The next edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), to be released this May, will be released to doctors amid controversy that a poorly tested diagnosis will classify millions of people as mentally ill.
The diagnosis of somatic symptom disorder will be put into a new section called "Somatic symptoms and related disorders." The controversy stems from the new category will extend the scope of mental disorder classification by eliminating the requirement that somatic symptoms must be "medically unexplained."
Allen Frances, Chair of the current (DSM-IV) task force warns that the DSM-5 definition of somatic symptom disorder "may result in inappropriate diagnoses of mental disorder and inappropriate medical decision making."
"The overinclusiveness of this diagnosis is suggested by the results of the DSM-5 field trial study reported by the somatic symptom disorder work group at the 2012 annual meeting of the American Psychiatric Association. Somatic symptom disorder captured 15 percent of patients with cancer or heart disease and 26 percent with irritable bowel syndrome or fibromyalgia, and it had a high false positive rate of 7 percent among healthy people in the general population."
It is obvious that people who are ill with diseases such as cancer would have some sort of psychological issues stemming from their disease because of stress and other factors.
But the new requirement would classify people as mentally ill even if they have a physical issue such as a chronic life threatening illness.
His statement in a current editorial says that previous DSM criteria "have always included reminders to clinicians to rule out other explanations before concluding that any mental disorder is present." But his suggestions to the DSM-5 work group that the same type of reminders should be included this time were rejected.
He suggests that "clinicians are best advised to ignore this new category. When a psychiatric diagnosis is needed for someone who is overly worried about medical problems the more benign and accurate diagnosis is adjustment disorder."
To read Dr. Allen Frances' rebuttal to the new guidelines in the British Medical Journal click here.
Published by Medicaldaily.com