Registering to submit comment in the second DSM-5 public review of draft criteria
May 12, 2011
Registering to submit comment in the second DSM-5 public review of draft criteria
Post #78 Shortlink: http://wp.me/pKrrB-15q
Second public review of draft proposals for DSM-5 criteria now open and runs from May to 15th June
Under the guise of “eliminating stigma” and eradicating “terminology [that] enforces a dualism between psychiatric and medical conditions” the American Psychiatric Association (APA) appears hell bent on colonising the entire medical field by licensing the application of a mental health diagnosis to all medical diseases and disorders.
If the most recent proposals of the “Somatic Symptom Disorders” Work Group gain DSM Task Force approval, all medical diseases and disorders, whether “established general medical conditions or disorders” like diabetes or conditions presenting with “somatic symptoms of unclear etiology” will have the potential for a bolt-on diagnosis of “somatic symptom disorder”.
CFS and ME patients, diagnosed or awaiting diagnosis, may be especially vulnerable to highly subjective criteria and difficult to quantify constructs such as “disproportionate distress and disability”, “catastrophising”, “health-related anxiety”, “[appraising] bodily symptoms as unduly threatening, harmful, or troublesome” with “health concerns [that] may assume a central role in the individual’s life, becoming a feature of his/her identity and dominating interpersonal relationships.”
There may be considerable implications for these highly subjective classifications for the diagnoses assigned and the treatments offered to US patients, for the provision of social care and payment of medical and disability insurance.
Who can submit comment?
The APA is inviting all stakeholders to submit comment and feedback on the draft framework for DSM-5 and the latest proposed revisions to diagnostic criteria – patients and families, patient advocates and patient organizations as well as clinicians, researchers, allied health professionals, lawyers and other end users.
It’s important that patients who are able to submit comment do so, but please also encourage patient organizations, informed clinicians, researchers, psychiatrists, psychologists and allied health professionals to submit feedback, too.
Last year, the APA received over 8000 comments from stakeholders across all DSM categories.
Where can I read examples of last year’s submissions?
Copies of last year’s submissions by patient organizations and advocates can be read here: http://tinyurl.com/DSM5submissions
I shall be opening a new page for copies of this year’s patient organization and patient advocate submissions.
How do I register to submit comment?
1. Go to the DSM-5 Development website: http://www.dsm5.org/Pages/Default.aspx
2. Look for the “Participate” box (right hand side of Home Page) and click on “Register Now”. (Log in names and passwords from last year’s public review do appear to have been retained.)
3. Complete the “Register to Make Comments” form: http://www.dsm5.org/Pages/Registration.aspx
Having registered a username, name, email address and country, and entered the “Captcha” code, a confirmation email with a temporary password will be auto generated. The Registration form is also accessible from each of the category Criteria pages, as well as from the Home Page.
You can register in advance, if you wish, then prepare and upload your submission at a later date, but remember the feedback period closes on 15 June.
4. To comment on the proposals of the “Somatic Symptom Disorders” Work Group, Login in and go to this page:
http://www.dsm5.org/proposedrevision/Pages/SomaticSymptomDisorders.aspx
You can submit comment, on that page, for one or more categories, or click on a specific category, for example,
http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=368
J 00 Complex Somatic Symptom Disorder
Login in and you will be presented with a WYSIWYG editor.
I would strongly recommend composing your comment in a draft email or word processor first and saving a copy, as last year, there were complaints that Captcha characters were hard to read and the uploading procedure glitchy – so please save a copy first. External links and references can be included but there is no facility for including attachments. There appears to be no maximum word or character length specified. I would also suggest that you head your submission with “For the attention of the Somatic Symptom Disorders Work Group” or similar.
What are the latest proposals for the “Somatic Symptom Disorders” categories?
The latest proposals are set out here, where the two key “Disorder Descriptions” and “Rationale” documents can also be downloaded: http://wp.me/pKrrB-13z
I’ll be posting extracts from the two key documents in the next post.
More Q and As on and around the public review, here: http://wp.me/pKrrB-12P
Related material:
On the subject of the use of the word “somatic” and “somatic symptom” , Angela Kennedy published this note, in June 2009:
I’ve noticed for some time that various people have been using the term ‘somatic’ as if it signified a ‘psychosomatic’ or ‘psychogenic’ condition.
This is incorrect. The OED definition of ‘somatic’ is “of or relating to the body, especially as distinct from the mind” (my italics). The word comes from the Greek ‘soma’ meaning ‘body’.
Even when proponents of ‘psychogenic’ explanations (it’s in your mind, you’re imagining it, misinterpreting it, faking it, caused it by your own beliefs etc. etc. etc.) use the term ‘somatic illness’ they actually do mean an illness of the body. They may then claim this somatic (or bodily illness) is caused by psychological dysfunction, but the word ‘somatic’ does not mean “illness caused by psychological dysfunction”. It merely means illness of a body, or a bodily illness.
It is important that this word is used correctly, especially when people write to the media, government, the medical establishment etc. Otherwise we are in danger of seeing apparent objections published, from advocates, to saying ME/CFS is a bodily illness, purely because someone has used the word ‘somatic’ incorrectly!
dx revision watch 
