Monday’s Mtg: What Is a Psychiatric Disorder?

What constitutes a psychiatric disorder has always been somewhat controversial.  (Homosexuality was considered one until 1973.)  The mental health profession uses the Diagnosis and Statistical Manual of Mental Disorders (DSM) to define mental disorders, and a major revision to the manual has just been completed.  Apparently it’s very controversial.  The guy who headed the last revision called the day the new team voted on the recent revision the “worst day” of his professional career.  DMS-5 made “vast” changes to the definition of a mental disorder, and a lot of people thought they made some bad inclusions and exclusions.  For example, hoarding is now a mental disorder and Asperger’s Syndrome no longer is.

Don’t even think this isn’t important.  The DSM affects what insurance companies will pay for and gives science’s imprimatur to an illness.  What’s considered a mental illness and what is not arguably affects more people than a lot of the topics we discuss.  The greatly expanded DSM-5’s definitions mean that millions of Americans will either (1) be labelled as mentally ill when they are not, or (2) will ge the help they need, depending on one’s point of view.

Also, I think this topic raises broader questions about medical care and how science should operate when it intersects with politics.  Given that science is under assault from both Right (climate change, evolution) and Left (vaccines, other junk science), I’m glad we’re doing a science topic again.

Bruce suggested this topic and, as our resident (ha) doctor, he will  present and run the meeting.  Below are some basic discussion questions and some links that I suggest we all try to read.
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DISCUSSION QUESTIONS –

  1. What is the DSM and how is it revised?  Who gets to make these decisions and what is the process?
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  2. What big changes were made to DSM-5 and why were they controversial?
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  3. When should laypeople second guess the judgments of the scientific community?  Is “never” really the right answer?
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  4. What kinds of political pressures is science – and especially medicine – subject to?  Is this really so bad?  What can be done?

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LINKS –

  • DSM-5 entry at Wiki.  Summarizes major changes and the basic controversy.
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  • Brief news account of the controversy over DSM-5.
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  • Long Scientific American article explains whole thing.
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  • In Psychology Today, the “worst day of my life” guy explains his objections  – but also the limits to the damage the new DSM may inflict.
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  • Honestly, I had trouble finding a defense of the revisions, but there are two sides to everything.  Bruce, do you know of any or have any other links?  Put them in comments and I’ll elevate them to this spot.
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Take a chill pill and join us there!

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