DSM-5 Round up: March #1

DSM-5 Round up: March #1

Post #229 Shortlink: http://wp.me/pKrrB-2H2

New York Times

Letter to the Editor

RONALD PIES
Lexington, Mass., March 18, 2013

The writer is a professor of psychiatry at SUNY Upstate Medical University and Tufts University.

Letter
Invitation to a Dialogue: Psychiatric Diagnoses

Published: March 19, 2013

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Macleans Canada

Normal behaviour, or mental illness?

Temper tantrum, or ‘disruptive mood dysregulation disorder’? A look at the new psychiatric guidelines that are pitting doctors against doctors

Anne Kingston | Tuesday, March 19, 2013

…Under the new “somatic symptom disorder” (SSD), for instance, people who express any anxiety about physical symptoms could also be saddled with a mental illness diagnosis, which could thwart their attempts to have their physical issues taken seriously. To meet the definition one only needs to report a single bodily symptom that’s distressing and/or disruptive to daily life and have just one of the following three reactions for at least six months: “ ‘disproportionate’ thoughts about the seriousness of their symptom(s); a high level of anxiety about their health; devoting excessive time and energy to symptoms or health concerns.”

Read more of this post

APA website: New documents and videos on ‘Somatic Symptom Disorder; article: Psychiatric News

APA website: New documents and videos on ‘Somatic Symptom Disorder; article: Psychiatric News

Post #228 Shortlink: http://wp.me/pKrrB-2Gi

Updates at March 7

Article in Die Psychiatrie

Somatic Symptom Disorders: a new approach in DSM-5

J. E. Dimsdale, University of California, San Diego, DSM Task force, Somatic Symptoms Work Group

Die Psychiatrie 2013; 10: 30–32

Summary

Following a brief historic discourse, problems with the current use and concepts the of somatoform disorders are described. The rationale for substituting the term “somatoform” with “somatic symptom” in DSM5 is explained and the new classification criteria for the group of “somatic symptom related disorders” are described, which include severity ratings.

A special aspect is that “Illness anxiety disorder” is introduced as a new diagnostic entity in DSM-5.

“Störung mit somatischen Symptomen”: ein neuer Ansatz in DSM-5

Zusammenfassung

Nach einem kurzen historischen Diskurs werden die Problembereiche und die Konzepte der somatoformen Störungen erläutert. Das Rational für einen Ersatz der “somatoformen” Störung durch eine “Störung mit somatischen Symptomen” in DSM5 wird erläutert. Die Klassifikationskriterien der Gruppe der “Störungen mit somatischen Symptomen” wird dargestellt.

Ein besonderer Aspekt ist die Einführung einer “Erkrankungsangst-Störung” in DSM-5.

Full paper can be downloaded here: http://bit.ly/W7filu

Doug Bremner, MD, comments on ‘Somatic Symptom Disorder’ here:

DSM-5 Somatic Symptoms Disorder is Going to Make Us All Mental

Doug Bremner | February 12, 2013

 

A number of new documents and short videos on ‘Somatic Symptom Disorder’ have been published on the APA’s new webpages, plus an article in Psychiatric News, published on March 1.

These are followed by recent, mainstream media coverage of concerns for all illness groups for the implications of misdiagnosis with ‘Somatic Symptom Disorder’ or for an additional diagnosis of ‘Somatic Symptom Disorder.’

http://www.psychiatry.org/practice/dsm/dsm5/dsm-5

Fact Sheet: Click link for PDF document   Somatic Symptom Disorder

Videos:

Joel E Dimsdale, Chair, DSM-5 Somatic Symptom Disorders Work Group

What is Somatic Symptom Disorder?

http://www.psychiatry.org/practice/dsm/dsm5/dsm-5-video-series-somatic-symptom-disorder

What was the rationale behind changes to Somatic Symptom Disorder?

http://www.psychiatry.org/practice/dsm/dsm5/dsm-5-video-series-changes-to-somatic-symptoms

