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Mental Disorder Diagnosis Changes with New Guidelines

By Merely Me Tuesday, February 16, 2010

The Diagnostic and Statistical Manual of Mental Disorders is going to be publishing its fifth edition in May 2013.  Nothing is written in stone yet but they are looking to overhaul many of the accepted diagnostic labels for mental disorders as well as their criteria.  The proposed draft revisions to the DSM disorders and criteria may be found on the American Psychiatric Association DSM-5 Development web site

There you may not only view the proposed changes but you can also add your comments until April 20, 2010.  

It is fascinating to read about what surprises are in store for those of us who suffer from any type of mood disorder or mental health challenges.  

Here are just some of the highlights:

  • Some mental health advocacy groups and mental health professionals are suggesting new conditions be added to the revised diagnostic manual. Some of these suggestions include: Apathy Syndrome, Fetal Alcohol Syndrome, Melancholia, Internet Addiction, Complicated Grief Disorder, Seasonal Affective Disorder, and Sensory Processing Disorder.

 

  • They are proposing the addition of a new mood disorder classification called Mixed Anxiety Depression.  The criteria would include: The patient has three or four of the symptoms of major depression (which must include depressed mood and/or anhedonia), and they are accompanied by anxious distress. The symptoms must have lasted at least 2 weeks, and no other DSM diagnosis of anxiety or depression must be present, and they are both occurring at the same time.

    Anxious distress is defined as having two or more of the following symptoms:  irrational worry, preoccupation with unpleasant worries, having trouble relaxing, motor tension, fear that something awful may happen.

 

  • They wish to exclude this particular Bipolar Disorder diagnosis from the manual. 296.6x Bipolar I Disorder - Most Recent Episode Mixed

 

 

  • For those children who do not meet the criteria for adults for Bipolar Disorder a new category, called "temper dysregulation disorder with dysphoria," will be created in order to accommodate children who are aggressive and irritable.

 

  • The diagnostic term of Learning Disabilities will be added as a new classification. The DSM-IV formerly used the term "Learning Disorder (and before that it was called Academic Skills Disorders)" to describe what we commonly now call Learning Disabilities.

 

  • Asperger's Syndrome and Pervasive Developmental Disorder Otherwise Not Specified are both going to be excluded from the new manual and will be subsumed by the umbrella diagnosis of Autism Spectrum Disorder.

 

  • They are changing the way addictions are formally labeled as in "Alcohol Dependence" will now be called "Alcohol-Use Disorder." In fact any label with the words "dependence" or "abuse" has been changed to a "use disorder."  They are also adding new labels such as Cannabis Withdrawal. 
  • The group is recommending that Obsessive Compulsive Disorder be included under a grouping of Anxiety and Obsessive-Compulsive Spectrum Disorders.

 

2/16/10 8:56am

Merely Me:  First thank you for being here. This site is often quite helpful to me personally. I have a few comments regarding the overhaul for the manual.

 

Taking out the words "abuse"  and other terms that I perceive as negative seems to be. There is much negativity regarding mental health. I have felt that most people in our society associate some blame toward the person having the disorder.  . Usually  no one blames the cancer patient for being ill.

 

My son Jeffrey who passed and was diagnosed with a "learning disability" in grade V used to object to the word "disability"..vehiemently! (This was only one issue in his suicide among many). He was very intelligent and called lazy...spoiled...etc by teachers and family members. Would the word "disorder" have changed anything..probably not.

 

Thanks once again for listening to me. 

 

Namaste ...Lotus Lady

 

 

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2/16/10 9:30am

I'm really glad for this information.  I know that this round of the depression was different.....there wasn't just depression involved and it's going on 2 years.

 

Anxious distress: irrational worry, preoccupation with unpleasant worries, having trouble relaxing, motor tension, fear that something awful may happen

 

I could never really put into words how I feel and this discribes it to a T.

 

Thanks for the info.

2/16/10 10:33am

OMG - I think I'm developing some kind of complicated anxiety disorder just reading about this!  Some of it makes sense to me, but one that really threw me was the Apathy Syndrome - what??  That's how I feel when I'm depressed, oftentimes.  What I had first heard about this, I thought the goal was to simplify the diagnosis of some of these disorders, but it seems like they are getting more and more specific.  I'll probably go and read this so I'll know better what I'm talking about.  Some of the changes in terms sound like they're being done in the spirit of being "politically correct" or something.  Like calling something a "disorder" instead of "abuse" perhaps takes away the "blame" on the person who is suffering from it, I don't know.

 

Thanks, Merely Me, for making us aware of being able to look at this ourselves.

Anonymous
Virginia
2/16/10 6:14pm

I too am not sure that I completely understood all that I just read.  I am always thinking there has to be a name for what I go through and I certainly can't be alone.  I have been diagnosed with depression, anxiety, and of coarse the famous bipolar.  I still don't clearly understand the bipolar part.  I never have high moments.  There is low and lower for me.  I get frustrated feeling I am just not properly diagnosed and therefor not properly treated, feeling trapped and disabled.  I exercise and eat right and still I have these crashes that have me trapped in my home sometimes for 1 or 2 weeks at a time.  I don't know what causes it and I feel ashamed that I don't have more control of my depression and anxiety.  My family suffers and my quilt and self worth continues to grow.  I am glad to know that maybe the future may hold answers for me, maybe a solution.  Thanks for sharing this. 

Virginia

2/16/10 8:43pm

MM, Thanks for your synopses of some of the changes from DSM-IV. If the changes reduce stigma, that is a good thing.

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By Merely Me— Last Modified: 05/16/11, First Published: 02/16/10