Saturday, May 12, 2012

The New Psychiatric Manual (DSM-5) Will Make You Crazy | Independent Sentinel

The New Psychiatric Manual (DSM-5) Will Make You Crazy | Independent Sentinel

The New Psychiatric Manual (DSM-5) Will Make You Crazy

May 12, 2012
By
That’s right, Mr. Martini. There is an Easter Bunny.
~ McMurphy in One Flew Over A Cuckoos Nest
Under the new psychiatric guidelines, the man in the lampshade will qualify for mental health care and medication. If he doesn’t do his job well, the boss will have to make the job work for him or face lawsuits and compensation payouts. When he gets older, accommodations will have to be made for him at work.
We are all crazy now. It’s going to cost us money but we get to blame mental illness for every wrong or silly thing we do. What a deal!
Cravings now count as addictions. So does Parental Alienation Syndrome which should include most of the country’s teenagers.
It gets worse.
They’ve made the definitions overly broad for addictions and require fewer symptoms to qualify. No one is irresponsible, no one is immoral because there is a diagnosis to cover you.
The changes to the new DSM-5 make a mockery of real mental illnesses and it is going to cost taxpayers, health insurance companies, schools who handle handicapped children, and Medicare at a time they can least afford it.
The DSM is the guidebook for insurers and government health plans and schools indirectly so they will be stuck with the costs. The manual is written by 162 professionals in secrecy. They receive comments but they’re secret too. It rakes in $5 million for the authors.
Apparently, psychiatrists want to drum up more business so they are changing the DSM (Diagnostic and Statistical Manual of Mental Disorders) to expand the list of recognized symptoms for addictions to include cravings and mild problems. It makes definitions for certain addictions and disorders very broad while reducing the number of symptoms needed for a diagnosis.
This could add 20 million new subscribers at a cost of hundreds of millions of dollars. Funds for more serious problems will likely be misdirected to cover the new costs. Medicare costs will go up considerably – we really can’t afford that. Special Education costs in schools will balloon.
Psychiatrist say the broader definitions allow for earlier treatment and saves preventive costs. As my grandfather used to say – hogwash.
There will be so many unwanted side effects. Employers could wave a right to trial and class actions suits and go pscyho instead. On the other hand, employers will be faced with a broader array of disorders by employees that will affect evaluations, suits and compensation.
Now gamblers are addicts and fall under “behavior addiction – not otherwise specified.” Rather broad, don’t you think? Where does personal responsibility come in? I see no place for it. We’re not responsible for anything anymore, we have a mental disorder.
Alcoholics will no longer be people who routinely miss work, drive while under the influence, or are arrested. Now it will include people who drink more than intended and crave alcohol. That includes a lot of people I know who like to party.
The DSM-5 includes new disorders like “mild neurocognitive disorder” (defined as a “minor cognitive decline” – often associated with aging – that requires “greater effort, compensatory strategies, or accommodation” to perform daily activities).
So the aged who can’t do their job also won’t be hirable because who is going to take a chance on having to accommodate them.
Then we have “attenuated psychosis syndrome” (a combination of low-level psychotic symptoms, distress and social dysfunction that the patient views as “sufficiently distressing and disabling” to seek professional help. That takes in a lot of people going through tough times. It takes in normal reactions to those times.
If you find these definitions extremely broad, you are not alone. Critics of the proposed DSM-5 continue to push for less expansive definitions, fearing that overly broad definitions will lead to over-diagnosis and hypochondria.
In an open letter from the Society for Humanistic Psychology, three major concerns with the proposed draft of the DSM-5 were outlined -
  • Lowering of diagnostic thresholds. It expands disorders like ADD which is already overly diagnosed with people being overly medicated.
  • Introduction of new disorders. Children and adults can be more easily victimized by the overzealous.
  • Lack of empirical grounding for some proposals.
The protesters also reject proposed changes in the definition of “mental disorder,” arguing that it de-emphasizes sociocultural factors and over-emphasizes biological theory.
The letter is in response to an unsatisfactory put-off by the DSM-5 Task Force Members. They justified their testing and they plan to do make these changes no matter what.
The British Psychological Association, an esteemed organization, roundly condemns the DSM-5 and its outrageous move to take normal behavior and classify it as a disorder – “Medicalizing normal experience stigmatizes and cheapens the human condition and promotes overtreatment with unnecessary and potentially harmful drugs. But the BPS critique goes too far and wide in denying the value of all psychiatric diagnosis.”
For instance, they want to take the serious illness of Schizophrenia and put it in the same category as a broad and unknown, unproven “psychosis risk disorder.” There is serious opposition to even including “psychosis risk disorder.” Seriously, what the heck is it? It could be anything.
The changes represent the single biggest expansion in 40 years coming at a time when we are borrowing 40 cents of every dollar spent and when Americans are now being encouraged to cast blame as the answer to all our problems. We are no longer behaving badly, we are mentally disordered.
The liberal definition will certainly increase addiction rates. Even people who didn’t think of themselves as addicts, now get to do so. I’m certain that is not a good mind set.
There is room for massive corruption here as psychiatrists increase business and with their close ties to Big Pharma, both enter into a possibly corrupt business expansion and mutual financial feeding frenzy. Psychiatrists love to drug people. In fact, that’s mostly what they do. They diagnose and then drug.