Will Somatic Symptom Disorder result in the missing of other medical problems?

http://www.psychiatry.org/practice/dsm/dsm5/dsm-5-video-series-somatic-symptom-disorder-and-other-medical-problems

Article: Psychiatric News (organ of the APA):

http://psychnews.psychiatryonline.org/newsArticle.aspx?articleid=1659603

Psychiatric News | March 01, 2013
Volume 48 Number 5 page 7-7
10.1176/appi.pn.2013.3a26
American Psychiatric Association
Professional News

Somatic Chapter Drops Centrality Of Unexplained Medical Symptoms

Mark Moran

“…But Joel Dimsdale, M.D., chair of the Somatic Symptom and Related Disorders Work Group, emphasized that the most important change overall in this set of disorders is removal of the centrality of medically unexplained symptoms. “That was a defining characteristic of these disorders in DSM-IV, but we believe it was unhelpful and promoted a mind-body dualism that is hard to justify,” he told Psychiatric News.

So, for instance, the diagnosis of somatization disorder in DSM-IV was based on a long and complex symptom count of medically unexplained symptoms. DSM-5 criteria eliminate that requirement and recognize that individuals who meet criteria for somatic symptom disorder—the new designation, marked by disproportionate thoughts, feelings, and behaviors related to somatic symptoms—may or may not have a medically diagnosed condition.

Hypochondriasis has been eliminated; most individuals who would previously have been diagnosed with hypochondriasis have significant somatic symptoms in addition to their high health anxiety and should receive a DSM-5 diagnosis of somatic symptom disorder. Those with high health anxiety without somatic symptoms should receive a diagnosis of illness anxiety disorder…

Read full article here

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Related material

Dimsdale JE. Medically Unexplained Symptoms: A Treacherous Foundation for Somatoform Disorders? Psychiatr Clin North Am, Volume 34, Issue 3, Pages 511-513 [PUBMED 21889675]

Overlapping Conditions Alliance (OCA)

“Members of the Overlapping Conditions Alliance (OCA) produced a white paper, Chronic Pain in Women: Neglect, Dismissal and Discrimination, to promote awareness and research of neglected and poorly understood chronic pain conditions that affect millions of American women. This report, which can be viewed and downloaded below, includes detailed policy recommendations to further these goals.” (Report 2010 and Report 2011)

http://www.endwomenspain.org/resources/policy-analysis-recommendations

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Recent mainstream media coverage of the SSD issue

ABC News Radio:
Guidelines for Diagnosing Psychiatric Disorder May Overlook Physical Illnesses

ABC News:
New Psych Disorder Could Mislabel Sick as Mentally Ill

Canada.com and syndicated to a number of other Canadian media sites:
New “catch all” psychiatric disorder could label people who worry about their health as mentally ill

Fox News Health:
Does somatic symptom disorder really exist?

DSM-5 Task Force Chair, David J Kupfer, MD, defends the SSD construct on Huffington Post (but provides no answers to my questions):

David J. Kupfer, M.D. Chair, DSM-5 Task Force

Somatic Symptoms Criteria in DSM-5 Improve Diagnosis, Care

DSM-5 Round up: February #2

DSM-5 Round up: February #2

Post #226 Shortlink: http://wp.me/pKrrB-2FC

Front page National Post, syndicated to Ottawa Citizen, Vancouver Sun, Montreal Gazette, Edmonton Journal and others. With contributions from Allen Frances, MD, Professor Frank Farley, Suzy Chapman.

New “catch all” psychiatric disorder could label people who worry about their health as mentally ill

Sharon Kirkey | February 18, 2013

A controversial new mental diagnosis could label thousands of people with legitimate medical illnesses as psychiatrically sick and in need of treatment if they worry “excessively” about their symptoms, observers says.

