The Moving Goalposts of Mental Illness

The latest edition of the manual psychiatrists use to assess patients has gone through a major and controversial set of changes. 

The latest edition of the manual psychiatrists use to assess patients has gone through a major and controversial set of changes which according to a report published in Current Biology (open access) runs the risk of:


“..moving the goalposts for mental disorders, the 158 experts preparing the manual on behalf of the American Psychiatric Association (APA) may make patients of millions of people who were hitherto considered normal.”

Common problems that were considered normal and may now be medicalised include normal grief after bereavement, harmless forgetting in advanced old age, excess worrying and overeating. Asperger syndrome has been removed and shifted in to the broader category of autism spectrum disorder. According to Al Frances, the chair of the taskforce that produced the previous revision (DSM-IV):

“My concern is that diagnosing the worried well diverts attention from the really sick. Redefining everyday problems as mental disorder underestimates human resiliency; burdens the individual with harmful medication and stigma; narrows personal horizons; costs a fortune; and creates the false sense we are a sick society.”

The new paper raises the issue of “the fundamental conflicts of interest that haunt the field” that may create perverse incentives towards medicalising the normal:

“Understandably, psychiatrists who investigate a hitherto unappreciated mental problem will lobby to get their hobby horse into the manual. Moreover, the pharmaceutical industry has a natural interest in widening the patient population, as this will boost their sales.”

For further reading regarding these issues check out the Pulitzer Prize winning Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker (a book that I just can’t recommend any more highly, it is positively riveting) and Crazy Like Us: The Globalization of the American Psyche by Ethan Watters. In May to coincide with the release of DSM-5 Al Frances will be releasing Saving Normal, a discussion on the issues discussed above.

Reference:

Gross, M. (2013). Has the manual gone mental? Current Biology (Vol 23 No 8). doi:10.1136/bmj.f1580

Image Credits: Image adapted from Shutterstock/lineartestpilot & Vadym Andrushchenko

LinkedIn meets Tinder in this mindful networking app

Swipe right to make the connections that could change your career.

Getty Images
Sponsored
Swipe right. Match. Meet over coffee or set up a call.

No, we aren't talking about Tinder. Introducing Shapr, a free app that helps people with synergistic professional goals and skill sets easily meet and collaborate.

Keep reading Show less

Dead – yes, dead – tardigrade found beneath Antarctica

A completely unexpected discovery beneath the ice.

(Goldstein Lab/Wkikpedia/Tigerspaws/Big Think)
Surprising Science
  • Scientists find remains of a tardigrade and crustaceans in a deep, frozen Antarctic lake.
  • The creatures' origin is unknown, and further study is ongoing.
  • Biology speaks up about Antarctica's history.
Keep reading Show less

This 1997 Jeff Bezos interview proves he saw the future coming

Jeff Bezos, the founder of Amazon.com, explains his plan for success.

Technology & Innovation
  • Jeff Bezos had a clear vision for Amazon.com from the start.
  • He was inspired by a statistic he learned while working at a hedge fund: In the '90s, web usage was growing at 2,300% a year.
  • Bezos explains why books, in particular, make for a perfect item to sell on the internet.
Keep reading Show less

Why are women more religious than men? Because men are more willing to take risks.

It's one factor that can help explain the religiosity gap.

Photo credit: Alina Strong on Unsplash
Culture & Religion
  • Sociologists have long observed a gap between the religiosity of men and women.
  • A recent study used data from several national surveys to compare religiosity, risk-taking preferences and demographic information among more than 20,000 American adolescents.
  • The results suggest that risk-taking preferences might partly explain the gender differences in religiosity.
Keep reading Show less