‘Psychologists to fight new list of mental illnesses’ | The Times | 20 March 2013

From The Times, 20 March 2013 (Story by Martin Barrow, Health Editor).

Millions of people risk being labelled as mentally ill under new classifications that have prompted calls for a boycott by psychologists.

Dozens of new disorders have been created in the new Diagnostic and Statistical Manual of Mental Disorders, which is due to be published in May following its first major revision since 1994.

The new disorders include Generalised Anxiety Disorder, which includes everyday worries; Minor Neurocognitive Disorder, for normal forgetting in old age; and Behavourial Addictions, which turn much of what people enjoy doing into a mental disorder.

Particular concern has been raised over “somatic symptom disorder”, which is defined by “excessive” anxiety about long-term physical illnesses, such as cancer or heart disease.

Many psychologists fear the changes will “medicalise” the anxiety that people routinely feel as a consequence of getting on with living their lives.

Today a group of psychologists launch an international campaign urging clinicians to boycott the new DSM until it is subjected to independent review.

The group, represented by mental health specialists from Britain, America, Canada, Australia and New Zealand, fear that millions of people will be diagnosed with mental illness and prescribed medication and therapy they do not need, while the underlying cause of their anxiety is not dealt with.

The group is led by Professor Peter Kinderman, head of the Institute of Psychology, Health and Society and the University of Liverpool.

He said: “My own favourite is ‘female orgasmic disorder’, which is the temerity to complain about your husband’s inability to perform in bed.

“I’m not making light of the problem, or any other problem. But the issue here might be the husband, not the wife’s state of mind. A misdiagnosis can sometimes be dangerous and counter-productive.”

He added: “It is similar with ADHD. Your kid may be diagnosed simply because he is not engaging at school. You should look at the kid, but also look at the school, the classroom, the teacher. They may be other reasons.”

The campaign launch coincides with the publication of stinging criticism of the new DSM by a former chairman of the manual.

Writing in the /British Medical Journal/ today, Professor Allen Frances said that “fuzzy boundary between psychiatry and general medicine is about the experience a seismic shift”.

Professor Frances, who is based at Duke University, is particularly concerned about the new condition of “somatic symptom disorder”. The condition is defined by “excessive” anxiety about long-term physical illnesses. Studies have shown that the DSM criteria applies to 15 per cent of patients with cancer or heart disease and 26 per cent with irritable bowel syndrome.

“Misapplication of these catch-all criteria, especially in primary care practice, may result in inappropriate diagnoses of mental disorder and inappropriate medical decision making,” Professor Frances said.

DSM is published by the American Psychiatric Association but its language and criteria for the classification of mental disorders are used around the world, including by many practioners in the UK.

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