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The media campaign on the DSM-5: recurring comments and lessons for the future of diagnosis in psychiatric practice

  • M. Maj (a1)

Abstract

Recurring arguments in the media campaign preceding and following the publication of the DSM-5 have been that the manual, referred to as ‘the bible of psychiatry’, mislabels many people who are basically normal, and that the diagnostic categories it contains are invalid, not being based on laboratory tests. We present data on the use of the DSM worldwide, and discuss the need to assess systematically the pros and cons of operational and prototype approaches to psychiatric diagnosis. We consider different views about what qualifies as mental disorder and how the boundary between pathology and normality should be fixed. We review the role of laboratory tests as applied in medicine, emphasising that most of them are probabilistic, not pathognomonic, markers of disease. We finally summarise the promise and limitations of the Research Domain Criteria project, aiming to ‘transform psychiatric diagnosis’ by replacing descriptive psychopathology with behavioural and neurobiological measures.

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Copyright

Corresponding author

Address for correspondence: Prof M. Maj, Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy. (Email: majmario@tin.it)

References

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American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Association: Arlington.
Angell, M (2011). The epidemic of mental illness: why? The New York Review of Books, June 23.
Bolton, D (2008). What is Mental Disorder? An Essay in Philosophy, Science, and Values. Oxford University Press: Oxford.
Carroll, BJ (2013 a). Quoted in: Frances A. The role of biological tests in psychiatric diagnosis. Huffington Post, May 22.
Carroll, BJ (2013 b). Biomarkers in DSM-5: lost in translation. Australian and New Zealand Journal of Psychiatry 47, 676681.
Cassels, C (2013). DSM-5 officially launched, but controversy persists. Medscape Multispecialty, May 18.
Cuthbert, BN (2014). The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 13, 2835.
Horgan, J (2013). Psychiatry in crisis! Mental health director rejects psychiatric “bible” and replaces with… nothing. Scientific American, May 4.
Insel, TR (2013). Transforming diagnosis. NIMH Director's Blog, April 29.
Kendell, R, Jablensky, A (2003). Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry 160, 412.
Kendler, KS (2005). Toward a philosophical structure for psychiatry. American Journal of Psychiatry 162, 433440.
Kendler, KS, Gardner, Jr CO (1998). Boundaries of major depression: an evaluation of DSM-IV criteria. American Journal of Psychiatry 155, 172177.
Kessler, RC, Zhao, S, Blazer, DG, Swartz, M (1997). Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. Journal of Affective Disorders 45, 1930.
Kroenke, K (2013). Diagnostic testing and the illusory reassurance of normal results. JAMA Internal Medicine 173, 416417.
Leibenluft, E, Uher, R, Rutter, M (2012). Disruptive mood dysregulation with dysphoria disorder: a proposal for ICD-11. World Psychiatry 11(Suppl. 1), 7781.
Maj, M (1998). Critique of the DSM-IV operational diagnostic criteria for schizophrenia. British Journal of Psychiatry 172, 458460.
Maj, M (2011). Psychiatric diagnosis: pros and cons of prototypes vs. operational criteria. World Psychiatry 10, 8182.
Maj, M (2013 a). Mental disorders as “brain diseases” and Jaspers' legacy. World Psychiatry 12, 13.
Maj, M (2013 b). “Clinical judgment” and the DSM-5 diagnosis of major depression. World Psychiatry 12, 8991.
Maj, M (2013 c). Adherence to psychiatric treatments and the public image of psychiatry. World Psychiatry 12, 185186.
Maj, M (2014 a). DSM-5, ICD-11 and ‘pathologization of normal conditions’. Australian and New Zealand Journal of Psychiatry 48, 193194.
Maj, M (2014 b). Keeping an open attitude towards the RDoC project. World Psychiatry 13, 13.
Ortigo, KM, Bradley, B, Westen, D (2010). An empirically based prototype diagnostic system for DSM-V and ICD-11. In: Contemporary Directions in Psychopathology: Scientific Foundations of the DSM-V and ICD-11 (ed. Millon, T, Krueger, RF and Simonsen, E), pp. 374390. Guilford: New York.
Parnas, J (2012). The core Gestalt of schizophrenia. World Psychiatry 11, 6769.
Parnas, J (2014). The RDoC program: psychiatry without psyche? World Psychiatry 13, 46–7.
Reed, GM, Mendonça Correia, J, Esparza, P, Saxena, S, Maj, M (2011). The WPA–WHO global survey of psychiatrists' attitudes towards mental disorders classification. World Psychiatry 10, 118131.
Regier, DA, Narrow, WE, Clarke, DE, Kraemer, HC, Kuramoto, SJ, Kuhl, EA, Kupfer, DJ (2013). DSM-5 field trials in the United States and Canada, Part II: test–retest reliability of selected categorical diagnoses. American Journal of Psychiatry 170, 5970.
Roan, S (2010). Revising the book on mental illness. Los Angeles Times, February 10.
Ryan, E (2011). Diagnosing gestational diabetes. Diabetologia 54, 480486.
Spitzer, RL, Endicott, J, Robins, E (1975). Clinical criteria for psychiatric diagnosis and DSM-III. American Journal of Psychiatry 132, 11871192.
Stein, DJ (2014). An integrative approach to psychiatric diagnosis and research. World Psychiatry 13, 5153.
Wakefield, JC (2013). DSM-5 grief scorecard: assessment and outcomes of proposals to pathologize grief. World Psychiatry 12, 171173.
Wakefield, JC (2014). Wittgenstein's nightmare: why the RDoC grid needs a conceptual dimension. World Psychiatry 13, 3840.
Wakefield, JC, First, MB (2012). Validity of the bereavement exclusion to major depression: does the empirical evidence support the proposal to eliminate the exclusion in DSM-5? World Psychiatry 11, 310.
Weinberger, DR, Goldberg, TE (2014). RDoCs redux. World Psychiatry 13, 3638.
Westen, D, Shedler, J (2000). A prototype matching approach to personality disorders: toward DSM-V. Journal of Personality Disorders 14, 109126.
Westen, D, Malone, JC, DeFife, JA (2012). An empirically derived approach to the classification and diagnosis of mood disorders. World Psychiatry 11, 172180.
Zimmerman, M, Galione, J (2010). Psychiatrists' and nonpsychiatrist physicians' reported use of the DSM-IV criteria for major depressive disorder. Journal of Clinical Psychiatry 71, 235238.

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