourage future directions in research.
    Efforts like the National Institute of Mental Health’s Research Domain Criteria (RDoC) are vital to the continued progress of our collective understanding of mental disorders. But they cannot serve us in the here and now, and they cannot supplant DSM-5. RDoC is a complementary endeavor to move us forward, and its results may someday culminate in the genetic and neuroscience breakthroughs that will revolutionize our field. In the meantime, should we merely hand patients another promissory note that something may happen sometime? Every day, we are dealing with impairment or tangible suffering, and we must respond. Our patients deserve no less.

    The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at www.psychiatry.org.


    http://www.madinamerica.com/2013/05/...k-of-validity/

    Great comments under the article. Really worth reading.
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  5. #5
    Member RubyTuesday's Avatar
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    This is awesome. This is really good news. When I got my M.A. in Psychology in 1984 I felt then that the DSM is scientifically invalid and is given way too much attention. Here is the problem: ANYONE, under enough stress, is going to manifest one or more psychodiagnostic categories. Conversely, ANYONE, with enough support and time, is going to be free of said diagnoses.

  6. #6
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    Oh yes, RubyTuesday, very well put.
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  7. #7
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    Next Steps: More Lessons Learned From the DSM-5 Boycott

    Jack Carney, DSW

    May 24, 2013

    If there is no struggle, there is no progress.
    – Frederick Douglass

    You never know what you’re going to accomplish when you start something. Which is why you start it. Of course, you have to have a plan – always a plan; you have to be associated with other committed individuals; and you have to be fortunate enough to be moving in the same direction as the flow of history. You’ll only know if you’re on the right track when you resolve the classic dilemma of whether to do or not do by doing.

    When we initiated the DSM-5 Boycott back in February, we had a plan and a series of objectives:

    • Dissuade as many professionals as possible from buying and using the DSM-5; cost the financially stressed American Psychiatric Association income; and undermine the status and prestige of the DSM and the APA;
    • Expand the membership of our Coordinating Committee and form working alliances with as many like-minded organizations as possible;
    • And, ultimately, disrupt and damage the APA’s relationships with the key players of the public mental health system – Big Pharma, Big Insurance and Big Government.

    We actually accomplished much of what we set out to do, but not in the manner that we anticipated. Lesson #1, which I wrote about earlier (The Politics of Systems Change: Lessons Learned from the Launch of the DSM-5 Boycott, 2/26/13), came in the barrage of criticism we received when we launched the Boycott. Our vulnerability – or at least the point at which we were attacked — was our apparent endorsement of the ICD-9 as an alternative to the new DSM. In fact, our suggested option to use the ICD-9 was more of a tactic, designed to enable professionals to bill for their services as well as to endorse our boycott statement. It was also based on a fact seemingly not known by most professionals and users of service, viz., that ICD codes and not DSM codes are required by all 3rd party payers for billing and reimbursement. And finally, when you’re starting something new, you and your projected audience can’t focus effectively on more than one thing at a time. For example, we had considered initiating simultaneously with the Boycott a “no-diagnosis” campaign, but were eventually convinced that would be a great distraction. We began to think of our effort to weaken the APA as happening in stages or steps, with each succeeding one adding to the momentum achieved by the one that had preceded it.

    In this case, step #2, which the Committee will soon begin to discuss in detail, will be the “no-diagnosis” campaign, which we hope to initiate sometime in the Fall. The DSM-5 Boycott will continue, and we’re hoping for some synergy between the two, that the one will reinforce and feed off the other. To get a bit ahead of myself, step or stage #3 will involve a critique of the ICD-10, which is scheduled to be issued in October, 2014, and will have as its objective the further disruption of the relationships between the Big 3 and the APA. With luck and hard work, this will be launched sometime early next year. We also anticipate that the Boycott will continue apace, through to the end of CY 2014. Both steps will be discussed in further detail below.

