DSM-5 Round up: April #1

DSM-5 Round up: April #1

Post #231 Shortlink: http://wp.me/pKrrB-2In

New York Post

A disease called ‘childhood’

Do 1 in 5 NYC preteens really suffer a mental woe? A psychiatry expert argues we’re overdiagnosing —and overmedicating — our kids

Allen Frances MD | March 30, 2013

Last week, The Post reported that more than 145,000 city children struggle with mental illness or other emotional problems. That estimate, courtesy of New York’s Health Department, equals an amazing 1 in 5 kids. Could that possibly be true?

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BBC Radio 4

http://www.bbc.co.uk/programmes/b01rl1q8

Medicalising Grief

Will the book that classifies mental illness lead to the medicalisation of grief?

Presented by Matthew Hill. Featuring Drs Jerome Wakefield, Lisa Cosgrove, Allen Frances (Chaired the Task Force for DSM-IV), Joanne Cacciatore and Gary Greenberg.

Available to listen again for the next 7 days online.

Counseling Today ACA podcasts help counselors prepare for DSM-5

Heather Rudow | March 27, 2013

Rebecca Daniel-Burke, ACA’s [American Counseling Association]director of professional projects and staff liaison to ACA’s DSM-5 Task Force, hosts the podcast series, which offers counselors a way to prepare for and understand potential changes. Daniel-Burke spoke with K. Dayle Jones for the first, 38-minute podcast, and Jason King for the second, which is 52 minutes long and available for CE credit…

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The New York Times invited readers to respond for a dialogue about psychiatric diagnoses and the forthcoming DSM-5. The dialogue was initiated by a letter from Ronald Pies, which concludes “‘Diagnosis’ means knowing the difference between one condition and another. For many patients, learning the name of their disorder may relieve years of anxious uncertainty. So long as diagnosis is carried out carefully and respectfully, it may be eminently humanizing. Indeed, diagnosis remains the gateway to psychiatry’s pre-eminent goal of relieving the patient’s suffering.”

http://www.nytimes.com/2013/03/20/opinion/invitation-to-a-dialogue-psychiatric-diagnoses.html

Ronald Pies

Controversy surrounding the soon-to-be-released fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5 — often called “psychiatry’s bible” — has cast a harsh light on psychiatric diagnosis. For psychiatry’s more radical critics, psychiatric diagnoses are merely “myths” or “socially constructed labels.” But even many who accept the reality of, say, major depression argue that current psychiatric diagnoses often “stigmatize” or “dehumanize” people struggling with ordinary grief, stress or anxiety…

Published responses:

http://www.nytimes.com/2013/03/24/opinion/sunday/sunday-dialogue-defining-mental-illness.html

Letters
Sunday Dialogue: Defining Mental Illness

Response to Letters from Ronald Pies via Psychiatric Times

http://www.psychiatrictimes.com/blog/pies/content/article/10168/2135248

Diagnosis and its Discontents: The DSM Debate Continues

Ronald W. Pies, MD | 29 March 2013

Dr Pies is Editor-in-Chief Emeritus of Psychiatric Times, and a professor in the psychiatry departments of SUNY Upstate Medical University and Tufts University School of Medicine. He is the author of The Judaic Foundations of Cognitive Behavioral Therapy; a collection of short stories, Ziprin’s Ghost; and, most recently, a poetry chapbook, The Heart Broken Open. His most recent book is The Three-Petalled Rose: How the Synthesis of Judaism, Buddhism, and Stoicism Can Create a Healthy, Fulfilled and Flourishing Life (iUniverse: 2013).

“As to diseases, make a habit of two things—to help, or at least to do no harm.”
–Hippocrates, Epidemics, in Hippocrates, trans. W. H. S. Jones (1923), Vol. I, 165 [italics added]

“An agnostic is someone who doesn’t know, and di– is a Greek prefix meaning “two.” So “diagnostic” means someone who doesn’t know twice as much as an agnostic doesn’t know.”
–Walt Kelly, Pogo

A funny thing happened to me on the way to the New York Times “Sunday Dialogue” —I made myself unclear.¹ This is not supposed to happen to careful writers, or to those of us who flatter ourselves with that honorific. So what went wrong?

In brief, I greatly underestimated the public’s strong identification of psychiatric diagnosis with the categorical approach of the recent DSMs. But whereas my letter to the Times was indeed occasioned by DSM-5’s release in May, my argument in defense of psychiatric diagnosis was not a testimonial in favor of any one type of diagnostic scheme—categorical, dimensional, prototypical² or otherwise…

http://www.meactionuk.org.uk/The-Achilles-Heel.htm

Stephen Ralph | March 30, 2013

In recent years I have been considering the reliability of the whole “CFS/ME” diagnostic process.

From personal experience I have encountered numerous doctors who failed to possess the detailed specialist knowledge they needed to make a diagnosis of Behçet’s disease at both GP and specialist level.

From personal experience I have learned that standard blood tests or even CT/MRI scans or indeed other diagnostic tests such as endoscopy can and do fail to detect a complex clinical disease present in a patient.

I have no doubt that there is a diagnostic black hole between the insufficient knowledge of the doctor and pathologies that are not detectable by the basic tests they choose to request which produce negative results they then choose to rely on.

The diagnoses of “CFS/ME” and now Somatic Symptom Disorder have in my view been deployed by liaison psychiatry to exploit that black hole.

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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.”

