Sunday 12 May 2013

Why the DSM-V is dividing psychiatry (and why you need to know this)

It's not strictly in the syllabus, but if you can fit this seamlessly into an exam question on diagnosing dysfunctional behaviour or disorders, then no doubt the examiner will be impressed.

If you've got a spare ten minutes, check out this article from the New Scientist on opposition to the DSM-V, and why the National Institute of Mental Health has withdrawn its support to the publication of the DSM-V. If not, read my very much condensed summary below.

The DSM-V is due out later this month (May 2013), replacing the current DSM-IV that's been around since the mid-1990s. Essentially, there's been a lot of complaints about the amount of reliance, by both the medical profession and researchers alike, on a psychiatry "bible". 

The main issue is that it's purely symptomatic - it ignores the biological nature of disorders.

Those who advocate psychology as a science want the biological and physical aspects of psychological disorders to be taken into account so that subjectivity isn't such an issue. They use the comparison of being diagnosed with physical illnesses such as cancer on the basis of self-report alone, rather than being screened and tested. (Though, note that not all "physical" illnesses can be tested for, such as IBS). 

Some of the more radical people want the DSM completely scrapped in favour of a biological approach to diagnosis, such as depression being diagnosed on the basis of serotonin, or schizophrenia after dopamine levels have been analysed. Others merely want both symptoms and biology to play a part in diagnosis.

Whatever you think is the right decision, including this in your G543 paper would show your interest in the subject, and could be a valuable evaluation point which makes the examiners stand up and take note. 

3 comments:

  1. I thought that the ICD was the more symptom-based one?!

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    Replies
    1. Both require symptoms in order for a diagnosis.

      The reason the ICD is sometimes thought to be MORE symptom based is because the ICD looks at symptoms in isolation, whilst the DSM looks at symptoms to do with the disorder, as well as environmental factors and general health.

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