D.S.M. Revisions May Sharply Increase Addiction Diagnoses - NYTimes.com

D.S.M. Revisions May Sharply Increase Addiction Diagnoses - NYTimes.com

May 11, 2012

Addiction Diagnoses May Rise Under Guideline Changes

WASHINGTON — In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation’s arbiter of mental illness have agreed to revise the definition of addiction, which could result in millions more people being diagnosed as addicts and pose huge consequences for health insurers and taxpayers.
The revision to the manual, known as the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., would expand the list of recognized symptoms for drug and alcohol addiction, while also reducing the number of symptoms required for a diagnosis, according to proposed changes posted on the Web site of the American Psychiatric Association, which produces the book.
In addition, the manual for the first time would include gambling as an addiction, and it might introduce a catchall category — “behavioral addiction — not otherwise specified” — that some public health experts warn would be too readily used by doctors, despite a dearth of research, to diagnose addictions to shopping, sex, using the Internet or playing video games.
Part medical guidebook, part legal reference, the manual has long been embraced by government and industry. It dictates whether insurers, including Medicare and Medicaid, will pay for treatment, and whether schools will expand financing for certain special-education services. Courts use it to assess whether a criminal defendant is mentally impaired, and pharmaceutical companies rely on it to guide their research.
The broader language involving addiction, which was debated this week at the association’s annual conference, is intended to promote more accurate diagnoses, earlier intervention and better outcomes, the association said. “The biggest problem in all of psychiatry is untreated illness, and that has huge social costs,” said Dr. James H. Scully Jr., chief executive of the group.
But the addiction revisions in the manual, scheduled for release in May 2013, have already provoked controversy similar to concerns previously raised about proposals on autism, depression and other conditions. Critics worry that changes to the definitions of these conditions would also sharply alter the number of people with diagnoses.
While the association says that the addiction definition changes would lead to health care savings in the long run, some economists say that 20 million substance abusers could be newly categorized as addicts, costing hundreds of millions of dollars in additional expenses.
“The chances of getting a diagnosis are going to be much greater, and this will artificially inflate the statistics considerably,” said Thomas F. Babor, a psychiatric epidemiologist at the University of Connecticut who is an editor of the international journal Addiction. Many of those who get addiction diagnoses under the new guidelines would have only a mild problem, he said, and scarce resources for drug treatment in schools, prisons and health care settings would be misdirected.
“These sorts of diagnoses could be a real embarrassment,” Dr. Babor added.
The scientific review panel of the psychiatric association has demanded more evidence to support the revisions on addiction, but several researchers involved with the manual have said that the panel is not likely to change its proposal significantly.
The controversies about the revisions have highlighted the outsize influence of the manual, which brings in more than $5 million annually to the association and is written by a group of 162 specialists in relative secrecy. Besieged from all sides, the association has received about 25,000 comments on the proposed changes from treatment centers, hospital representatives, government agencies, advocates for patient groups and researchers. The organization has declined to make these comments public.
While other medical specialties rely on similar diagnostic manuals, none have such influence. “The D.S.M. is distinct from all other diagnostic manuals because it has an enormous, perhaps too large, impact on society and millions of people’s lives,” said Dr. Allen J. Frances, a professor of psychiatry and behavioral sciences at Duke, who oversaw the writing of the current version of the manual and worked on previous editions. “Unlike many other fields, psychiatric illnesses have no clear biological gold standard for diagnosing them. They present in different ways, and illnesses often overlap with each other.”
Dr. Frances has been one of the most outspoken critics of the new draft version, saying that overly broad and vaguely worded definitions will create more “false epidemics” and “medicalization of everyday behavior.” Like some others, he has also questioned whether a private association, whose members stand to gain from treating more patients, should be writing the manual, rather than an independent group or a federal agency.