The newest version of psychiatry’s official catalogue of mental disorders, due to be published in May, will contain a newly expanded definition of “somatic symptom disorder,” or SSD.

Under the previous edition of the Diagnostic and Statistical Manual of Mental Disorders — an influential guidebook used by doctors around the globe — somatoform disorders applied to people with medically unexplained health complaints. The diagnosis required that physical, bodily symptoms couldn’t be traced to any identifiable, underlying medical cause.

In the fifth and latest edition of the manual, known as DSM-5, that proviso has been removed.

The new diagnosis doesn’t distinguish between “medically unexplained” symptoms or symptoms related to an actual underlying medical problem…

The Hindu

In search of a revolutionary road

K.S. Jacob | February 16, 2013

UK Times

Anna Maxted | February 19, 2013

In America, the bereaved may now be diagnosed with depression.

Experts here are appalled, says Anna Maxted (with contributions from Professor Peter Kinderman, head of the Institute of Psychology, Health and Society at the University of Liverpool, Debbie Kerslake, chief executive, Cruse Bereavement Care, Kathleen Walton).

Psychomédia

Accueil

DSM-5 : une catégorie controversée de troubles de symptôme somatique remplace les troubles somatoformes

Soumis par Gestion le 18 février 2013

DSM-5
Actualités
Troubles de symptôme somatique (somatoformes)

La prochaine édition du Manuel diagnostique et statistique des troubles mentaux (1) (DSM-5) dont la publication par l’American Psychiatric Association (APA) est prévue pour mai 2013, remplace la catégorie des troubles somatoformes par la catégorie troubles de symptômes somatiques.

Les troubles somatoformes du DSM-IV incluent la somatisation, la conversion, le trouble douloureux, l’hypocondrie et la peur d’une dysmorphie corporelle. Ces troubles, explique le psychiatre David J. Kupfer, qui a dirigé les travaux de révision, sont caractérisés par la présence de symptômes évocateurs d’une maladie ou d’une blessure physique, mais qui ne peuvent être entièrement être expliqués par une affection médicale générale, un autre trouble mental, ou par des effets secondaires de médicaments ou de substances. Les symptômes entraînent une grande détresse ou d’importantes perturbations de la capacité à fonctionner dans la vie quotidienne…

Psychomédia avec sources:
– David J. Kupfer,
Somatic Symptoms Criteria in DSM-5 Improve Diagnosis, Care
– Allen Frances, DSM-5 Refuses to Reduce Overdiagnosis of ‘Somatic Symptom Disorder’

DSM-5 Round up: February #1

DSM-5 Round up: February #1

Post #225 Shortlink: http://wp.me/pKrrB-2F7

Update: More recent coverage:

The first in a series of three commentaries by Allen Frances, MD, on the Somatic Symptoms Disorder issue has received over 25,000 page views on Psychology Today, alone. It was also published at Huffington Post and on “Education Update,” and now also at Psychiatric Times.

Mislabeling Medical Illness As Mental Disorder

Allen Frances, MD | February 13, 2013

Fox Health News

A psychiatrist’s take on the DSM-5 Somatic Symptom Disorder diagnosis, Dr Keith Ablow, for Fox News Health:

Does somatic symptom disorder really exist?

Keith Ablow, MD |  for Fox News Health | February 14, 2013

Currents An interactive newsletter of NASW-WA

(Washington State Chapter of the National Association of Social Workers is a membership organization.)

