Psychiatric diagnosis and treatment in America and the worldover may undergo a major revision if dozens of proposals of experts of far-reaching implications are accepted.
Under this, children who throw too many tantrums could be diagnosed with “temper dysregulation with dysphoria” and men who are just way too interested in sex face being labelled as suffering from “hypersexual disorder,” the Washington Post reported.
If dozens of proposals by the American Psychiatric Association to revise the Diagnostic and Statistical Manual of Mental Disorders (DSM) are accepted, it will be the first since 1994 of the massive tome that has served as the bible for modern psychiatry for more than half a century, it said.
The product of more than a decade of work by hundreds of experts, the proposed revisions are designed to bring the best scientific evidence to bear on psychiatric diagnoses and could have far-reaching implications, the report said.
The revision could determine who gets diagnosed as mentally ill, who should get powerful psychotropic drugs, and whether and how much insurance companies will pay for care.
“It not only determines how mental disorders are diagnosed, it can impact how people see themselves and how we see each other,” American Psychiatric Association president Alan Schatzberg said.
“It influences how research is conducted as well as what is researched...... It affects legal matters, industry and government programmes.”
The proposals will be debated in an intense process over the next two years, with potentially billions of dollars at stake for pharmaceutical companies, insurance firms, government health plans, doctors, researchers and patient advocacy groups, the report said.
Even before being made public, the proposed changes have been the subject of bitter debate over whether the process was based on solid scientific evidence and was adequately shielded from influence by the pharmaceutical industry, and whether some critics were driven by financial interests in maintaining the old diagnostic criteria, it said.
Supporters argue that the revisions would make diagnoses more accurate, creating more precise definitions and sometimes reducing the number of psychiatric labels.
For example, “autistic disorder” and “Asperger’s disorder” would be replaced with a new, single category called “autism spectrum disorders.”
Critics, however, fear the new diagnoses could unnecessarily stigmatise many people and lead to unnecessary use of psychiatric medications that can sometimes produce serious side effects.
After being posted on the Internet, which of the proposed changes become final will be determined by a public comment period that will last until April 20. After further review, and votes by the association’s Board of Trustees and Assembly, a final version may be released by May 2013.
“We’re mindful of the concern that we don’t want to over diagnose,” Schatzberg said. “We want to, in fact, get an accurate assessment of what the degree of psychopathology might be in the culture.”