Under the new criteria, people who often drink more than intended and crave alcohol may be considered mild addicts. Under the old criteria, more serious symptoms, like repeatedly missing work or school, being arrested or driving under the influence, were required before a person could receive a diagnosis as an alcohol abuser.
Dr. George E. Woody, a professor of psychiatry at the University of Pennsylvania School of Medicine, said that by describing addiction as a spectrum, the manual would reflect more accurately the distinction between occasional drug users and full-blown addicts. Currently, only about 2 million of the nation’s more than 22 million addicts get treatment, partly because many of them lack health insurance.
Dr. Keith Humphreys, a psychology professor at Stanford who specializes in health care policy and who served as a drug control policy adviser to the White House from 2009 to 2010, predicted that as many as 20 million people who were previously not recognized as having a substance abuse problem would probably be included under the new definition, with the biggest increase among people who are unhealthy users, rather than severe abusers, of drugs.
“This represents the single biggest expansion in the quality and quantity of addiction treatment this country has seen in 40 years,” Dr. Humphreys said, adding that the new federal health care law may allow an additional 30 million people who abuse drugs or alcohol to gain insurance coverage and access to treatment. Some economists have said that the number could be much lower, though, because many insurers will avoid or limit coverage of addiction treatment.
The savings from early intervention usually show up within a year, Dr. Humphreys said, and most patients with a new diagnosis would get consultations with nurses, doctors or therapists, rather than expensive prescriptions for medicines typically reserved for more severe abusers.
Many scholars believe that the new manual will increase addiction rates. A study by Australian researchers found, for example, that about 60 percent more people would be considered addicted to alcohol under the new manual’s standards. Association officials expressed doubt, however, that the expanded addiction definitions would sharply increase the number of new patients, and they said that identifying abusers sooner could prevent serious complications and expensive hospitalizations.
“We can treat them earlier,” said Dr. Charles P. O’Brien, a professor of psychiatry at the University of Pennsylvania and the head of the group of researchers devising the manual’s new addiction standards. “And we can stop them from getting to the point where they’re going to need really expensive stuff like liver transplants.”
Some critics of the new manual have said that it has been tainted by researchers’ ties to pharmaceutical companies.
“The ties between the D.S.M. panel members and the pharmaceutical industry are so extensive that there is the real risk of corrupting the public health mission of the manual,” said Dr. Lisa Cosgrove, a fellow at the Edmond J. Safra Center for Ethics at Harvard, who published a study in March that said two-thirds of the manual’s advisory task force members reported ties to the pharmaceutical industry or other financial conflicts of interest.
Dr. Scully, the association’s chief, said the group had required researchers involved with writing the manual to disclose more about financial conflicts of interest than was previously required.
Dr. O’Brien, who led the addiction working group, has been a consultant for several pharmaceutical companies, including Pfizer, GlaxoSmithKline and Sanofi-Aventis, all of which make drugs marketed to combat addiction.
He has also worked extensively as a paid consultant for Alkermes, a pharmaceutical company, studying a drug, Vivitrol, that combats alcohol and heroin addiction by preventing craving. He was the driving force behind adding “craving” to the new manual’s list of recognized symptoms of addiction.
“I’m quite proud to have played a role, because I know that craving plays such an important role in addiction,” Dr. O’Brien said, adding that he had never made any money from the sale of drugs that treat craving.
Dr. Howard B. Moss, associate director for clinical and translational research at the National Institute on Alcohol Abuse and Alcoholism, in Bethesda, Md., described opposition from many researchers to adding “craving” as a symptom of addiction. He added that he quit the group working on the addiction chapter partly out of frustration with what he described as a lack of scientific basis in the decision making.
“The more people diagnosed with cravings,” Dr. Moss said, “the more sales of anticraving drugs like Vivitrol or naltrexone.”

Break Up the Psychiatric Monopoly - NYTimes.com

Break Up the Psychiatric Monopoly - NYTimes.com

May 11, 2012

Diagnosing the D.S.M.

