Psychiatry Takes a Header: The NIMH Withdraws Support for DSM-5

[Jackpine Radical]

Just two weeks before DSM-5 is due to appear, the National Institute of Mental Health, the world's largest funding agency for research into mental health, has indicated that it is withdrawing support for the manual.

In a humiliating blow to the American Psychiatric Association, Thomas R. Insel, M.D., Director of the NIMH, made clear the agency would no longer fund research projects that rely exclusively on DSM criteria. Henceforth, the NIMH, which had thrown its weight and funding behind earlier editions of the manual, would be “re-orienting its research away from DSM categories.” "The weakness” of the manual, he explained in a sharply worded statement, “is its lack of validity.” “Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."


That consensus is now clearly missing. Whether it ever really existed remains in doubt. As one consultant for DSM-III conceded to the New Yorker magazine about the amount of horsetrading that drove that supposedly "evidenced-based" edition from 1980: “There was very little systematic research, and much of the research that existed was really a hodgepodge—scattered, inconsistent, ambiguous.”

According to Insel, too much of that problem remains. As he cautioned of a manual whose precision and reliability has been overstated for decades, “While DSM has been described as a 'Bible' for the field, it is, at best, a dictionary, creating a set of labels and defining each.” And not even a particularly good dictionary, apparently. Of the decision to steer research in mental health away from the manual and its parameters, Insel states: “Patients with mental disorders deserve better.”

http://www.psychologytoday.com/blog/side-effects/201305/the-nimh-withdraws-support-dsm-5

[bemildred]

1. Unempirical twaddle, yes. Opinions and biases treated as facts.

An excellent doorstop.

[cleanhippie]

2. You make it sound like religion.

[Jackpine Radical]

3. It sorta is.

[bemildred]

10. Pretty much, It sure is not science. nt

[Fumesucker]

4. Objective laboratory measurements are not really all that practical inside someone's psyche

From my point of view as a mentally ill person (bipolar) I'm not particularly thrilled by the idea of being placed in a laboratory setting for study.

[Jackpine Radical]

5. We could have a long discussion about that, but

the upshot is that from my perspective, much of what we label "mental illness" is the individual's attempt to cope with a crazy world.

[Fumesucker]

6. It's certainly nothing like the world we are evolved to deal with n/t

[ananda]

7. The DSM has been a disgrace for years.

I'm sure big pharma likes it though.

[Jackpine Radical]

9. Exactly.

Pills are so much handier and cheaper than caring human contact.

[cbdo2007]

13. Is there a better system?

[TroglodyteScholar]

8. Good!

Most suspicious book since the Bible....

[Jackpine Radical]

11. I'd call it a dead-heat tie with

the Malleus Maleficarum.

[Jackpine Radical]

12. The only problem with this news is that NIMH will now resort to

an even crazier system based on "biological psychiatry."

[lumberjack_jeff]

14. Diagnostic criteria about psychological disorders is ambiguous by necessity.

I have my own concerns with DSM V, especially as it pertains to autism spectrum disorders, but dismissing it as invalid would only be beneficial if there were something with which to replace it.