Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Sunday, April 7, 2013

DSM-5: Take My Survey, Please

Yup, it'll be here soon. I was hesitant to write about it, and I can barely call it by its name. Maybe if I don't say it, it'll disappear.
What convinced me to write about it was the dumb, completely irrelevant fact that it's going to be published on my birthday. And you can preorder it on Amazon for only $133.22.

Here's a list of some of the changes:

1. Asperger's subsumed under the heading of Autism Spectrum Disorder.
2. Inclusion of Binge Eating Disorder.
3. Bereavement exception removed from the diagnosis of depression.
4. Gender Identity disorder changes its name to, "Gender Dysphoria".
5. Addition of Disruptive Mood Regulation Disorder for children who display “persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.”
6. Inclusion of Hoarding and addition of Excoriation as individual diagnoses.
7. Substance Abuse and substance Dependence combined under the heading, "Substance Use Disorder."
8. Dissolution of the Multiaxial System. Axes I, II, and III are now combined, with separate notations for psychosocial and contextual factors (formerly Axis IV) and disability (formerly Axis V).
9. Chapters restructured based on disorders’ apparent relatedness to one another. These changes will align DSM-5 with the World Health Organization’s (WHO) International Classification of Diseases, eleventh edition (ICD-11).

I've been wondering about why I'm so wary of this new manual. Maybe because it's the "bible" of psychiatry, and reimbursement will be based on it, despite the sometimes nebulous scientific underpinnings of some of its content. Or maybe because it has the potential to pathologize normal elements of the human condition, such as grief following a loss, or temper tantrums during childhood.

And I wonder which of the changes will do the most harm. And which the most good.

What do you think? Please take the following 4 question survey. I'll post the results, and write in detail about whichever changes are the best and worst, in your opinion.