AT its annual meeting this week, the American Psychiatric Association did two wonderful things: it rejected one reckless proposal that would have exposed nonpsychotic children to unnecessary and dangerous antipsychotic medication and another that would have turned the existential worries and sadness of everyday life into an alleged mental disorder.
But the association is still proceeding with other suggestions that could potentially expand the boundaries of psychiatry to define as mentally ill tens of millions of people now considered normal. The proposals are part of a major undertaking: revisions to what is often called the “bible of psychiatry” — the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M. The fifth edition of the manual is scheduled for publication next May.
I was heavily involved in the third and fourth editions of the manual but have reluctantly concluded that the association should lose its nearly century-old monopoly on defining mental illness. Times have changed, the role of psychiatric diagnosis has changed, and the association has changed. It is no longer capable of being sole fiduciary of a task that has become so consequential to public health and public policy.
Psychiatric diagnosis was a professional embarrassment and cultural backwater until D.S.M.-3 was published in 1980. Before that, it was heavily influenced by psychoanalysis, psychiatrists could rarely agree on diagnoses and nobody much cared anyway.
D.S.M.-3 stirred great professional and public excitement by providing specific criteria for each disorder. Having everyone work from the same playbook facilitated treatment planning and revolutionized research in psychiatry and neuroscience.
Surprisingly, D.S.M.-3 also caught on with the general public and became a runaway best seller, with more than a million copies sold, many more than were needed for professional use. Psychiatric diagnosis crossed over from the consulting room to the cocktail party. People who previously chatted about the meaning of their latest dreams began to ponder where they best fit among D.S.M.’s intriguing categories.
The fourth edition of the manual, released in 1994, tried to contain the diagnostic inflation that followed earlier editions. It succeeded on the adult side, but failed to anticipate or control the faddish over-diagnosis of autism, attention deficit disorders and bipolar disorder in children that has since occurred.
Indeed, the D.S.M. is the victim of its own success and is accorded the authority of a bible in areas well beyond its competence. It has become the arbiter of who is ill and who is not — and often the primary determinant of treatment decisions, insurance eligibility, disability payments and who gets special school services. D.S.M. drives the direction of research and the approval of new drugs. It is widely used (and misused) in the courts.
Until now, the American Psychiatric Association seemed the entity best equipped to monitor the diagnostic system. Unfortunately, this is no longer true. D.S.M.-5 promises to be a disaster — even after the changes approved this week, it will introduce many new and unproven diagnoses that will medicalize normality and result in a glut of unnecessary and harmful drug prescription. The association has been largely deaf to the widespread criticism of D.S.M.-5, stubbornly refusing to subject the proposals to independent scientific review.
Many critics assume unfairly that D.S.M.-5 is shilling for drug companies. This is not true. The mistakes are rather the result of an intellectual conflict of interest; experts always overvalue their pet area and want to expand its purview, until the point that everyday problems come to be mislabeled as mental disorders. Arrogance, secretiveness, passive governance and administrative disorganization have also played a role.
New diagnoses in psychiatry can be far more dangerous than new drugs. We need some equivalent of the Food and Drug Administration to mind the store and control diagnostic exuberance. No existing organization is ready to replace the American Psychiatric Association. The most obvious candidate, the National Institute of Mental Health, is too research-oriented and insensitive to the vicissitudes of clinical practice. A new structure will be needed, probably best placed under the auspices of the Department of Health and Human Services, the Institute of Medicine or the World Health Organization.
All mental-health disciplines need representation — not just psychiatrists but also psychologists, counselors, social workers and nurses. The broader consequences of changes should be vetted by epidemiologists, health economists and public-policy and forensic experts. Primary care doctors prescribe the majority of psychotropic medication, often carelessly, and need to contribute to the diagnostic system if they are to use it correctly. Consumers should play an important role in the review process, and field testing should occur in real life settings, not just academic centers.
Psychiatric diagnosis is simply too important to be left exclusively in the hands of psychiatrists. They will always be an essential part of the mix but should no longer be permitted to call all the shots.
Allen Frances, a former chairman of the psychiatry department at Duke University School of Medicine, led the task force that produced D.S.M.-4.

via NYT > Opinion by By ALLEN FRANCES on 5/11/12
The time has come for us to admit that psychiatric diagnosis is too important to be left exclusively in the hands of psychiatrists.


The previous lack of a proper diagnostic system had set psychiatry adrift – lurching toward hermeneutics and away from healing. DSM-III ... Now it was the center of every clinical, research, teaching, forensic conversation.

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Principles and Practice of Child and Adolescent Forensic Psychiatry. Diane H. Schetky, Elissa P. Benedek

Principles and Practice of Child and Adolescent Forensic Psychiatry


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About the Author
Elissa P. Benedek, M.D., is Clinical Professor of Psychiatry at the University of Michigan Medical Center in Ann Arbor, Michigan. Diane H. Schetky, M.D., is in the private practice of forensic psychiatry in Rockport, Maine. She is also Clinical Professor of Psychiatry at the University of Vermont College of Medicine at Maine Medical Center in Portland, Maine.

