So these folks are implying that the rework of the DSM-4 into DSM-5 was tainted in some way by association of the authors with pharma or other industries? Do I understand that correctly?
Is there an example that anyone has pointed to where DSM-5 could have been written differently, to the detriment of a commercial enterprise? (What little I've read in the DSM-5 is enough to leave one with glazed eyes.)
readthenotes1 · 25m ago
I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research.
I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...
brooke2k · 1m ago
The DSM isn't about understanding how the brain works, it's about correlating sets of symptoms to treatments. If your issues are characterized by this broad set of symptoms, then likely you'll benefit from these sorts of treatments, and etc. We don't have a good understanding of how the brain works, but we're pretty confident that people with schizophrenia often benefit from antipsychotic medications.
SketchySeaBeast · 15m ago
The brain is certainly difficult to study, but does it not stand to reason that there should be a collection of the current understanding? No one is calling the DSM V the final, definitive, work, there's a reason it's numbered.
mapontosevenths · 1h ago
Sometime in the early 2000's we passed a point where more than 50% of the population had an AXIS 2 or higher chemical disorder[1]. It was around this point that I became skeptical of the DSM.
If the majority of people are crazy, it's likely that our definition of "crazy" needs work.
That said, the situation isn't as dire as some folks with a vested interest would have you believe... If you're reading this and you're someone who needs to hear it: Keep taking your medicine! They'll work the kinks out eventually, and even if there is a conspiracy, it isn't against you personally.
[1] I meant personality disorder. Leaving the mistake to avoid making the thread confusing.
SketchySeaBeast · 1h ago
What is an Axis II chemical disorder? I'm fairly certain that Axis II was personality disorders and intellectual disabilities in the DSM IV.
70% of people 60 years of age and older have high blood pressure[1], 50% of men regardless of age. Does this mean that our definition of high blood pressure needs work?
I'm not arguing that the DSM is perfect, but it's possible for something to be bad and also common. But I appreciate the "Keep taking your meds" sentiment as well, it has bigger problem overall, but it can still help people.
>I'm fairly certain that Axis II was personality disorders and intellectual disabilities in the DSM IV.
You are 100% correct, I thought personality disorders and typed chemical disorders for some reason. I'll leave the mistake so the thread makes sense.
> Does this mean that our definition of high blood pressure need work?
I think there's a difference between a disorder that is defined mechanistically and a disease that is only defined relatively. For example, if you're missing an arm, or at huge risk of stroke that's fairly obvious. However, if you are less happy than average, and more than 50% are also less happy then average... something is wrong with the math.
*EDIT* To make matters worse I should have said Axis 1 instead of 2. This is what I get for trying to remember a 20+ year old reference without citing it.
Ok, so we're on the same page as to what we're referring to, but, to be clear, that 50% claim is incorrect[1], it's much lower than that.
Who is claiming that more than 50% of people are "less happy than average"? That's not a disorder. I'm fairly certain that the DSM doesn't make a claim like that, does the APA? It feels straw-manish.
I know that it's hard to diagnose these more intangible issues, but they are still very important regardless. If more than 50% of people in a society were unhappy, isn't it possible that the society is making them that way and it's not something wrong with the scale?
I tried to correct myself above, and included the source this time.
The actual statistic I was misremembering says that 50.8% of people will meet the requirements for an Axis 1 or higher diagnoses before the age of 75. You're right that it's important to be accurate. Mea Culpa.
To the actual point of my wildly incorrect claim: If most people are judged to be mentally ill at some point in their life, and most of the diagnoses can only be made relative to some baseline that's deemed to be "normal", isn't that just a different way of saying that it's "normal" to be mentally ill?
SketchySeaBeast · 4m ago
I don't think that it's incorrect at all to say that half of us will at some or multiple points in time suffer from some disorder, in fact I find it comforting to recognize that we will all go through this at some point.
We all go through rough patches that can make our mental health slip, just like we go through rough patches where our physical health slips. What's important is that we recognize when something is wrong and get the help we need.
Just like my first point, it's normal to be older and have high blood pressure, but if that's the case, you should probably be taking medication.
tomjakubowski · 7m ago
Most mental health diagnoses are transient. If half of people at some point experience diagnosable mental illness in their lives, that doesn't seem all that outlandish to me. Most of us will, at some point, have some kind of non-psychiatric illness, too.
lazide · 48m ago
[flagged]
dang · 4m ago
Please keep nationalistic flamebait off this site. It leads to nationalistic flamewars, which we want to avoid here.