    More now on Lesson #1. Very, very few people in the U.S., professionals and users of service included, appear to care a damn about the DSM-5. Since we launched the boycott in early February, only 1939 individuals have signed our Boycott petition and, perhaps more disconcerting, only one organization of professionals, the National Alliance of Professional Psychological Providers (NAPPP), has agreed to be a Boycott co-sponsor, and that only quite recently. Just today, another psychologist-dominated organization, one with an outsized reputation as progressive, opted not to co-sponsor the Boycott. Peter Breggin must be rolling his eyes at that decision. One could argue that we’ve simply done a lousy job reaching out to folks, particularly professionals, but our FB ads indicate they and our websites have been seen by thousands of individuals.


    More at:
    http://www.madinamerica.com/2013/05/...m-5-boycott-2/
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  8. #8
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    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) is coming under scrutiny.

    Thomas Insel, The director of the US National Institute of Mental Health, is questioning the manual's validity, pressing scholars and scientists to shift away from the manual's current philosophy. Much of the DSM's current validity is based on nothing more than disease categorization, listing mental health disorders such as bipolar disorder and schizophrenia based on symptoms alone. Insel wants to take a more objective approach forward, using cognitive testing, brain scans, and genetic studies to diagnose mental health conditions. Insel's approach will abandon the current DSM philosophy that has been published by the American Psychiatric Association for the past 60 years.

    Dr Allen Frances, chairman of the DSM-4 committee, has criticized the current process, "People with mild problems are [often] over-medicated." Furthermore, he states, "The new edition exhibits a loosening of criteria in several major disorders and could lead to further over-medication." He believes "the work on DSM-5 has displayed the most unhappy combination of soaring ambition and weak methodology" and there exists an "inexplicably closed and secretive process" to the revision of the current DSM-5.

    DSM creates medical disorders out of thin air

    Many complaints about the DSM revolve around growing statistics that this psychiatrist's bible is turning simple illnesses into full blown medical conditions. Experts believe mental disorders are being created out of thin air and definitions of these disorders are widening, as people become over-diagnosed. This is allowing pharmaceutical companies a perfect opportunity to come in and expand their market for new drugs. This is a serious and growing problem, especially since 70 percent of those serving on the DSM-5 committees have financial ties to pharmaceutical companies.

    Instead of the current system, Insel wants to see a more scientific approach, implementing more genetic, imaging, physiologic, and cognitive data, to be studied and clustered in relations to treatment response.

    Insel elaborated that medical definitions of conditions like heart disease, lymphoma, or AIDS are based on objective laboratory studies and not based on just clinical clusters of symptoms, as the DSM prescribes.

    "In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain... Imagine deciding that EKGs were not useful because many patients with chest pain did not have EKG changes. That is what we have been doing for decades when we reject a bio marker because it does not detect a DSM category," Insell says.

    Evidence suggests anti psychotic drugs actually cause more mental illness

    As scientists start basing the DSM on real scientific data, is it time to announce what no one in the psychotic drug community want to share? Anti-psychotic drugs are actually causing more mental illness.

    Marcia Angell, Former editor and chief of the New England Journal of Medicine, exposes the marketing tactic that drug companies have used to fool the public into taking more anti-psychotic medications.

    Depression is said to be caused by too little serotonin in the brain, which antidepressants are often prescribed to correct. Similarly, schizophrenia is said to be caused by too much dopamine, which psychotic drugs are often used to lower. Both of these misconceptions are not scientific fact, and here's why, Angell points out.

    These chemical imbalances in the brain are generally deemed "causes" of mental illness because psychotic drugs have leveling effects only after they are used and observed to have this effect!

    This implies that depressed thoughts come from too little medication!

    Angel suggests this crooked logic likewise "argues that fevers are caused by too little aspirin!"