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1 Boring Old Man » it’s about time…

1 Boring Old Man » it’s about time…

1 Boring Old Man
it’s about time…

Posted on Saturday 12 May 2012

Diagnosing the D.S.M.
New York Times[op-ed]
By ALLEN FRANCES
May 11, 2012

At its annual meeting this week, the American Psychiatric Association did two wonderful things: it rejected one reckless proposal that would have exposed nonpsychotic children to unnecessary and dangerous antipsychotic medication and another that would have turned the existential worries and sadness of everyday life into an alleged mental disorder. But the association is still proceeding with other suggestions that could potentially expand the boundaries of psychiatry to define as mentally ill tens of millions of people now considered normal. The proposals are part of a major undertaking: revisions to what is often called the “bible of psychiatry” — the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M. The fifth edition of the manual is scheduled for publication next May.
I was heavily involved in the third and fourth editions of the manual but have reluctantly concluded that the association should lose its nearly century-old monopoly on defining mental illness. Times have changed, the role of psychiatric diagnosis has changed, and the association has changed. It is no longer capable of being sole fiduciary of a task that has become so consequential to public health and public policy. Psychiatric diagnosis was a professional embarrassment and cultural backwater until D.S.M.-3 was published in 1980. Before that, it was heavily influenced by psychoanalysis, psychiatrists could rarely agree on diagnoses and nobody much cared anyway. D.S.M.-3 stirred great professional and public excitement by providing specific criteria for each disorder. Having everyone work from the same playbook facilitated treatment planning and revolutionized research in psychiatry and neuroscience.
Surprisingly, D.S.M.-3 also caught on with the general public and became a runaway best seller, with more than a million copies sold, many more than were needed for professional use. Psychiatric diagnosis crossed over from the consulting room to the cocktail party. People who previously chatted about the meaning of their latest dreams began to ponder where they best fit among D.S.M.’s intriguing categories. The fourth edition of the manual, released in 1994, tried to contain the diagnostic inflation that followed earlier editions. It succeeded on the adult side, but failed to anticipate or control the faddish over-diagnosis of autism , attention deficit disorders and bipolar disorder in children that has since occurred.
Indeed, the D.S.M. is the victim of its own success and is accorded the authority of a bible in areas well beyond its competence. It has become the arbiter of who is ill and who is not — and often the primary determinant of treatment decisions, insurance eligibility, disability payments and who gets special school services. D.S.M. drives the direction of research and the approval of new drugs. It is widely used (and misused) in the courts. Until now, the American Psychiatric Association seemed the entity best equipped to monitor the diagnostic system. Unfortunately, this is no longer true. D.S.M.-5 promises to be a disaster — even after the changes approved this week, it will introduce many new and unproven diagnoses that will medicalize normality and result in a glut of unnecessary and harmful drug prescription. The association has been largely deaf to the widespread criticism of D.S.M.-5, stubbornly refusing to subject the proposals to independent scientific review. Many critics assume unfairly that D.S.M.-5 is shilling for drug companies. This is not true. The mistakes are rather the result of an intellectual conflict of interest; experts always overvalue their pet area and want to expand its purview, until the point that everyday problems come to be mislabeled as mental disorders. Arrogance, secretiveness, passive governance and administrative disorganization have also played a role.
New diagnoses in psychiatry can be far more dangerous than new drugs. We need some equivalent of the Food and Drug Administration to mind the store and control diagnostic exuberance. No existing organization is ready to replace the American Psychiatric Association. The most obvious candidate, the National Institute of Mental Health, is too research-oriented and insensitive to the vicissitudes of clinical practice. A new structure will be needed, probably best placed under the auspices of the Department of Health and Human Services, the Institute of Medicine or the World Health Organization.
All mental-health disciplines need representation — not just psychiatrists but also psychologists, counselors, social workers and nurses. The broader consequences of changes should be vetted by epidemiologists, health economists and public-policy and forensic experts. Primary care doctors prescribe the majority of psychotropic medication, often carelessly, and need to contribute to the diagnostic system if they are to use it correctly. Consumers should play an important role in the review process, and field testing should occur in real life settings, not just academic centers. Psychiatric diagnosis is simply too important to be left exclusively in the hands of psychiatrists. They will always be an essential part of the mix but should no longer be permitted to call all the shots.
I thought changing my own mind was hard enough. The DSM-III sure put a damper on my plans thirty years ago. But reading all the history, and particularly the climate of the times – something I didn’t get when it was happening, I now see why there was a DSM-III. I still have complaints, but they’re specific rather than global. But my change of heart is miniscule compared to that of Dr. Frances. It’s quite something to have been in on all the other revisions and in charge of the last one, and reach the conclusion in this op-ed. He sure gave it the old college try, working tirelessly for the last three years to effect needed change from inside psychiatry. My hats off to him for being able to write this op-ed. He’s an unlikely candidate to lead the charge, or maybe he’s the perfect choice, or both!…