DSM 5 Changes

DSM-5: A Summary of Proposed Changes

Carlton E. Munson, PhD, LCSW-C | February 12, 2013

The Health Care Blog

Mislabeling Medical Illness

Allen Frances, MD | February 12, 2013

Huffington Post Blogger

Bruce E. Levine
Practicing clinical psychologist, writer

DSM-5: Science or Dogma? Even Some Establishment Psychiatrists Embarrassed by Newest Diagnostic Bible

Bruce E. Levine | February 10, 2013

Earlier coverage:

Huffington Post

DSM-5: Science or Dogma? Even Some Establishment Psychiatrists Embarrassed by Newest Diagnostic Bible

Bruce E. Levine | February 10, 2013

Practicing clinical psychologist, writer

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DIE WELT/Worldcrunch All news is global

Translated (and possibly abridged) from original article in German

Worldcrunch All news is global

Psychiatrists Not Crazy About The Revised Manual Of Mental Disorders

Fanny Jiménez and Christiane Löll | February 5, 2013

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Allen Frances, MD, now blogs at Saving Normal.

Archive posts at DSM 5 in Distress will remain accessible and open for new comments.

Saving Normal
Mental health and what is normal.
by Allen Frances, M.D.

DSM 5 Boycotts and Petitions
Too many, too sectarian

Allen Frances, MD | February 8, 2013

There are already about a dozen different DSM 5 petitions and boycotts out there. This is completely understandable – there is lots in DSM 5 to be angry at or frightened about.

Unfortunately, though, this is not a case of more the merrier. Fragmentation into a number of small protests will greatly reduce their aggregate impact…

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David J. Kupfer, MD, chairs the DSM-5 Task Force. On February 8, Dr Kupfer published in defence of the SSD construct on Huffington Post. Part Three in the Allen Frances and Suzy Chapman series of commentaries on the SSD criteria was published earlier, last week, Saving Normal on Psychology Today:

Huffington Post

David J. Kupfer, M.D.
Chair, DSM-5 Task Force

Somatic Symptoms Criteria in DSM-5 Improve Diagnosis, Care

David J. Kupfer, MD | February 8, 2013

While the goal of the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is clear, accurate criteria for diagnosing mental disorders, the motivation behind the book’s revision was the improvement of diagnosis and clinical care. Somatoform disorders are one area where definitive progress was made.

Somatoform disorders are characterized by symptoms suggesting physical illness or injury, but which may not be fully explained by a general medical condition, another mental disorder, or by medication or substance side effects. The symptoms are either very distressing or result in significant disruption of an individual’s ability to function in daily life. People suffering from somatoform disorders are often initially seen in general medical settings as opposed to psychiatric settings…

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This new post from Christopher Lane on the DSM-5 ‘Somatic Symptom Disorder’ controversy has been designated a Psychology Today “Essential Read” editor pick:

Side Effects
From quirky to serious, trends in psychology and psychiatry
by Christopher Lane, Ph.D.

DSM-5 Has Gone to Press Containing a Major Scientific Gaffe
The APA declined to correct the error, despite multiple warnings.

Christopher Lane, PhD | February 8, 2013

When DSM-5 is published three months from now, in the middle of May, it will contain at least one major scientific gaffe. The Trustees of the American Psychiatric Association voted to include a definition of Somatic Symptom Disorder (SSD) so broad and over-inclusive that it is certain to include medical patients with an outsized concern about their health, as well as those who are merely vigilant in trying to maintain it…

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Lightweight feature in UK Times Magazine, Saturday, February 9, 2013:

The Asperger’s effect

Louise Carpenter | February 9 2013

Once it was a taboo. Now, in Silicon Valley, it’s almost a job qualification. So has the diagnosis lost its stigma, wonders Louise Carpenter…

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Article on mental health diagnosis and DSM-5 co-authored by Dr Raj Persaud, Consultant Psychiatrist, and Professor Sir Simon Wessely, Professor of Psychological Medicine, Institute of Psychiatry, King’s College London.

http://www.simonwessely.com/dsm5.html

DSM-5 and the future of psychiatry
Did 2012 prove that psychiatric disease doesn’t exist?

From doctors.net.uk 1.2.2013

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At the end of this article is a link to a forthcoming CPD Certified conference at the Wolfson Lecture Theatre, Institute of Psychiatry, June 4-5, 2013:

Conference:

DSM-5 and the Future of Psychiatric Diagnosis: Where is the roadmap taking us?

