DSM-5 Round up: January #1

DSM-5 Round up: January #1

Post #218 Shortlink: http://wp.me/pKrrB-2Bs

American Journal of Psychiatry

Editorials | January 01, 2013

The Initial Field Trials of DSM-5: New Blooms and Old Thorns

Robert Freedman, M.D.; David A. Lewis, M.D.; Robert Michels, M.D.; Daniel S. Pine, M.D.; Susan K. Schultz, M.D.; Carol A. Tamminga, M.D.; Glen O. Gabbard, M.D.; Susan Shur-Fen Gau, M.D., Ph.D.; Daniel C. Javitt, M.D., Ph.D.; Maria A. Oquendo, M.D., Ph.D.; Patrick E. Shrout, Ph.D.; Eduard Vieta, M.D., Ph.D.; Joel Yager, M.D.

Am J Psychiatry 2013;170:1-5. 10.1176/appi.ajp.2012.12091189

View Author and Article Information
Copyright © 2013 by the American Psychiatric Association


“A rose is a rose is a rose” (1). For psychiatric diagnosis, we still interpret this line as Robins and Guze did for their Research Diagnostic Criteria—that reliability is the first test of validity for diagnosis (2). To develop an evidence-based psychiatry, the Robins and Guze strategy (i.e., empirically validated criteria for the recognizable signs and symptoms of illness) was adopted by DSM-III and DSM-IV. The initial reliability results from the DSM-5 Field Trials are now reported in three articles in this issue (3–5). As for all previous DSM editions, the methods used to assess reliability reflect current standards for psychiatric investigation (3). Independent interviews by two different clinicians trained in the diagnoses, each prompted by a computerized checklist, assessment of agreement across different academic centers, and a pre-established statistical plan are now employed for the first time in the DSM Field Trials. As for most new endeavors, the end results are mixed, with both positive and disappointing findings…

Full free text

Washington Post

Antidepressants to treat grief? Psychiatry panelists with ties to drug industry say yes

Peter Whoriskey | December 27, 2012

It was a simple experiment in healing the bereaved: Twenty-two patients who had recently lost a spouse were given a widely used antidepressant.

The drug, marketed as Wellbutrin, improved “major depressive symptoms occurring shortly after the loss of a loved one,” the report in the Journal of Clinical Psychiatry concluded.

When, though, should the bereaved be medicated? For years, the official handbook of psychiatry, issued by the American Psychiatric Association, advised against diagnosing major depression when the distress is “better accounted for by bereavement.” Such grief, experts said, was better left to nature.

But that may be changing…

Medscape Medical News > Psychiatry

APA Answers Criticism of Pharma-Influenced Bias in DSM-5

Deborah Brauser | January 4, 2013

The American Psychiatric Association (APA) has fired back a strong response to a recent article by the Washington Post questioning the possibility of pharmaceutical industry influence on decisions regarding the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)…

Ed: Note for watchers of DSM-5’s Timeline. Although the Timeline has the final texts schedule for submission to the publishers by December 2012, in his commentary below, Dr Frances discloses that DSM-5 will go to press at the end of January. The new edition of DSM is slated for release at the APA’s 166th Annual Meeting, May 18-22, 2013, San Francisco.

Psychology Today

DSM5 in Distress
The DSM’s impact on mental health practice and research
by Allen Frances, M.D.

Last Plea to DSM 5: Save Grief From the Drug Companies
Let us respect the dignity of love and loss.

Allen J. Frances, M.D. | January 3, 2013

Psychiatric News
Psychiatric News | January 04, 2013
Volume 48 Number 1 page 7-7
American Psychiatric Association
Professional News

Eating-Disorders Guideline Still Current and Valid, Panel Finds

Mark Moran | January 4, 2013

A review of the 2006 APA practice guideline on eating disorders finds that it is substantially current and is not affected by changes in diagnostic criteria in DSM-5.

Huffington Post

‘Eating Disorders Not Otherwise Specified’: What’s Changing With EDNOS In DSM-5?