2 Comments for 'it’s about time…'

  1. May 12, 2012 | 1:19 am
    He’s over at Scientific American, too, with a complementary op-ed.
    I think this is an open admission of a broken social contract between psychiatry and the public, and it may be a Kuhnian paradigm shifting moment…
  2. @secuti
    May 12, 2012 | 11:17 am
    Dr. Allen Francis lecture on diagnostic inflation and DSM V given May 6th in Toronto. http://bit.ly/KhLuhd

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... going to be much greater, and this will artificially inflate the statistics considerably,” said Thomas F. Babor, a psychiatric epidemiologist at the University of Connecticut who is an editor of the international journal Addiction.


Prescription for disaster
Winnipeg Free Press
Dr. James Bolton, an assistant professor of psychiatry at the University of Manitoba -- whose most recent study of anxiety medication use in Manitoba appeared in the April issue of the Canadian Journal of Psychiatry -- agreed, noting, "Medications for ...

and more »


Two proposed changes dropped from psychiatric guide
Reuters
By Julie Steenhuysen | CHICAGO (Reuters) - Two proposed psychiatric diagnoses failed to make the last round of cuts in the laborious process of revising the Diagnostic and Statistical Manual of Mental Disorders -- an exhaustive catalog of symptoms used ...


Psychiatric Hospitals in the US Industry Market Research Report Now Available ...
Albany Times Union
For these reasons, industry research firm IBISWorld has added a report on the Psychiatric Hospitals industry to its growing industry report collection. The Psychiatric Hospitals industry treats about 15.0% of the US population in any given year, ...

and more »


Winter Birthday Study Links Season Of Birth, Mental Health
Huffington Post
Past research has also hinted the season one is born in might affect mental health, with scientists suggesting a number of reasons for this apparent effect. "For example, maternal infections — a mother may be more likely to have the flu over the ...

and more »


Prescription for disaster
Winnipeg Free Press
Dr. James Bolton, an assistant professor of psychiatry at the University of Manitoba -- whose most recent study of anxiety medication use in Manitoba appeared in the April issue of the Canadian Journal of Psychiatry -- agreed, noting, "Medications for ...

and more »

(title unknown)

via Psychiatry on 5/12/12


Psychiatrists say diagnosis manual needs overhaul
GMA News
LONDON - Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a year for further revisions, despite some modifications which eliminated two controversial diagnoses.

Times have changed, the role of psychiatric diagnosis has changed, and the association has changed. It is no longer capable of being sole fiduciary of a task that has become so consequential to public health and public ...

via psychiatric diagnosis - Google Blog Search by kevinkervick on 5/12/12
Times have changed, the role of psychiatric diagnosis has changed, and the association has changed. It is no longer capable of being sole fiduciary of a task that has become so consequential to public health and public ...

via psychiatric diagnosis - Google Blog Search by Gunraj Sandhu on 5/12/12
With the changing times, it is necessary to alter the boundaries as the role of the psychiatric diagnosis also change. Until 1980, psychiatric diagnosis was considered to be a professional embarrassment and cultural backwater ...

via candidaabrahamson by candidaabrahamson on 5/12/12
In May, 2008, the House if Representatives voted to make May Borderline Personality Disorder (BPD) awareness month. Although not as well-known as bipolar disorder or schizophrenia, the disorder is actually at least as common, found in 1-2% of the adult population, most frequently women. Patients account for 20% of inpatient hospitalizations. According to the DSM-IV-TR, [...]


Psychiatric Hospitals in the US Industry Market Research Report Now Available ...
Virtual-Strategy Magazine
For these reasons, industry research firm IBISWorld has added a report on the Psychiatric Hospitals industry to its growing industry report collection. The Psychiatric Hospitals industry treats about 15.0% of the US population in any given year, ...

and more »


Two Disputed Psychiatric Diagnoses Dropped From Revised DSM
Huffington Post
By Julie Steenhuysen CHICAGO, May 9 (Reuters) - Two proposed psychiatric diagnoses failed to make the last round of cuts in the laborious process of revising the Diagnostic and Statistical Manual of Mental Disorders - an exhaustive catalog of symptoms ...