A two day international conference following the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will take place at the Institute of Psychiatry on the 4th and 5th of June 2013.

Mental health practitioners and researchers around the world anticipate the DSM-5 that is due to published by the American Psychiatric Association within the first few months of 2013.

Discussions about the DSM-5 have stretched well beyond the world of academic psychiatry having become a matter of intense public interest and media coverage.

The aim of this conference is to have a rigorous and comprehensive discussion of the clinical, research, and public health implications of the DSM-5. The perspective is international and speakers will include top scientists, key policy makers, patient representatives, and front-line clinicians.

Speakers include:

Professor David Kupfer, Head of DSM-5 Planning Committee and Professor at the University of Pittsburgh

Professor William Carpenter, DSM-5 Task Force Member and Professor at the University of Maryland

Professor David Clark, Professor of Experimental Psychology, University of Oxford

Dr Clare Gerada, General Practitioner and Chair of the Council of the Royal College of General Practitioners

Professor Catherine Lord, Director of the Center for Autism and the Developing Brain and Professor at the University of Michigan

Professor Vikram Patel, Professor of International Mental Health, London School of Hygiene and Tropical Medicine

Professor Nikolas Rose, Head of the Department of Social Science, Health and Medicine, Kings College London

Sir Michael Rutter, First Professor of child psychiatry in the UK and Professor of Developmental Psychopathology at Kings College London

Professor Norman Sartorius, Former director of the World Health Organization’s Division of Mental Health, and a former president of the World Psychiatric Association

Price: £350 (including lunches and an evening reception)

Dates:

* Tuesday 4th June | 09:45- 17:30 (evening reception to follow)

* Wednesday 5th June | 09:45 – 17:15

Venue: Wolfson Lecture Theatre, Institute of Psychiatry

This event is CPD Certified

DSM-5 goes to press with ‘Somatic Symptom Disorder’ amid widespread professional and consumer concern

DSM-5 goes to press with ‘Somatic Symptom Disorder’ amid widespread professional and consumer concern

Post #224 Shortlink: http://wp.me/pKrrB-2EV

Update: On February 8, David J. Kupfer, MD, Chair, DSM-5 Task Force, published in defence of the ‘Somatic Symptom Disorder’ category on Huffington Post:

Somatic Symptoms Criteria in DSM-5 Improve Diagnosis, Care

Last week, the American Psychiatric Association sent the next edition of its Diagnostic and Statistical Manual of Mental Disorders to the publishers.

When DSM-5 is released in May, it will introduce a new ‘catch-all’ diagnosis that could capture many thousands more patients under a mental disorder label.

Today, on Saving Normal at Psychology Today, Allen Frances, MD, who chaired the DSM-IV Task Force, publishes the third in a series of commentaries voicing considerable concern for all illness groups for the implications of an additional diagnosis of ‘Somatic Symptom Disorder.’

Why Did DSM 5 Botch Somatic Symptom Disorder?

Allen Frances writes:

“Once it is an official DSM 5 mental disorder, SSD is likely to be widely misapplied – to 1 in 6 people with cancer and heart disease and to 1 in 4 with irritable bowel syndrome and fibromyalgia…The definition of SSD is so loose it will capture 7% of healthy people (14 million in the US alone) suddenly making this pseudo diagnosis one of the most common of all ‘mental disorders’ in the general population.”

Suzy Chapman writes:

“These highly subjective, difficult to assess criteria have the potential for widespread misapplication, particularly in busy primary care settings – causing stigma to the medically ill and potentially resulting in poor medical workups, inappropriate treatment regimes and medico-legal claims against clinicians for missed diagnoses.

“Why has the Task Force and APA Board of Trustees been prepared to sign off on a definition and criteria set that lacks a body of rigorous evidence for its validity, safety and prevalence, thereby potentially putting the public at risk? And why is APA prepared to abrogate its duty of care as a professional body and expose its membership, physicians and the allied health professional end-users of its manual to the risk of potential law suits?”

