We were told prior to its publication that DSM-5 would be a 'living document' subject to correction. It turns out that this correction needs to begin right now -- DSM-5 in its current form is unacceptably imprecise and cries out for an immediate and thorough re-editing.
Frankly, every new version of the manual (beginning with the first edition) has had its critics. It's always been viewed by some as "cookbook psychiatry" while others have found it immensely helpful in sorting through the myriad signs and symptoms of mental and emotional disorders.
I doubt DSM-5 will remain the international standard for research journals; it will almost certainly not gain any clinical following outside the U.S.; and it will also probably lose its role as the lingua franca of American psychiatry.
A clear lesson from history: Whenever a profit is to be made by twisting the DSM, it will be twisted. The DSM-5 will give drug companies running room to continue their disease mongering of female sexual disorders, hyping this DSM diagnosis as a means of pushing pills.
The golden rule: an underlying medical illness or medication side effect has to be ruled out before ever deciding that someone's symptoms are caused by mental disorder. And the underlying medical illness may take time to declare itself.
You may have already heard our big news in psychiatry: The first major revision of the Diagnostic and Statistical Manual (DSM) since the mid-1990s has just been approved by American Psychiatric Association's Board of Trustees. And the new DSM-5 will be published in May.
The petition to reform DSM 5 speaks with the powerful voice of more than 50 mental-health associations. It represents a significant percentage of the potential customers who eventually will have to decide whether or not DSM 5 is worth buying and using.
My motivation for taking on this unpleasant task is simple: to prevent DSM 5 from promoting a general diagnostic inflation that will result in the mislabeling of millions of people as mentally disordered.
Nothing can illustrate how far DSM 5 has gone off track better than the words spoken in its defense by DSM 5 leadership. Here are the 10 most wrong-headed quotations, and I have annotated them with my own thoughts.