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DSM-5 and ICD-10-CM Round up: February #3

DSM-5 and ICD-10-CM Round up: February #3

Post #227 Shortlink: http://wp.me/pKrrB-2FY

Updates:

American Psychiatric Association News release:

Release No. 13-11: February 28, 2013

APA Annual Meeting in San Francisco, May 18-22; DSM-5 to be Released

ARLINGTON, Va. (Feb. 28, 2013) – The American Psychiatric Association’s 166th Annual Meeting, the world’s largest psychiatric meeting, will run Saturday, May 18 to Wednesday, May 22, 2013 in San Francisco at the Moscone Convention Center. The much anticipated DSM-5, the latest revision of the Diagnostic and Statistical Manual of Mental Disorders, will be released at the meeting…

Clinical Psychiatry News Digital Network

DSM-5 expected to be more ‘user-friendly’

Doug Brunk | March 3, 2013

ABC News Radio

An edited version of the ABC News coverage of concerns for new DSM-5 disorder ‘Somatic Symptom Disorder’ that replaces four DSM-IV Somatoform Disorder categories has been published on ABC News Radio:

Guidelines for Diagnosing Psychiatric Disorder May Overlook Physical Illnesses

CMS pledges commitment to October 1, 2014 ICD-10-CM compliance:

Click link for PDF document   CMS letter

CMS: No Further Delays in ICD-10-CM/PCS Implementation

Chris Dimick | AHIMA & ICD-10 | February 27, 2013

The Centers for Medicare and Medicaid Services (CMS) will maintain their commitment to the current ICD-10-CM/PCS compliance date of October 1, 2014, according to a letter sent to AHIMA President Kathleen A. Frawley.

The letter was sent in response to AHIMA’s call for CMS to stand firm on its ICD-10 implementation date after more than 80 physician groups represented by the American Medical Association called on CMS in January to delay or abandon the ICD-10 conversion…

Susan Donaldson James reports for ABC News on DSM-5‘s ‘Somatic Symptom Disorder’:

Contributions from Allen Frances, MD, Joel E Dimsdale, MD (Chair, DSM-5 Somatic Symptom Disorder Work Group), Lori Chapo-Kroger (P.A.N.D.O.R.A), Suzy Chapman (Dx Revision Watch), Bridget Mildon (FND Hope) and Marianne Russo (The Coffee Klatch)

ABC News

New Psych Disorder Could Mislabel Sick as Mentally Ill

Susan Donaldson James | February 27, 2013

Critics worry that patients will be misdiagnosed as mentally ill and won’t get treatment, affecting mostly those with chronic and difficult to diagnose neurological disorders and multi-system diseases like ME/CFS, ones that are poorly understood and can take years to get medical answers.

“A lot of people will be written off as crocks — it’s just in their head,” said Dr. Allen Frances, who was chair of the task force that created the DSM-4 and professor emeritus of psychiatry at Duke University. “They won’t get the medical work-up they need.”

…But [SSD work group chair] Dimsdale defends the updated DSM…”If it doesn’t work, we’ll fix it in the DSM-5.1 or DSM-6.”

Robert Sibley, senior writer for Ottawa Citizen, comments on DSM-5‘s ”Somatic Symptom Disorder’:

Ottowa Citizen (and  a number of syndications)

Column: Is life itself a sickness in need of a cure?

Robert Sibley | February 20, 2013

…In a recent article, Postmedia’s Sharon Kirkey quotes a statement from the American Psychiatric Association, which will publish a new edition of the DSM in May: “Some patients with illnesses like heart disease or cancer will indeed experience thoughts, feelings or behaviours related to their illness that will be extreme or overwhelming.” These individuals “may qualify for an SSD diagnosis…”

Results of recent American Psychiatric Association Trustee elections:

Helio

APA releases election results

February 25, 2013

DSM-5 (published by American Psychiatric Publishing Inc.) is planned for release at the APA’s 166th Annual Meeting, in San Francisco (May 18-22).

Psychiatric News | February 15, 2013
Volume 48 Number 4 page 21-21
10.1176/appi.pn.2013.2b24

American Psychiatric Association
Annual Meeting Highlights

Sessions Will Provide In-Depth Look at New DSM

Kuhl Emily, Ph.D.

Sidney Zizook, M.D., who served as an advisor to the DSM-5′s Mood Disorder Work Group, defends the removal of the DSM ‘bereavement exclusion’:

Scientific American

Getting Past the Grief over Grief

Sidney Zisook | February 25, 2013

These days, I get a lot of grief about grief. I am part of the work group that changed some of the ways that grief and clinical depression are described and differentiated in the new Diagnostic and Statistical Manual of Mental Disorders, typically referred to as DSM-5. That has led to a lot of conversations with colleagues who are upset about bereavement…

Kupfer DJ, Regier DA, et al in JAMA ONLINE FIRST

JAMA ONLINE FIRST

DSM-5—The Future Arrived FREE ONLINE FIRST

David J. Kupfer, MD; Emily A. Kuhl, PhD; Darrel A. Regier, MD, MPH

Author Affiliations: University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania (Dr Kupfer); and American Psychiatric Institute for Research and Education, Division of Research, American Psychiatric Association, Arlington, Virginia (Drs Kuhl and Regier).

JAMA. 2013;():1-2. doi:10.1001/jama.2013.2298.
Published online February 25, 2013

Jerome C. Wakefield, PhD, DSW, for Psychiatry Weekly, on the DSM ‘bereavement exclusion’ issue:

Remember the Bereavement Exclusion

Psychiatric Weekly

Jerome C. Wakefield, PhD, DSW | February 18, 2013

School of Social Work, Department of Psychiatry; New York University, NY

First published in Psychiatry Weekly, Volume 8, Issue 4, February 18, 2013

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

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: