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...American Psychiatric Association (APA), which publishes the DSM, has long wanted the fifth version to be a more rational, understandable document, but that's not proving to be easy. Publication has been delayed at least twice, and the association now doesn't expect to produce DSM-5 until 2013, 14 years after research on it began. One reason is that there are so many stakeholders: patients, shrinks, HMOs, academics. Patients want their illnesses covered; shrinks need to get paid academics want definitions to be consistent with research - research that is itself uneven. Sometimes, DSM changes can be made...
Maybe. One method might be to write diagnostic criteria for depression that are sharper than the loose catalog of symptoms used today. The current Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association (APA), lists such vague symptoms as "fatigue" and "indecisiveness" as possible markers of depression. And while the definition must be broad enough to encompass a disease that manifests in many different ways in many different patients, even mental-health specialists hotly debate what constitutes true depression. A commentary in the Lancet accompanying the new paper asks, "If the diagnosis of depression cannot...
...large contingent of APA specialists is currently rewriting the diagnostic manual, but the revision won't be out until at least 2012. In the meantime, most people will probably continue to use their general physician for front-line psychiatric care. That may be preferable to not seeking care at all, but for high-risk patients - such as those who have a family history of depression, recent stressful life events, chronic illness or substance abuse - it would be wiser to seek specialized attention...
...long? Last week, a research organization called the American Psychopathological Association (which goes by the acronym APPA, to distinguish it from the APA) brought many of the key players in the development of the DSM-V to a conference in New York City to discuss some of the reasons the writing of the book is so complicated...
...obvious reason is that so many people have a stake in what the world defines as crazy and what it calls normal. Famously, homosexuality was listed as a DSM condition until a 1974 vote among APA members removed it. Other groups of mental-health professionals and patients want certain disorders to be added (and covered by insurance): sexual compulsivity, for instance, is not in the DSM, even though "sexual aversion disorder" (302.79) - the persistent and distressing avoidance of genital contact not explained by another disorder like depression - is included. (Read an interview with an author who has bipolar disorder...