Two proposed changes dropped from psychiatric guide
Chicago Tribune
CHICAGO (Reuters) - Two proposed psychiatric diagnoses failed to make the last round of cuts in the laborious process of revising the Diagnostic and Statistical Manual of Mental Disorders -- an exhaustive catalog of symptoms used by doctors to diagnose ...

via Medicine JournalFeeds » Psychiatry by admin on 5/12/12
White matter abnormalities and illness severity in major depressive disorder.
Br J Psychiatry. 2012 May 10;
Authors: Cole J, Chaddock CA, Farmer AE, Aitchison KJ, Simmons A, McGuffin P, Fu CH
Abstract

BACKGROUND: White matter abnormalities have been implicated in the aetiology of major depressive disorder; however, the relationship between the severity of symptoms and white matter integrity is currently unclear. AIMS: To investigate white matter integrity in people with major depression and healthy controls, and to assess its relationship with depressive symptom severity. METHOD: Diffusion tensor imaging data were acquired from 66 patients with recurrent major depression and a control group of 66 healthy individuals matched for age, gender and IQ score, and analysed with tract-based spatial statistics. The relationship between white matter integrity and severity of depression as measured by the Beck Depression Inventory was examined. RESULTS: Depressive illness was associated with widespread regions of decreased white matter integrity, including regions in the corpus callosum, superior longitudinal fasciculus and anterior corona radiata, compared with the control group. Increasing symptom severity was negatively correlated with white matter integrity, predominantly in the corpus callosum. CONCLUSIONS: Widespread alterations in white matter integrity are evident in major depressive disorder. These abnormalities are heightened with increasing severity of depressive symptoms.
PMID: 22576724 [PubMed - as supplied by publisher]

via Medicine JournalFeeds » Psychiatry by admin on 5/12/12
Adjustment disorders in primary care: prevalence, recognition and use of services.
Br J Psychiatry. 2012 May 10;
Authors: Fernández A, Mendive JM, Salvador-Carulla L, Rubio-Valera M, Luciano JV, Pinto-Meza A, Haro JM, Palao DJ, Bellón JA, Serrano-Blanco A,
Abstract

BACKGROUND: Within the ICD and DSM review processes there is growing debate on the future classification and status of adjustment disorders, even though evidence on this clinical entity is scant, particularly outside specialised care. AIMS: To estimate the prevalence of adjustment disorders in primary care; to explore whether there are differences between primary care patients with adjustment disorders and those with other mental disorders; and to describe the recognition and treatment of adjustment disorders by general practitioners (GPs). METHOD: Participants were drawn from a cross-sectional survey of a representative sample of 3815 patients from 77 primary healthcare centres in Catalonia. The prevalence of current adjustment disorders and subtypes were assessed face to face using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Multilevel logistic regressions were conducted to assess differences between adjustment disorders and other mental disorders. Recognition and treatment of adjustment disorders by GPs were assessed through a review of patients’ computerised clinical histories. RESULTS: The prevalence of adjustment disorders was 2.94%. Patients with adjustment disorders had higher mental quality-of-life scores than patients with major depressive disorder but lower than patients without mental disorder. Self-perceived stress was also higher in adjustment disorders compared with those with anxiety disorders and those without mental disorder. Recognition of adjustment disorders by GPs was low: only 2 of the 110 cases identified using the SCID-I were detected by the GP. Among those with adjustment disorders, 37% had at least one psychotropic prescription. CONCLUSIONS: Adjustment disorder shows a distinct profile as an intermediate category between no mental disorder and affective disorders (depression and anxiety disorders).
PMID: 22576725 [PubMed - as supplied by publisher]


Two proposed changes dropped from psychiatric guide
Chicago Tribune
CHICAGO (Reuters) - Two proposed psychiatric diagnoses failed to make the last round of cuts in the laborious process of revising the Diagnostic and Statistical Manual of Mental Disorders -- an exhaustive catalog of symptoms used by doctors to diagnose ...


Generosity the signature of a caring community's response
Vancouver Sun
That topped off a community-wide $26.5-mil-lion campaign to build the Greta and Robert HN Ho Psychiatry and Education Centre and advance LGH's mental-health and addiction care. . SHOCK AND ORE: Hoping to top last year's $850000 haul, organizers and ...

Behavior and Law: Mike Nova: BREIVIC SYNDROME

Behavior and Law: Mike Nova: BREIVIC SYNDROME

Mike Nova: BREIVIC SYNDROME 


Last Update: 5:51 PM 5/3/2012

Mike Nova:

Breivik Syndrome is the Grandiose - Persecutory type of Delusional Disorder with resulting mass murder in a messianic quest to promote militant far right ideology which serves as a defensive reaction formation and overcompensation in intense, elaborate, psychotic and delusional, antifeministic and "anti immigrant" castration phobia.