    Pulitzer Prize winner, Robert Whitaker says that in the past, people with hospitalized mental illness would recover without medication in as little as six to eight months. Now, with medication, patients are struggling longer and harder with adverse affects and withdrawal symptoms that include a stunning 85 percent chronic relapse rate.

    This is because psychotropic drugs are interfering with a person's neurotransmitters, disturbing the brain's natural processes that maintain normal biological functions.

    Whitaker further explains, "It is well understood that psychoactive drugs disturb neurotransmitter function, even if that was not the cause of the illness in the first place. When, for example, an SSRI antidepressant like Celexa increases serotonin levels in synapses, it stimulates compensatory changes through a process called negative feedback. In response to the high levels of serotonin, the neurons that secrete it (presynaptic neurons) release less of it, and the post synaptic neurons become desensitized to it. In effect, the brain is trying to nullify the drug's effects."

    This implies that pharmaceutical drugs are getting in the way of natural recovery in most cases, and that over-diagnosis is commonplace due to the current, unscientific DSM rhetoric.


    http://www.naturalnews.com/040540_me...sychiatry.html
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  9. #9
    Senior Member Junior's Avatar
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    70 percent of those serving on the DSM-5 committees have financial ties to pharmaceutical companies.
    Oh my god.....
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  10. #10
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    Robert Whitaker & Allen Frances on Al Jazeera TV: “Redefining Mental Illness”

    May 23, 2013


    Robert Whitaker notes on Al Jazeera’s “Inside Story” that a helpful diagnostic text must be both reliable and valid, and the DSM is neither – resulting in a harmful expansion of diagnosis and medication. Allen Frances says that experts “always expand, they never reduce” their authority over a domain. 5% of the population has a psychiatric disorder that can be diagnosed and effectively treated, Frances says, but the DSM is misused such that more than 25% of the population is so diagnosed and a “ridiculous” 20% of the population is taking medication.


    http://www.madinamerica.com/2013/05/...ental-illness/


    And from Al Jazeera website (to watch the video, click on the link below);


    The Diagnostic and Statistical Manual of Mental Disorders (DSM), known as the bible of psychiatry, is the most influential guide for helping doctors in the US define what a mental illness is.

    Under the new guidelines a person who is grief-stricken after the death of someone close could be diagnosed with major depressive disorder.

    [The DSM] it's not really a bible, it shouldn't be worshipped. It's a guide, it's mostly a guide to clinical care to help in deciding who has what disorder, and what's the best treatment for it. Unfortunately [it] has been taken out of context, and used in many real life decisions often beyond the competence of the manual … so it's moved out of the clinical arena ... and now it has all sort of society influences often beyond its competence.

    Dr Allen Frances, a the former chair of the Psychiatry Department at Duke University

    Elderly people who become forgetful but do not have dementia could be labelled as having minor neuro-cognitive disorder. And toddlers who throw tantrums could be diagnosed with disruptive mood dysregulation disorder.

    Revisions like these have sparked a backlash among some respected psychiatrists in the US, who say the new guidelines are turning normal behaviour into illness, and will lead to the medication of patients that should not be.

    The director of the National Institute of Mental Health issued a statement saying it was time to move away from the DSM-5 :

    "The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure .... In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever."

    But those who worked on the latest version of the DSM defend it as the "strongest science available" to help diagnose and treat those suffering from mental illness.

    David Kupfer, the chairman of the committee that produced DSM-5, dismissed the criticisms of the manual as "A gross mischaracterisation of important changes instituted to help provide more precise diagnoses for people seeking help ... DSM-5 is a guide book representing the strongest science available to help clinicians provide the best care possible for their patients".

    A study by professors from Harvard and Tufts universities published in March 2012 analysed the financial disclosures of 141 members of the work groups drafting the new psychiatry guide.

    They found that 69 percent of the authors had ties to the pharmaceutical industry - that is a higher proportion than the 57 percent in the previous version of the book.


    More at: http://www.aljazeera.com/programmes/...617473825.html
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