From May, an additional mental health diagnosis of ‘Somatic Symptom Disorder’ (SSD) can be applied whether patients have diagnosed medical diseases like diabetes, angina, cancer or multiple sclerosis, chronic illnesses like IBS, fibromyalgia, chronic fatigue syndrome or chronic pain disorders, or unexplained conditions that have so far presented with bodily symptoms of unclear etiology.

A person will meet the criteria for ‘Somatic Symptom Disorder’ by reporting just one or more bodily symptoms that are distressing or disruptive to daily life, that have persisted for at least six months, and having just one of the following three responses:

1) disproportionate, persistent thoughts about the seriousness of their symptoms;
2) persistently high level of anxiety about their health or symptoms;
3) devoting excessive time and energy to symptoms or health concerns.

In the DSM-5 field trials, 15% of the ‘diagnosed illness’ study group (the trials looked at patients with either cancer or coronary heart disease) met the criteria for an additional mental health diagnosis of SSD.

26% of patients who comprised the irritable bowel syndrome or fibromyalgia study group were coded for SSD.

A disturbingly high 7% of the ‘healthy’ control group were also caught by these overly-inclusive criteria.

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Psychiatric creep

As the criteria stand, this new disorder will potentially result in a ‘bolt-on’ mental health diagnosis being applied to all chronic illnesses and medical conditions if the clinician decides the patient’s response to distressing symptoms is ‘excessive’ or their coping strategies are ‘maladaptive,’ or that they are ‘catastrophising’ or displaying ‘fear avoidance.’ Or if the practitioner feels the patient is spending too much time on the internet researching data, symptoms and treatments, or that their lives have become ‘dominated’ by ‘illness worries,’ they may be vulnerable to an additional diagnosis of SSD.

Patients with chronic, multiple bodily symptoms due to rare conditions or multi-system diseases like Behçet’s syndrome or Systemic lupus, which may take several years to diagnose, will also be vulnerable to misdiagnosis with a mental disorder.

There is no substantial body of research to support the validity, reliability or safety of the ‘Somatic Symptom Disorder’ diagnosis.

During the second public review of draft criteria for DSM-5, the ‘Somatic Symptom Disorder’ section received more submissions from advocacy organizations, patients, and professionals than almost any other disorder category. But rather than tighten up the criteria or subject the entire disorder section to independent scientific review, the SSD Work Group’s response has been to lower the threshold even further – potentially pulling even more patients under a mental disorder label.

The ‘Somatic Symptom Disorder’ Work Group has rejected eleventh hour calls from professionals and patients to review its criteria before going to print.

APA says there will be opportunities to reassess and revise DSM-5‘s new disorders, post publication, and that it intends to start work on a ‘DSM-5.1’ release. But patient groups, advocates and professionals are not reassured by a ‘publish first – patch later’ approach to science.

Read Parts One and Two, here:

Part One: Mislabeling Medical Illness As Mental Disorder | Allen Frances, December 8, 2012

Part Two: Bad News DSM-5 Refuses To Correct Somatic Symptom Disorder | Allen Frances, January 16, 2013

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Notes for media, websites, bloggers:

1. The next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) will be published by American Psychiatric Publishing Inc. in May 2013. It will be known as ‘DSM-5 ‘ and has been under development since 1999.
http://www.dsm5.org/Pages/Default.aspx
http://www.dsm5.org/Documents/DSM%205%20development%20factsheet%201-16-13.pdf

2. The American Psychiatric Association (APA) has spent $25 million on the development of DSM-5.

3. The Diagnostic and Statistical Manual of Mental Disorders is used by mental health and medical professionals for diagnosing and coding mental disorders. It is used by psychiatrists, psychologists, therapists, counselors, primary health care physicians, nurses, social workers, occupational and rehabilitation therapists and allied health professionals.

