Diagnostic and Statistical Manual of Mental Disorders

David Kupfer is the one responsible for the revision of the DSM edition 5 that was published last May. The goal of this new edition was to move towards a dimensionality approach, which classifies mental illnesses as overlapping. Individuals are placed on a single spectrum to identify the severity of the illness.

As many topics, the DSM-5 brought about many controversies. First of all, many thought it was a premature shift, that is, not enough research and experiments were done to change from a categorical to a dimensionality approach. It has been argued that the scales used for assessment were not based on strong evidence, which creates low inter-rater agreement; different psychiatrists reached different conclusions. Is it reasonable to base our diagnostics on a manual that doesn’t seem to have high reliability and validity? The distinction between divers disorders was a problem prior to the fifth edition, however it seems that it only worsen. Creating a spectrum means that there is no distinct walls between each disorder. This leads to co-morbidity and thus perhaps treating patients for the wrong illness. This change in the DSM-5 means that people’s diagnosis, which was previously based on the categorical assessment, could be different now. Furthermore, the diagnostic threshold has lowered for several disorders such as for autism. Will this create problems and mistrust from patients?

The cure to this problem is gold standard; unfortunately this is quite nonexistent for many disorders. Thus there is a great need for a better understanding of mental disorder in order to diagnose and treat patients properly. This is crucial because many individuals are affected. Shouldn’t they analyze and adjust the DSM adequately before publishing a new version or base diagnosis on these?

In addition, as the years pass the number of disorders increased in the DSM. This is a positive element, because it implies that we can treat and help a broader proportion of the population. However there might be an exaggerated emphasis on creating new disorders.

In sum, the DSM is important in diagnosing individuals that are suffering from a disorder because they can receive the help needed to get better or\and receive the adequate resources. However, I believe that it should be taken with caution as it has many flaws and fundamental consequences.