Catherine Pearson | January 4, 2013

It took Autumn Whitefield-Madrano more than 20 years to seek treatment for her eating disorder. The writer was 9 when she started having symptoms, primarily binging, and 33 when she finally got help. When she did, the diagnosis surprised her. Whitefield-Madrano had EDNOS, or an “Eating Disorder Not Otherwise Specified…”

Media coverage: APA Board of Trustees approves DSM-5 diagnostic criteria

Media coverage: American Pyschiatric Association Board of Trustees approves final DSM-5 diagnostic criteria

Post #213 Shortlink: http://wp.me/pKrrB-2xF

See also Post #212 for APA News Release (12.01.12) and Message from APA President, Dilip Jeste, M.D.

Additional media coverage and commentary will be added to the top of this post as it comes to my attention.

Updates to Media coverage

Huffington Post blog

Dilip V. Jeste, M.D.
President of the American Psychiatric Association

The New DSM Reaches the Finish Line

Dilip V. Jeste, MD | December 11, 2012

Psychiatric Times

Bereavement and the DSM-5, One Last Time

Ronald W. Pies, MD | December 11, 2012

New York Times


A Tense Compromise on Defining Disorders

Benedict Carey | December 10, 2012


Worried about work? You may need therapy: Psychiatric “bible” may classify more chronic worriers as mentally ill

Sharon Kirkey | Postmedia News |December 9, 2012

LA Times

Changes to the psychiatrists’ bible, DSM: Some reactions

Rosie Mestel | December 9, 2012


Redefining Mental Illness

Elements Behavioral Health

Binge Eating to Be Added to Mental Disorders Manual

December 8, 2012

With contribution from Sharon Kirkey


Psychiatrists To Take New Approach In Bereavement

Audio of interview with Jerome Wakefield plus transcript

December 5, 2012

New Scientist

Psychiatry is failing those with personality disorders

December 5, 2012

Psychiatric Times

APA Approves DSM-5: Final Stages Under Way

By Laurie Martin, Web Editor | December 6, 2012


The New Temper Tantrum Disorder

Will the new diagnostic manual for psychiatrists go too far in labeling kids dysfunctional?

David Dobbs| December 7, 2012

It won’t be published until May, but the American Psychiatric Association’s Diagnostic Statistical Manual, Fifth Edition, or DSM-5—an updating of the field’s highly influential and pleasingly profitable handbook—is already in deep trouble. Every decade or so, DSM publishes a major edition, and often the changes stir controversy. But the alterations the APA announced for DSM-5 this week sparked unusually ferocious attacks from critics, many of them highly prominent psychiatrists. They say the manual fails to check a clear trend toward overdiagnosis and overmedication—and that a few new or expanded diagnoses defy both common sense and empirical evidence. This medicine is not going down well…

British Psychological Society (BPS)

DSM5 approved but controversy continues

NHS Choices

Asperger’s not in DSM-5 mental health manual

Psychology Today Blogs

The People’s Professor

Psychology 360: A brain-behavior buffet, heavy to lite, A to Z by Frank Farley, Ph.D.

Reboot Diagnosis: DSM-5 Goes Live, Nascent Movement Arises

A new open global movement emerges to re-think and re-design diagnosis

Published on December 3, 2012 by Frank Farley, Ph.D. in The People’s Professor

…Our Committee’s strategy at this point is to reboot the whole program of diagnosis, to re-examine the very fundaments of the concept of diagnosis, and to assess what might be involved in creating an alternative approach to those presently available, creating a blueprint, if you will.

Any new or evolved approach would have to meet, in my view, more rigorous scientific criteria, responding to what I call “The Seven Sins of Psychiatric/Psychological science,” (Farley, 2012), incorporate the cultural/social/relationship/humanistic side of our lives, and involve all the principal disciplinary and professional stakeholders in the U.S and internationally. Given the relentless criticisms of the DSM over several decades and the failure to take some of these serious criticisms into account, our Committee (which now consists of myself and Jon Raskin as co-chairs, and members Dean Brent Robbins, Donna Rockwell, Krishna Kumar, Sarah Kamens, and student consultant Erinn Chalene Cosby) has decided to convene with international collaboration an International Ongoing/Online Summit on Diagnosis (or similar title). Among other things we anticipate bringing together scholars and practioners globally and from across the various fields involved in diagnosis to address the Olympian task of an improved approach or approaches to what we have now. We feel the psychological health and well-being of every distressed individual requires a valid and humane approach to diagnosis, and the Zeitgeist is ready…

