ME Association submission to the consultation on the revision of the American Diagnostic and Statistical Manual of Mental Disorders

June 13, 2011

The ME Association has submitted the following comments to the consultation on the proposed, new American Diagnostic and Statistical Manual of Mental Disorders, otherwise known as the “DSM-5”. Our contribution was officially acknowledged on Sunday (June 12) at 10.52am.

The ME Association is a UK based medical charity that provides information and support for people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome).

The concerns we express below refer to the proposal to create a new and wide-ranging psychiatric category – Complex Somatic Symptom Disorder (CSSD) – in the next edition of the American Diagnostic and Statistical Manual of Mental Disorders (ie DSM V) and the widespread belief that people with ME and CFS may become included in this new medical terminology.

ME is recognised by the World Health Organisation (in section G93:3 of ICD 10) and by the UK Department of Health as a complex neurological disorder – a fact that is now supported by numerous published research studies.

CFS, which includes a wider group of clinical presentations, is indexed to the WHO neurological classification.

It is not therefore appropriate to use the proposed terminology of CSSD – either by intention or mistake – to describe or classify people with ME or CFS as having somatic presentations of mental health disorders in any other system of disease classification or explanation such as the DSM.

This proposal itself has a number of major flaws, including:

• A very limited and partial scientific rationale with too much reliance on subjective judgements.

• An implied acceptance that diagnoses are always correct.

• An assumption that all that is important in psychological medicine is already known and what remains uncertain can be summarised in one new clinical entity.

Psychological Medicine already attracts a lot of negative criticism and this proposal will only make matters worse.

The APA therefore needs to reflect on its full responsibilities when reviewing a subject area as complex and uncertain as this.

We therefore suggest that you drop CSSD and instead refer to ‘chronic distress that may be related to psychological or physical events or a combination'. This is a term that should lead to empathetic, focused management.


3 thoughts on “ME Association submission to the consultation on the revision of the American Diagnostic and Statistical Manual of Mental Disorders”

  1. We have to admit that the psycho-brigade is consistent. None of them ever learns from history; make a monumental mistake (e.g. “M.S. is a form of hysteria”), close your mind and do it all again.

    Their arrogance is breath-taking. Apparently, everything without an indisputable cause must be ‘all in the mind’. Presumably, over the years the psychos have tried to cure leprosy, TB, leukemia, etc – all without success of course.

    What they should be asked is how much successful treatment they applied to all those illnesses which they used to claim as psychological. They cured no-one, but still they were omniscient.

    Are they arrogant, egotistic or just plain stupid? It strikes me that they suffer from a serious, psychological disorder!

    We desperately need two things:
    i) research and treatment
    ii) some effective propaganda to change public perceptions created by the unscientific, unethical, immoral psycho-zealots.

    Thank you to every involved with formulating the ME Association’s response to the current nonsense.

  2. Very well done, thank you for a concise and clear submission. Let’s hope they take note of this and the hundreds of others.

  3. Yes well done, I find it so hard to believe that these psychologist can still say that ME is not a genuine physiological disorder!! What is wrong with them???

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