His whole career revelved around promoting strategies for policing and incarceration that clearly don't work, and the APA celebrated him for it. They have a huge bias toword the notion that everyone needs their help. Problems with the DSM wouldn't matter so much, if the APA hadn't shoehorned themselves, and their bible of the DSM, into countless aspects of government and healthcare.
qualeed · 39m ago
The DSM-5 is from the "American Psychiatric Association".
Phillip Zimbardo, and the link you linked to, are the "American Psychological Association".
These are two different associations.
Theresa Miskimen is the president of the American Psychiatric Association, not Zimbardo.
No comments yet
alessandru · 46m ago
so ... apa ...the apa that writes the dsm-5, psychiatric disorders, the medical group, is the american PSYCHIATRIC assn.
the psychologists, they never went to medical school, so despite forming an organization and many publications, have little to do with diagnostic standards for medical doctors.
for clarity: THERE ARE TWO APA, the one written about in the article is not the same as the one in this comment.
sekh60 · 18m ago
There's also the American Philosophical Association.
Telemakhos · 4m ago
There used to be an American Philological Association, but they decided to change their name to the "Society for Classical Studies," because most people don't know the word "philology."
Is there an example that anyone has pointed to where DSM-5 could have been written differently, to the detriment of a commercial enterprise? (What little I've read in the DSM-5 is enough to leave one with glazed eyes.)
I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...
If the majority of people are crazy, it's likely that our definition of "crazy" needs work.
That said, the situation isn't as dire as some folks with a vested interest would have you believe... If you're reading this and you're someone who needs to hear it: Keep taking your medicine! They'll work the kinks out eventually, and even if there is a conspiracy, it isn't against you personally.
[1] I meant personality disorder. Leaving the mistake to avoid making the thread confusing.
70% of people 60 years of age and older have high blood pressure[1], 50% of men regardless of age. Does this mean that our definition of high blood pressure needs work?
I'm not arguing that the DSM is perfect, but it's possible for something to be bad and also common. But I appreciate the "Keep taking your meds" sentiment as well, it has bigger problem overall, but it can still help people.
[1] https://www.cdc.gov/nchs/products/databriefs/db511.htm
You are 100% correct, I thought personality disorders and typed chemical disorders for some reason. I'll leave the mistake so the thread makes sense.
> Does this mean that our definition of high blood pressure need work?
I think there's a difference between a disorder that is defined mechanistically and a disease that is only defined relatively. For example, if you're missing an arm, or at huge risk of stroke that's fairly obvious. However, if you are less happy than average, and more than 50% are also less happy then average... something is wrong with the math.
*EDIT* To make matters worse I should have said Axis 1 instead of 2. This is what I get for trying to remember a 20+ year old reference without citing it.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
Who is claiming that more than 50% of people are "less happy than average"? That's not a disorder. I'm fairly certain that the DSM doesn't make a claim like that, does the APA? It feels straw-manish.
I know that it's hard to diagnose these more intangible issues, but they are still very important regardless. If more than 50% of people in a society were unhappy, isn't it possible that the society is making them that way and it's not something wrong with the scale?
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3105841/
The actual statistic I was misremembering says that 50.8% of people will meet the requirements for an Axis 1 or higher diagnoses before the age of 75. You're right that it's important to be accurate. Mea Culpa.
To the actual point of my wildly incorrect claim: If most people are judged to be mentally ill at some point in their life, and most of the diagnoses can only be made relative to some baseline that's deemed to be "normal", isn't that just a different way of saying that it's "normal" to be mentally ill?
We all go through rough patches that can make our mental health slip, just like we go through rough patches where our physical health slips. What's important is that we recognize when something is wrong and get the help we need.
Just like my first point, it's normal to be older and have high blood pressure, but if that's the case, you should probably be taking medication.
https://news.ycombinator.com/newsguidelines.html
His whole career revelved around promoting strategies for policing and incarceration that clearly don't work, and the APA celebrated him for it. They have a huge bias toword the notion that everyone needs their help. Problems with the DSM wouldn't matter so much, if the APA hadn't shoehorned themselves, and their bible of the DSM, into countless aspects of government and healthcare.
Phillip Zimbardo, and the link you linked to, are the "American Psychological Association".
These are two different associations.
Theresa Miskimen is the president of the American Psychiatric Association, not Zimbardo.
No comments yet
the psychologists, they never went to medical school, so despite forming an organization and many publications, have little to do with diagnostic standards for medical doctors.
for clarity: THERE ARE TWO APA, the one written about in the article is not the same as the one in this comment.