Psychiatry Metastasizes into the Rest of Medicine

I was going to say “into REAL medicine” but I guess the rest of medicine is almost as full of cruelty and quackery as psychiatry, they’re just somewhat constrained by obvious physical injuries and mortality.  But psychiatry promises to open new vistas of profiteering in medicine.

Your Physical Illness May Now Be Labeled a Mental Disorder

In “Physical Illnesses May Soon Be Labeled ‘Mental Disorders’” (December 27, 2012), I wrote about a disturbing development taking place in the drafting of the fifth edition of the DSM—the manual used to decide if people have a psychiatric disorder or not. Those who use the DSM to diagnose include a wide range of health care practitioners: psychiatrists and other physicians (such as primary care doctors), psychologists, social workers, occupational and rehab therapists. The list is long.

In that December piece, I described Somatic Symptom Disorder, a new mental illness that was being proposed for the new edition of the DSM. I wrote:

“People can be diagnosed with Somatic Symptom Disorder if, for at least six months, they’ve had one or more symptoms that are distressing and/or disruptive to their daily life, and if they have one [only one] of the following three reactions:

Criteria #1: disproportionate thoughts about the seriousness of their symptom(s);

Criteria #2: a high level of anxiety about their symptoms or health; or

Criteria #3: devoting excessive time and energy to their symptoms or health concerns.

Can you see how this diagnosis potentially includes everything from a stomach ache to cancer?

To repeat, this time using a hypothetical: For six months, you’ve had bad gastrointestinal symptoms that have been ‘disruptive to your daily life’ because you can’t be far from a bathroom. In the subjective view of a health practitioner, you’ve spent ‘excessive time and energy devoted’ to trying to figure out what to do about it (criteria #3). The result: you may well be diagnosed as suffering from a mental illness called Somatic Symptom Disorder.”

This is absurd. (For an analysis of the dangers of being diagnosed with Somatic Symptom Disorder, please read my full piece from December 27th.)

Despite the vehement opposition of many in the health care field—including many therapists—the American Psychiatric Association (who publishes the DSM) has included Somatic Symptom Disorder in the its fifth edition—DSM-5—which will be published in May. The refusal of the APA to even broaden the criteria for coming under Somatic Symptom Disorder is not just a bitter disappointment, but a potentially dangerous mistake for reasons outlined in my previous piece.

Among the professionals who fought hard against the inclusion of this new diagnosis is Allen Frances, M.D. who was the chair of the DSM-4 Task Force and of the department of psychiatry at Duke University School of Medicine, Durham, NC. He is currently a professor emeritus at Duke. He has just written a comprehensive article about this development: “Bad News: DSM 5 Refuses To Correct Somatic Symptom Disorder.” In it, he says:

“Somatic Symptom Disorder is defined so over inclusively by DSM 5 that it will mislabel 1 in 6 people with cancer and heart disease; 1 in 4 with irritable bowel and fibromyalgia…For reasons that I can’t begin to fathom, DSM 5 has decided to proceed on its mindless and irresponsible course. The sad result will be the mislabeling of potentially millions of people with a fake mental disorder that is unsupported by science and flies in the face of common sense.” …

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