This psychopathology is both individual and social.

How many are afflicted with it, lurking there in the dark, behind their flags and "manifestos"?




Addiction Diagnoses May Rise Under Guideline Changes - New York Times - General Psychiatry News

Google Reader - General Psychiatry News



New York Times

Addiction Diagnoses May Rise Under Guideline Changes
New York Times
WASHINGTON — In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation's arbiter of mental illness have agreed to revise the definition of addiction, ...
Rewrite means millions more likely to be called addictsMinneapolis Star Tribune
Guideline revisions may increase addiction diagnosesBend Bulletin
You could be addicted but not know itOmaha World-Herald

all 10 news articles »
 

"For three decades psychiatrists have turned to Lishman's "Organic Psychiatry" as the standard neuropsychiatry reference. It stood as the last great single author reference text in medicine..." - General Psychiatry News

Google Reader - General Psychiatry News

via psychiatry - Google Blog Search by admin on 5/11/12
'For three decades psychiatrists have turned to Lishman's 'Organic Psychiatry' as the standard neuropsychiatry reference. It stood as the last great single...
 

Lishman's Organic Psychiatry: A Textbook of Neuropsychiatry

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"For three decades psychiatrists have turned to Lishman's "Organic Psychiatry" as the standard neuropsychiatry reference. It stood as the last great single author reference text in medicine, a combination of meticulous, exhaustive research conveyed in a beautifully clear style. Now the mantle has been passed to a group of five distinguished authors and it is to their considerable credit that the attributes which made Organic Psychiatry such a distinctive voice remain. The fourth Edition of Lishman's Organic Psychiatry is a rich blend of detailed clinical inquiry and up to date neuroscience. It should be on every psychiatrist;s book shelf."--Anthony Feinstein, MPhil, PhD., FRCP, Professor, Department of Psychiatry, University of Toronto, CanadaOver the past 30 years, thousands of physicians have depended on Lishman's "Organic Psychiatry." Its authoritative and reliable clinical guidance was - and still is - beyond compare.The new edition of this classic textbook has now been extensively revised by a team of five authors, yet it follows the tradition of the original single-authored book. It continues to provide a comprehensive review of the cognitive, emotional and behavioural consequences of cerebral disorders and their manifestations in clinical practice. Enabling clinicians to formulate incisive diagnoses and appropriate treatment strategies, "Lishman's Organic Psychiatry" is an invaluable source of information for practising psychiatrists, neurologists and trainees.This new edition: covers recent theoretical and clinical developments, with expanded sections on neuropsychology and neuroimagingincludes a new chapter on sleep disorders whilst the chapters on Alzheimer's disease and related dementias, Epilepsy, Movement disorders and Traumatic brain injury have been extensively revised reflecting the greatly improved understanding of their underlying pathophysiologiesshowcases the huge advances in brain imaging and important discoveries in the fields of molecular biology and molecular geneticshas been enhanced with the inclusion of more tables and illustrations to aid clinical assessmentincorporates important diagnostic tools such as magnetic resonance brain images.

Widespread alterations in white matter integrity are evident in major depressive disorder. These abnormalities are heightened with increasing severity of depressive symptoms. - General Psychiatry News

Google Reader - General Psychiatry News

via Medicine JournalFeeds » Psychiatry by admin on 5/12/12
White matter abnormalities and illness severity in major depressive disorder.
Br J Psychiatry. 2012 May 10;
Authors: Cole J, Chaddock CA, Farmer AE, Aitchison KJ, Simmons A, McGuffin P, Fu CH
Abstract

BACKGROUND: White matter abnormalities have been implicated in the aetiology of major depressive disorder; however, the relationship between the severity of symptoms and white matter integrity is currently unclear. AIMS: To investigate white matter integrity in people with major depression and healthy controls, and to assess its relationship with depressive symptom severity. METHOD: Diffusion tensor imaging data were acquired from 66 patients with recurrent major depression and a control group of 66 healthy individuals matched for age, gender and IQ score, and analysed with tract-based spatial statistics. The relationship between white matter integrity and severity of depression as measured by the Beck Depression Inventory was examined. RESULTS: Depressive illness was associated with widespread regions of decreased white matter integrity, including regions in the corpus callosum, superior longitudinal fasciculus and anterior corona radiata, compared with the control group. Increasing symptom severity was negatively correlated with white matter integrity, predominantly in the corpus callosum. CONCLUSIONS: Widespread alterations in white matter integrity are evident in major depressive disorder. These abnormalities are heightened with increasing severity of depressive symptoms.
PMID: 22576724 [PubMed - as supplied by publisher]