Medscape Medical News > Psychiatry

Experts React to DSM-5 Approval

Deborah Brauser | December 3, 2012

Experts and organizations are weighing in on this weekend’s decision by the American Psychiatric Association (APA) Board of Trustees to approve the final diagnostic criteria for the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)…

Press Connects

Psychiatrists to make vast changes to diagnosis manual

CBS News

Asperger’s syndrome dropped from American Psychiatric Association manual

CBS/AP/ December 3, 2012, 10:38 AM


What Effect Will Changes To The DSM-5 Have On People With (And Without) Mental Health Issues?

Alice G. Walton, Contributor | December 3, 2012

Family Practice News, Practice Trends

APA Approves Final DSM-5 Criteria

Mary Ellen Schneider | Family Practice News Digital Network | December 3,  2012


Psychiatric Group Approves New ASD Category

Autism & Asperger

Lee Wilkinson | December 3, 2012

Science Insider

Text of Divisive Psychiatric Manual Finalized

Greg Miller | December 3, 2012

Health News Review

Critic calls American Psychiatric Assoc. approval of DSM-V “a sad day for psychiatry”

Posted by Gary Schwitzer in Disease mongering, Evidence-based medicine | December 03, 2012

Psychology Today

Side Effects
From quirky to serious, trends in psychology and psychiatry

Christopher Lane, Ph.D. | December 2, 2012

A Disaster for Childhood Diagnoses

The next edition of the diagnostic manual will make a bad situation worse

The Board of Trustees of the American Psychiatric Association tried yesterday to project confidence in the next edition of its problem-plagued manual, assuring Americans that radical changes to the DSM “passed” all necessary hurdles and represented a “major milestone” for American psychiatry.

But DSM-5 is now certain to include highly controversial changes, including approval of Attenuated Psychosis Syndrome and Disruptive Mood Dysregulation Disorder—proposals that sparked widespread concern and skepticism when first circulated…

Medscape Medical News > Psychiatry

DSM-5 Gets APA’s Official Stamp of Approval

Caroline Cassels | December 2, 2012

The final diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has been approved by the leadership of the American Psychiatric Association (APA).

In an official communiqué released December 1 at 3:31 pm Eastern Time, the APA announced that its Board of Trustees approved the manual’s proposed criterial…


A relational view of DSM V: a care-rationing document?

Claudia M Gold | December 2, 2012

Because DSM V the newest version of the Diagnostic and Statistical manual, sometimes referred to as the “bible of psychiatry” set to come out in May 2013, makes no mention of relationships, the relational perspective is that it is a flawed instrument. The whole discussion about what categories should and should not be included is off the mark. Nonetheless, as it currently dictates who will and who will not receive treatment, it is a force to be reckoned with…

Psychology Today Blogs

DSM5 in Distress

DSM 5 Is Guide Not Bible- Ignore Its Ten Worst Changes: APA approval of DSM-5 is a sad day for psychiatry.

Allen J Frances MD | December 2, 2012

This is the saddest moment in my 45 year career of studying, practicing, and teaching psychiatry. The Board of Trustees of the American Psychiatric Association has given its final approval to a deeply flawed DSM 5 containing many changes that seem clearly unsafe and scientifically unsound. My best advice to clinicians, to the press, and to the general public – be skeptical and don’t follow DSM 5 blindly down a road likely to lead to massive over-diagnosis and harmful over-medication. Just ignore the ten changes that make no sense.

Brief background. DSM 5 got off to a bad start and was never able to establish sure footing. Its leaders initially articulated a premature and unrealizable goal- to produce a paradigm shift in psychiatry. Excessive ambition combined with disorganized execution led inevitably to many ill conceived and risky proposals.

These were vigorously opposed. More than fifty mental health professional associations petitioned for an outside review of DSM 5 to provide an independent judgment of its supporting evidence and to evaluate the balance between its risks and benefits. Professional journals, the press, and the public also weighed in- expressing widespread astonishment about decisions that sometimes seemed not only to lack scientific support but also to defy common sense.

