A new diagnosis will turn millions of people into mentally ill
A new fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a classification of psychiatric disorders used worldwide and developed by specialists of the American Psychiatric Association, is scheduled to enter into force in May of this year. In the new fifth edition of the manual, a new category will appear – the so-called "somatic symptom disorder" (somatic symptom disorder).
The new category will expand the range of classification of mental disorders by eliminating the requirement that somatic symptoms "should not have a medical explanation." In the DSM-5, the emphasis shifts to an "excessive" reaction to painful chronic somatic symptoms accompanied by "dysfunctional thoughts, feelings or behavior."
However, the head of the current (according to the DSM-4) commission, Allen Frances, warns that the introduction of a definition of a violation of the perception of somatic symptoms in the DSM-5 may lead to incorrect diagnoses of mental disorders and, accordingly, incorrect medical decisions.
His worries are not unfounded. The results of the DSM-5 trials in clinical conditions showed that 15% of patients with oncological diseases and heart diseases, as well as 26% of patients with irritable bowel syndrome and fibromyalgia fall under the diagnosis of "impaired perception of somatic symptoms". Moreover, when examining healthy people in the general population, the new diagnosis was characterized by an extremely high level of false positive diagnostic results, amounting to 7%.
Every decision leading to a diagnosis should be based on determining the delicate balance between over- and under-diagnosis. At the same time, Frances believes that the developers of the DSM-5 have chosen too ambiguous and non-specific definition. He states that clinicians are better off ignoring the emergence of this new category. In cases where a person expresses excessive concern about his medical problems, a milder and at the same time accurate diagnosis is "adaptation disorder".
The article by A. Frances The new somatic symptom disorder in DSM-5 risks mislabeling many people as mentally ill is published in the British Medical Journal.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on BMJ materials:
New disorder could classify millions of people as mentally ill.
Portal "Eternal youth" http://vechnayamolodost.ru26.03.2013