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art
1903 Posts |
 Posted - 06/12/2013 : 15:43:54
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When I was a psychology student back in the stone age, we were already laughing at what was then the DSM 3 I believe. Homosexuality by that time was no longer an official psychiatric disorder, but most people thought of it as one. If one were looking for something emblematic of the arrogance and wrong-headedness of the psychiatric profession, one need look no further than their approach to gay patients back in those days, and well beyond in many cases.
It was around that time I read Thomas Szasz and I began to understand the fundamental illogic of treating "disorders" of thought and behavior as if they were actual physical illnesses. Of course, that has added resonance for us mind/body explorers.
Anyway, I think it's safe to say that the practice of psychiatry has caused more misery than it has relieved.
I hope someday we will be taking a more practical approach to mental health (we should always bear in mind we're talking metaphorically here. It's easy to get mixed up otherwise.) by talking more about happiness and fulfillment and its lack, rather than in terms of illness and symptoms...So many people in the world are unhappy. I think it's the price of modernity. It's not people who are sick nearly so much as our false and alienating materialistic society. |
Edited by - art on 06/12/2013 16:01:08 |
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pspa123
672 Posts |
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pspa123
672 Posts |
Posted - 06/12/2013 : 16:43:14
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| To me the very words, Intermittent Explosive Disorder, are absurd. Some people have a bad temper. That does not rate them a psychiatric diagnosis, in my ever so humble opinion. And whether or not Mother Jones is reliable, the interviewee said what he said and as the author of DSM IV I think his opinion is entitled to consideration. |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 16:56:46
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quote:
Originally posted by pspa123
Grief and depression in DSM 5.
http://www.nejm.org/doi/full/10.1056/NEJMp1201794
The actual DSM-5 is out and published. It's a lot safer to reference the actual publication rather than a description from a year ago of what some people had proposed, as much was proposed and changed over that time. |
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pspa123
672 Posts |
Posted - 06/12/2013 : 16:58:58
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| The two month window was in fact removed. |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 16:59:16
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quote:
Originally posted by pspa123
To me the very words, Intermittent Explosive Disorder, are absurd. Some people have a bad temper. That does not rate them a psychiatric diagnosis, in my ever so humble opinion.
This category was designed to address a prototype situation where a man loses job after job because he explodes in meetings or to the boss and is concerned about his now ruined career. Do you think that is a problem? A disorder? That some changes in the criteria are needed, or do you just dislike the name? |
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pspa123
672 Posts |
Posted - 06/12/2013 : 17:02:40
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| Lots of things are problems. That does not make them psychiatric disorders with a diagnostic code, treatment plan and prescription. If you don't believe there is a difference, then we should just agree to disagree because our philosophies are irreconcilable. |
Edited by - pspa123 on 06/12/2013 17:03:09 |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 17:09:09
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quote:
Originally posted by pspa123
The two month window was in fact removed.
Yes, because a person can be grieving and depressed. The footnote still states that normal grieving, which is considered a minimum of year if you check Persistent Complex Bereavement, is similar in appearance but not the same thing. All they did was remove the hard time frame requirement and offer flexibility in diagnosis. If you check the note it makes specific reference to the varied cultural norms for distress in recognition that this is a diverse experience and may be longer for some, shorter for other cultures. I could argue both sides of having a time frame and I would certainly not jump to judge either as an effort to diagnose the bereaved with major depression. |
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pspa123
672 Posts |
Posted - 06/12/2013 : 17:10:50
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So you dismiss the critique in the New England Journal of Medicine? They are not exactly Mother Jones.
"Unfortunately, the effect of this proposed change would be to medicalize normal grief and erroneously label healthy people with a psychiatric diagnosis. And it will no doubt be a boon to the pharmaceutical industry, because it will encourage unnecessary treatment with antidepressants and antipsychotics, both of which are increasingly used to treat depression and anxiety.
Nor will this change help practitioners deal with the common dilemma presented by the bereaved patient with mild depressive symptoms — the question of how to tell whether such a patient is heading toward major depression or should be left alone to grieve. The answer is often not clear after a first visit, in which case a period of watchful waiting is reasonable. If the symptoms persist or intensify, a diagnosis of clinical depression becomes more likely."
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Edited by - pspa123 on 06/12/2013 17:12:05 |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 17:12:21
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quote:
Originally posted by pspa123
Lots of things are problems. That does not make them psychiatric disorders with a diagnostic code, treatment plan and prescription. If you don't believe there is a difference, then we should just agree to disagree because our philosophies are irreconcilable.
The DSM is a diagnostic manual; it does not include any recommendations for treatment.
"DSM-5 is a manual for assessment and diagnosis of mental disorders and does not include information or guidelines for treatment of any disorder. That said, determining an accurate diagnosis is the first step toward being able to appropriately treat any medical condition, and mental disorders are no exception. DSM-5 will also be helpful in measuring the effectiveness of treatment, as dimensional assessments will assist clinicians in assessing changes in severity levels as a response to treatment. "
http://www.dsm5.org/about/pages/faq.aspx#7
As I mentioned before, psychologists, counselors and social workers all use this same system and they don't (with a couple of very small exceptions) write prescriptions. |
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pspa123
672 Posts |
Posted - 06/12/2013 : 17:14:34
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"As I mentioned before, psychologists, counselors and social workers all use this same system and they don't (with a couple of very small exceptions) write prescriptions."
And how often, do you think, they refer to doctors who do? I have seen this myself on multiple occasions. |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 17:27:39
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quote:
Originally posted by pspa123
So you dismiss the critique in the New England Journal of Medicine?
I read the article and it looked like they were commenting on a different revision, but without the exact text of the proposal from a year ago I can't really tell what they are looking at. If you have a comment on the actual publication version I'll look at it. |
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pspa123
672 Posts |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 20:12:21
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quote:
Originally posted by pspa123
http://psychcentral.com/blog/archives/2012/01/07/why-psychiatry-needs-to-scrap-the-dsm-system-an-immodest-proposal/
It's hard to disagree with that guy's basic argument that one shouldn't treat the DSM as a bible, but other than researchers who need a standardized population I doubt many in practice do (the author himself recognizes this). Perhaps if a separate set of research categories is developed as proposed by the NIMH that will allow the DSM to experiment with formats that might be able to worry less about the research value and be more "practical". It remains to be seen what that would mean, however. |
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altherunner
Canada
511 Posts |
Posted - 06/12/2013 : 21:50:58
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| OMG, love your abbreviations. drop in again, TTFN! |
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DSM 5 out -Somatic Symptom Disorder