DSM 5 has neither been able to self correct nor willing to heed the advice of outsiders. It has instead created a mostly closed shop- circling the wagons and deaf to the repeated and widespread warnings that it would lead to massive misdiagnosis. Fortunately, some of its most egregiously risky and unsupportable proposals were eventually dropped under great external pressure (most notably ‘psychosis risk’, mixed anxiety/depression, internet and sex addiction, rape as a mental disorder, ‘hebephilia’, cumbersome personality ratings, and sharply lowered thresholds for many existing disorders). But APA stubbornly refused to sponsor any independent review and has given final approval to the ten reckless and untested ideas that are summarized below.

The history of psychiatry is littered with fad diagnoses that in retrospect did far more harm than good. Yesterday’s APA approval makes it likely that DSM 5 will start a half or dozen or more new fads which will be detrimental to the misdiagnosed individuals and costly to our society.

The motives of the people working on DSM 5 have often been questioned. They have been accused of having a financial conflict of interest because some have (minimal) drug company ties and also because so many of the DSM 5 changes will enhance Pharma profits by adding to our already existing societal overdose of carelessly prescribed psychiatric medicine. But I know the people working on DSM 5 and know this charge to be both unfair and untrue. Indeed, they have made some very bad decisions, but they did so with pure hearts and not because they wanted to help the drug companies. Their’s is an intellectual, not financial, conflict of interest that results from the natural tendency of highly specialized experts to over value their pet ideas, to want to expand their own areas of research interest, and to be oblivious to the distortions that occur in translating DSM 5 to real life clinical practice (particularly in primary care where 80% of psychiatric drugs are prescribed).

The APA’s deep dependence on the publishing profits generated by the DSM 5 business enterprise creates a far less pure motivation. There is an inherent and influential conflict of interest between the DSM 5 public trust and DSM 5 as a best seller. When its deadlines were consistently missed due to poor planning and disorganized implementation, APA chose quietly to cancel the DSM 5 field testing step that was meant to provide it with a badly needed opportunity for quality control. The current draft has been approved and is now being rushed prematurely to press with incomplete field testing for one reason only- so that DSM 5 publishing profits can fill the big hole in APA’s projected budget and return dividends on the exorbitant cost of 25 million dollars that has been charged to DSM 5 preparation.

This is no way to prepare or to approve a diagnostic system. Psychiatric diagnosis has become too important in selecting treatments, determining eligibility for benefits and services, allocating resources, guiding legal judgments, creating stigma, and influencing personal expectations to be left in the hands of an APA that has proven itself incapable of producing a safe, sound, and widely accepted manual.

New diagnoses in psychiatry are more dangerous than new drugs because they influence whether or not millions of people are placed on drugs- often by primary care doctors after brief visits. Before their introduction, new diagnoses deserve the same level of attention to safety that we devote to new drugs. APA is not competent to do this.

So, here is my list of DSM 5’s ten most potentially harmful changes. I would suggest that clinicians not follow these at all (or, at the very least, use them with extreme caution and attention to their risks); that potential patients be deeply skeptical, especially if the proposed diagnosis is being used as a rationale for prescribing medication for you or for your child; and that payers question whether some of these are suitable for reimbursement. My goal is to minimize the harm that may otherwise be done by unnecessary obedience to unwise and arbitrary DSM 5 decisions.

1) Disruptive Mood Dysregulation Disorder: DSM 5 will turn temper tantrums into a mental disorder- a puzzling decision based on the work of only one research group. We have no idea whatever how this untested new diagnosis will play out in real life practice settings, but my fear is that it will exacerbate, not relieve, the already excessive and inappropriate use of medication in young children. During the past two decades, child psychiatry has already provoked three fads- a tripling of Attention Deficit Disorder, a more than twenty-times increase in Autistic Disorder, and a forty-times increase in childhood Bipolar Disorder. The field should have felt chastened by this sorry track record and should engage itself now in the crucial task of educating practitioners and the public about the difficulty of accurately diagnosing children and the risks of over- medicating them. DSM 5 should not be adding a new disorder likely to result in a new fad and even more inappropriate medication use in vulnerable children.

2) Normal grief will become Major Depressive Disorder, thus medicalizing and trivializing our expectable and necessary emotional reactions to the loss of a loved one and substituting pills and superficial medical rituals for the deep consolations of family, friends, religion, and the resiliency that comes with time and the acceptance of the limitations of life.

3) The everyday forgetting characteristic of old age will now be misdiagnosed as Minor Neurocognitive Disorder, creating a huge false positive population of people who are not at special risk for dementia. Since there is no effective treatment for this ‘condition’ (or for dementia), the label provides absolutely no benefit (while creating great anxiety) even for those at true risk for later developing dementia. It is a dead loss for the many who will be mislabeled.

4) DSM 5 will likely trigger a fad of Adult Attention Deficit Disorder leading to widespread misuse of stimulant drugs for performance enhancement and recreation and contributing to the already large illegal secondary market in diverted prescription drugs.

5) Excessive eating 12 times in 3 months is no longer just a manifestation of gluttony and the easy availability of really great tasting food. DSM 5 has instead turned it into a psychiatric illness called Binge Eating Disorder.

6) The changes in the DSM 5 definition of Autism will result in lowered rates- 10% according to estimates by the DSM 5 work group, perhaps 50% according to outside research groups. This reduction can be seen as beneficial in the sense that the diagnosis of Autism will be more accurate and specific- but advocates understandably fear a disruption in needed school services. Here the DSM 5 problem is not so much a bad decision, but the misleading promises that it will have no impact on rates of disorder or of service delivery. School services should be tied more to educational need, less to a controversial psychiatric diagnosis created for clinical (not educational) purposes and whose rate is so sensitive to small changes in definition and assessment.

7) First time substance abusers will be lumped in definitionally in with hard core addicts despite their very different treatment needs and prognosis and the stigma this will cause.

8) DSM 5 has created a slippery slope by introducing the concept of Behavioral Addictions that eventually can spread to make a mental disorder of everything we like to do a lot. Watch out for careless overdiagnosis of internet and sex addiction and the development of lucrative treatment programs to exploit these new markets.

9) DSM 5 obscures the already fuzzy boundary been Generalized Anxiety Disorder and the worries of everyday life. Small changes in definition can create millions of anxious new ‘patients’ and expand the already widespread practice of inappropriately prescribing addicting anti-anxiety medications.

10) DSM 5 has opened the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings.

DSM 5 has dropped its pretension to being a paradigm shift in psychiatric diagnosis and instead (in a dramatic 180 degree turn) now makes the equally misleading claim that it is a conservative document that will have minimal impact on the rates of psychiatric diagnosis and in the consequent provision of inappropriate treatment. This is an untenable claim that DSM 5 cannot possibly support because, for completely unfathomable reasons, it never took the simple and inexpensive step of actually studying the impact of DSM on rates in real world settings.

Except for autism, all the DSM 5 changes loosen diagnosis and threaten to turn our current diagnostic inflation into diagnostic hyperinflation. Painful experience with previous DSM’s teaches that if anything in the diagnostic system can be misused and turned into a fad, it will be. Many millions of people with normal grief, gluttony, distractibility, worries, reactions to stress, the temper tantrums of childhood, the forgetting of old age, and ‘behavioral addictions’ will soon be mislabeled as psychiatrically sick and given inappropriate treatment.

People with real psychiatric problems that can be reliably diagnosed and effectively treated are already badly shortchanged. DSM 5 will make this worse by diverting attention and scarce resources away from the really ill and toward people with the everyday problems of life who will be harmed, not helped, when they are mislabeled as mentally ill.

Our patients deserve better, society deserves better, and the mental health professions deserve better. Caring for the mentally ill is a noble and effective profession. But we have to know our limits and stay within them.

DSM 5 violates the most sacred (and most frequently ignored) tenet in medicine- First Do No Harm! That’s why this is such a sad moment.

UK Guardian

Asperger’s syndrome dropped from psychiatrists’ handbook the DSM

December 3, 2012


DSM-5, latest revision of Diagnostic and Statistical Manual, merges Asperger’s with autism and widens dyslexia category

Asperger’s syndrome is to be dropped from the psychiatrists’ Diagnostic and Statistical Manual (DSM) of Mental Disorders, the American publication that is one of the most influential references for the profession around the world.

The term “Asperger’s disorder” will not appear in the DSM-5, the latest revision of the manual, and instead its symptoms will come under the newly added “autism spectrum disorder”, which is already used widely. That umbrella diagnosis will include children with severe autism, who often do not talk or interact, as well as those with milder forms…

The Australian

Parents fear loss of autism funding

Dan Box | December 3, 2012

THE diagnosis of Asperger’s syndrome is being dropped from the world-leading US medical manual of psychiatric conditions, in a decision that could affect the support and funding available to thousands of Australian families.

The decision is among the first major revisions to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders since 1994…

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Media coverage

Huffington Post

DSM-5: Psychiatrists OK Vast Changes To Diagnosis Manual

Lindsey Tanner | December 1, 2012

CHICAGO — For the first time in almost two decades the nation’s psychiatrists are changing the guidebook they use to diagnose mental disorders. Among the most controversial proposed changes: Dropping certain familiar terms like Asperger’s disorder and dyslexia and calling frequent, severe temper tantrums a mental illness.

The board of trustees for the American Psychiatric Association voted Saturday in suburban Washington, D.C., on scores of revisions that have been in the works for several years. Details will come next May when the group’s fifth diagnostic manual is published.

The trustees made the final decision on what proposals made the cut; recommendations came from experts in several task force groups assigned to evaluate different mental illnesses…

MedPage Today

DSM-5 Wins APA Board Approval

John Gever, Senior Editor | December 1, 2012

The American Psychiatric Association’s board of trustees has approved the fifth edition of its influential diagnostic manual, dubbed DSM-5, the group announced Saturday.

The board vote is the last step before the manual is formally released at the APA’s annual meeting next May. The association’s Diagnostic and Statistical Manual of Mental Disorders was last revised in 1994; that edition is known colloquially as DSM-IV…

Dyslexia is out of DSM-5: Psychiatrists voted Saturday, Dec. 1, 2012

Tina Burgess | December 1, 2012

On Saturday, Dec. 1, 2012, the board of trustees of the American Psychiatric Association voted in Washington, D.C., that the term “dyslexia” will be eliminated from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

According to Saturday’s The Seattle Times report, “Board members were tightlipped about the update, but its impact will be huge, affecting millions of children and adults worldwide.”

Eliminating the term “dyslexia” from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has major implications for students with dyslexia…


Psychiatric association approves changes to diagnostic manualCNN International

Miriam Falco, CNN Medical Managing Editor | December 2, 2012

(CNN) — Starting next year, the process of diagnosing autism may see drastic changes following the revision of the official guide to classifying psychiatric illnesses.

After years of reviewing and refining criteria used by psychiatrists and other experts to diagnose mental health disorders, the American Psychiatric Association board of trustees on Saturday approved major changes to the manual, better known as DSM-5…

Dallas Morning News

Asperger’s to be removed from revised edition of American Psychiatric Association’s diagnostic manual

Associated Press The Dallas Morning News

Published: 02 December 2012 12:59 AM

CHICAGO — The now familiar term “Asperger’s disorder” is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But “dyslexia” and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation’s psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association’s new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education….

Wall Street Journal


Psychiatric Association’s Diagnosis Revisions Seen Upending Evaluations

Melinda Beck | December 1, 2012

Asperger’s syndrome is out and hoarding is in, and starting next year, psychiatrists may diagnose some children with a new “disruptive mood dysregulation disorder” if they have severe tantrums three or more times a week for more than a year.

After more than a decade of discussion and often heated debate, the Board of Trustees of the American Psychiatric Association voted Saturday in Arlington, Va., to approve the fifth edition of the group’s “Diagnostic and Statistical Manual for Mental Disorders” or DSM-5, the official guide to classifying psychiatric illnesses.

The changes – the first major revisions since 1994 — could…

Exclusive subscriber content – sub required to view full commentary.

USA Today

Psychiatrists to make vast changes to diagnosis manual

Sharon Jayson | December 2, 212

Manual also is important for the health insurance industry in deciding what treatments to cover.

7:58 PM EST December 1. 2012 – Asperger’s is out, but binge eating and hoarding are in as official mental disorders in the latest version of the diagnostic bible published by the American Psychiatric Association, following a vote Saturday by that group’s board…

Bloomberg Businessweek – News from Business

Psychiatrists Redefine Disorders Including Autism

Elizabeth Lopatto | December 2, 2012

The vote yesterday by the American Psychiatric Association was alternately called “a disaster” by Allen Frances, who led work on the previous version, and a “conservative document” by David Kupfer, who led the panel that presented the latest edition…

Detroit Free Press

Psychiatric group changing mental illness diagnoses

Lyndsey Tanner | December 2, 2012

The board of trustees for the American Psychiatric Association voted Saturday in suburban Washington, D.C., on scores of revisions that have been in the works for several years. Details will come in May, when the group’s fifth diagnostic manual is published…

Decoded Science

Diagnostic and Statistical Manual V: Small Changes with Big Implications

Gina Putt | December 1, 2012

The American Psychiatric Association’s timeline calls for the ”Final Revisions by the APA Task Force; Final Approval by APA Board of Trustees; Submission to American Psychiatric Publishing, Inc..” in December of 2012. This edition, the fifth, attempts to further…

NPR (blog)

Weekend Vote Will Bring Controversial Changes To Psychiatrists’ Bible

Alix Spiegel | ‎November 30, 2012‎

…The APA refuses to say anything about what’s in and what’s out, and they’ve also told people associated with the DSM-5 that they shouldn’t speak specifically, so it’s very hard to know. But some of the changes that were published last year on the APA website…

From Ben Carey, NYT, November 26

Thinking Clearly About Personality Disorders

Benedict Carey | November 26, 2012 | 355 Comments

This weekend the Board of Trustees of the American Psychiatric Association will vote on whether to adopt a new diagnostic system for some of the most serious, and striking, syndromes in medicine: personality disorders.

Personality disorders occupy a troublesome niche in psychiatry. The 10 recognized syndromes are fairly well represented on the self-help shelves of bookstores and include such well-known types as narcissistic personality disorder, avoidant personality disorder, as well as dependent and histrionic personalities.

But when full-blown, the disorders are difficult to characterize and treat, and doctors seldom do careful evaluations, missing or downplaying behavior patterns that underlie problems like depression and anxiety in millions of people.

The new proposal — part of the psychiatric association’s effort of many years to update its influential diagnostic manual — is intended to clarify these diagnoses and better integrate them into clinical practice, to extend and improve treatment. But the effort has run into so much opposition that it will probably be relegated to the back of the manual, if it’s allowed in at all…

Clinical Psychiatry News

Neuroticism and the DSM-5: What Lies Ahead?


By: MICHAEL BRODSKY, M.D., Clinical Psychiatry News Digital Network

If substantive changes to the DSM-5 framework do not occur before publication, clinicians will be called upon to evaluate personality using dimensional measures in addition to the personality diagnostic categories familiar to psychiatrists from the DSM-IV.

In this article, I want to consider the personality dimension of neuroticism, a construct with a long tradition of research and considerable evidence of both internal and external validity (Am. Psychol. 2009;64:241-56). Recent epidemiologic findings suggest that scores along this dimension may carry important clinical implications for mental and physical health…

Round-up: media coverage following Lancet’s criticism of DSM-5 proposals for grief

Round-up: media coverage following Lancet’s criticism of DSM-5 proposals for grief

Post #144 Shortlink: http://wp.me/pKrrB-1V2

Previous Post #143:

Criticism of DSM-5 proposals for grief in this week’s Lancet: Editorial and Essay


Christopher Lane, Ph.D.:  Good Grief: The APA Plans to Give the Bereaved Two Weeks to Conclude Their Mourning, Britain’s “Lancet” calls the proposal “dangerously simplistic and flawed.”

Allen Frances, MD: Lancet Rejects Grief As a Mental Disorder, Will DSM 5 Finally Drop This Terrible Idea




Libby Purves, columnist and author, lost a son in his late teens to suicide.

The Times

Why must grief be a sign of mental illness?

Libby Purves | February 20, 2012

Treating the bereaved for depression after two weeks typifies our urge to medicalise everyday experience…

Content behind sub or paywall



From Medscape Medical News > Psychiatry

Lancet Weighs in on DSM-5 Bereavement Exclusion

Megan Brooks | February 16, 2012

February 16, 2012 — An editorial that appears in this week’s Lancet expresses concerns about the proposed elimination of the bereavement exclusion to major depression in the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) from the American Psychiatric Association (APA)…

Read on


Daily Mail

Lancet urges doctors to treat grief with empathy, not pills

Lauren Paxman | February 17, 2012

‘Grief is not a mental illness that should be treated with pills’: Doctors hit back at creeping medicalisation of life events

Treatment of grief with antidepressants is ‘dangerously simplistic’, experts say

Backlash follows the American Psychiatric Association’s reclassification of grief as a mental illness. In an unsigned editorial in the influential medical journal The Lancet, experts argue that grief does not require psychiatrists and that ‘legitimising’ the treatment of grief with antidepressants ‘is not only dangerously simplistic, but also flawed.’ 

Read on


ABC News Radio

February 17, 2012

Grief: Normal, Not A Mental Illness

(NEW YORK) — Grief following the death of a loved one isn’t a mental illness that requires psychiatrists and antidepressants, according to editors of The Lancet, who oppose “medicalizing” an often-healing response to overwhelming loss.

Routinely legitimizing the treatment of grief with antidepressants “is not only dangerously simplistic, but also flawed,” says the unsigned lead editorial appearing in Friday’s edition of the influential international medical journal. “Grief is not an illness; it is more usefully thought of as part of being human and a normal response to the death of a loved one.”

Read On


The Australian

Individual difference suffers in the neverending explosion of mental illness

Frank Furedi | February 18, 2012

YOU may be suffering from a mental illness that you never realised existed. The American Psychiatric Association has just published a draft version of the updated edition of its Diagnostic and Statistical Manual. According to this diagnostic bible, called DSM-5, shyness in children and confusion over gender is likely to be labelled as a mental disorder.

Read on for subscribers




Good Grief! Psychiatry’s Struggle to Define Mental Illness Goes Awry

A proposed new definition of depression would include normal bereavement. Why that’s a bad idea.

Maia Szalavitz | @maiasz | February 17, 2012

The editors of the forthcoming fifth edition of the Diagnostic and Statistical Manual — psychiatry’s diagnostic handbook — are having a hard time. They’ve been attacked by autism advocacy groups for proposing to eliminate the Asperger’s diagnosis. They’ve been slammed for adding a diagnosis, or “prediagnosis,” for people determined to be “at high risk” of developing schizophrenia. And, now, they’re being pummeled for introducing a provision to diagnose grief as depression…

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Grief is not an illness, warns The Lancet

Stephen Adams Medical Correspondent | February 17, 2012

Bereaved relatives overcome by grief should not be given pills and treated as if they are clinically depressed, a leading medical journal warns today (Fri).

“Grief is not an illness”, say the journal’s editors in an impassioned editorial, which argues that “medicalising” such a normal human emotion is “not only dangerously simplistic, but also flawed”.

Doctors tempted to prescribe pills “would do better to offer time, compassion, remembrance and empathy”, they write.

The editors are worried by moves which appear to categorise extreme emotions as problems that need fixing.

Their fears have been prompted by the publication of a new draft version of the psychiatrists’ ‘bible’, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5…

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Inside Ireland

The Lancet: Grief is not an illness

Sarah Greer | February 17, 2012

A leading medical journal has today warned that bereaved relatives should not be given pills and treated as if they are clinically depressed.

“Grief is not an illness,” the journal’s editors say. They argue that ‘medicalising’ such a normal human emotion is ‘not only dangerously simplistic, but also flawed’, and say doctors who are tempted to prescribe pills ‘would do better to offer time, compassion, remembrance and empathy’.

The editors are worried by moves which appear to categorise extreme emotions as problems that need fixing…

Read on


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