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We promise that if you like your psychiatrist, you can keep him …


… just don’t confuse that with getting any better. Here’s a quick summary of the unsolved problems that made psychiatry’s most recent Diagnostic and Statistical Manual (DSM-V) so controversial:

Many mental diseases listed were determined by vote or committee consensus, not research. In fact, there is no rigorous research that identifies most mental diseases in the manual.

Inflation of disorders. Nonetheless, there was a dramatic increase between the first and the fourth edition in disorders listed, from 106 in DSM–1 to 374 in DSM–4. Also, criteria have grown ever more inclusive, driving apparent “epidemics” of depression, bipolar disorder and ADHD, with no real public accountability. The number of pages increased as well, from 130 in the first 1952 edition to 991 pages in the fifth.

Transparency. It is hard to say how many psychiatrists, psychotherapists, counsellors and nurses depend on DSM diagnoses for their living, but transparency may be an unmet challenge when personal well-being is at stake. More.

Put another way: The world won’t be any madder if the fifth Manual is the last.

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