The DSM is also used for reimbursement and informs government, public health policy, courts and legal specialists, education, forensic science, prisons, drug regulation agencies, pharmaceutical companies and researchers. Diagnostic criteria defined within DSM determine what is considered a mental disorder and what is not, which treatments and therapies health insurers will authorise funding for, and for how long.

4. Four existing disorder categories in the DSM-IV ‘Somatoform Disorders’ section: somatization disorder [300.81], hypochondriasis [300.7], pain disorder, and undifferentiated somatoform disorder [300.82] will be eliminated and replaced with a single new category – ‘Somatic Symptom Disorder’ for DSM-5.

5. APA has held three stakeholder comment periods during which professional and public stakeholders have been invited to submit comment on the proposals for the revision of DSM-IV categories and criteria (in February-April 2010; May-June 2011; May-June 2012).

6. DSM-5 is slated for release at the American Psychiatric Association’s 166th Annual Meeting, San Francisco (May 18-22, 2013). The new manual is available for pre-order and will cost $199: http://www.psychiatry.org/dsm5

7. Allen Frances, MD, was chair of the DSM-IV Task Force and of the Department of Psychiatry at Duke University School of Medicine, Durham, NC; Dr Frances is currently professor emeritus, Duke.

8. Dr Frances blogs at DSM 5 in Distress, and Saving Normal at Psychology Today.

Mislabeling Medical Illness As Mental Disorder was published on December 8, 2012

Bad News DSM-5 Refuses To Correct Somatic Symptom Disorder was published on January 16, 2013

For additional information on ‘Somatic Symptom Disorder’:

Somatic Symptom Disorder could capture millions more under mental health diagnosis by Suzy Chapman for Dx Revision Watch, May 26, 2012

Suzy Chapman

Deutschlandfunk Radio: Wissenschaft Im Brennpunkt: Störungswahn? DSM-5 with Allen Frances

Deutschlandfunk Radio: Wissenschaft Im Brennpunkt: Störungswahn? (DSM-5) with Allen Frances, MD

Post #223 Shortlink: http://wp.me/pKrrB-2EH

Flash:
http://www.dradio.de/dlf/sendungen/wib/1990949

Mp3 (12MB):
http://ondemand-mp3.dradio.de/file/dradio/2013/02/03/dlf_20130203_1630_c745d088.mp3

Deutschlandfunk Radio

http://www.dradio.de/dlf/sendungen/wib/1990949/

27:21 mins

WISSENSCHAFT IM BRENNPUNKT (Science In Focus)
03.02.2013

Störungswahn? (Delusional disorder?)

Psychiater streiten um die Zukunft ihres Fachs (Psychiatrists argue about the future of their profession)

Von Martin Hubert with contributions from Allen Frances, MD, and others

In einigen Monaten erscheint das neue amerikanische Handbuch zur Diagnose psychiatrischer Krankheiten, das “DSM-5”. Aber schon heute erzeugt es heftigen Streit. Denn das “DSM-5” wird die Entwicklung der Psychiatrie auf Jahre hinaus wesentlich beeinflussen.

Kritiker meinen, dass es zu viel neue und überflüssige Störungsbilder enthalte. Außerdem definiere es Störungen oft so weich, dass auch Durchschnittsmenschen künftig zum psychiatrischen Fall würden. Die Verteidiger des Handbuchs kontern: Es habe in der Geschichte immer wieder neue Störungen gegeben, auf die die Psychiater zu reagieren hätten. Außerdem seien weiche Kriterien nötig, um Risikopatienten früh erkennen und therapieren zu können. Wann ist ein Patient wirklich gefährdet – und wann leiden die Psychiater selbst unter Störungswahn? Der Streit zeigt, in welche Richtung sich die Psychiatrie insgesamt entwickeln könnte.

Weiterführende Links:

Seiten des Deutschlandradios:

Links ins Netz: