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Changes proposed to the manual of mental illness causes controversy for many
The American Psychiatric Association is proposing to revise how it categorizes mental illnesses, which has ignited a storm of controversy among the medical community, the pharmaceutical industry and the public.
Doctors and pharmacists are concerned about the affects these changes will have on the way patients are diagnosed and prescribed medicine. The guideline currently used, called the Diagnostic and Statistical Manual-VI has been in effect for 16 years. The APA says it wants to put out a fifth edition.
“Anything you put in that book, any little change you make, has huge implications not only for psychiatry but for pharmaceutical marketing, research, for the legal system, for who’s considered to be normal or not, for who’s considered disabled,” said Dr. Michael First, a professor of psychiatry at Columbia University to the New York Times .
The manual defines all psychiatric disorders and lists the criteria for diagnosis. It is the only sourcebook on how to diagnose mental illness.
The first recorded account of the insane is found on the 1870 US Census that included a category for “idiocy/insanity.” From those two basic categories now expand over 300 disorders, which are accounted for in the manual. The psychiatric drugs used to treat these disorders, most of which have been patented within the last 60 years, are now innumerable.
Psychiatry has seen an epidemic misdiagnosis of attention deficit disorder, obsessive-compulsive disorder, bipolar disorder and autism in recent years. One of the goals of this revision is to redress such over diagnosis. The APA is determined to prevent a similar epidemics fueled by the burgeoning pharmaceutical industry by revising the criteria of these trendy disorders.
The revisions also call for a jettison of some illnesses including agoraphobia without history of panic disorder.
Reclassifying is another method the taskforce has used to refine the meanings of certain diseases. Personality disorders category is undergoing a major reformulation based on a proposed 4-part assessment with an increasing degree of specificity of traits and types.
Additions have been made also. Substance induced tic disorder and hoarding disorder may make a debut in the anxiety disorder category.
The DSM-V task force, a group of doctors assigned by the American Psychiatric Association, is the one making these editorial decisions. Logically, doctors are the best suited for this task, but the APA believes those affected should also be allowed to get their word in.
With a progressive attitude towards democracy and a sense of social responsibility, the APA has encouraged feedback from the general public to these revisions, which they will consider when composing their revised drafts to the manual.
Long-time psychiatric patient Zach Myers says, “I’m not going to read the revisions. Crazy is chronic and the stigma is the same. As long as my meds don’t change, I don’t care what they call it.”
Myers, a 30-year-old unemployed Memphis native was diagnosed with Bipolar II disorder his senior year of college when he had a nervous breakdown. After his diagnosis, he dropped out of the University of Mississippi and has since subsisted off of his social security mental disability pension. He now spends most of his time spending at coffee shops where he likes to read books and visit friends.
Proposing such dialogue between patients and practitioners is groundbreaking, and it underscores the multidimensional multidisciplinary interest in these changes.
“The more people that get to comment the better because otherwise there’s going to be some self-serving interest there,” says Eldon New, scholar of psychology. New, a graduate of Rhodes college and avid reader of psychological texts, studied the DSM when it was first introduced thirty years ago.
New has been been keeping up with the changes made to the original DSM throughout his education at Rhodes College and the University of Memphis and his career as a computer software engineer in Memphis, TN.
Doctors, invariably, give preference to the psychiatric areas of their specialty. Most psychiatrists in the United States service children, perhaps one of the reasons why the majority of the new prescribers to psychiatric drugs are under the age of 13.
Patients have a personal interest as they are unwilling to fall victim to the judgment of influential academicians and the opportunistic instincts of pharmaceutical lobbyists.
Not only doctors and patients, but also pharmaceutical companies, insurance companies and lawmakers have interests.
“The change that makes sense to me is the kind that takes place over a hundred years. I’m not sure culture changes enough in ten or twenty years enough to justify relabeling things,” says Eldon New.
To read the proposed revisions to the DSM-IV, click here.
Photos taken by Priyanka Bhagat in Memphis, TN
One of the most unrelenting advertising campaigns circulating promotes Microsoft’s Bing search engine, “the first ever decision engine.” This is Microsoft’s definitive attempt to rival monolithic Google, who has not had close contender in the history of the internet. Trying to rival this behemoth is an ambitious goal, and Microsoft is breaking ground in the dialogue about the ownership of the internet and the media in an attempt to underhand Google.
On Novemeber 24, Microsoft proposed to pay media conglomerate Newscorp to disallow Google from indexing their property, which would effectively cut Google off from displaying news from the world’s biggest news conglomerate.
This is an enticing deal to news corporations, whose revenue has been declining since the advent of the internet. An influx of competition has driven drown the price of news; and news corporations are hurting for cash.
Owner of Newscorp, Rupert Murdoch has proven willing to eschew convention. He is a major player in the legislation concerning ownership of the media and communication politics. Perhaps it is not outlandish to think he might consider this offer which would in effect cut his product off to a formidable percentage of his patrons. It’s probably The Wall Street Journal, owned by Newscorp, could lose would up to 25 percent of their internet readership, according to seekingalpha.com.
In addition to cutting off Google’s main news supply. Microsoft has affiliates with many of the world’s biggest corporations, like Ebay, Dell, AT&T to name a few. Microsoft offers a cashback incentive to internet shoppers who search for goods through their engine. Consumers receive a percentage of their money back for the purchases made through these affiliate merchants.
Bing’s marketing campaign stresses the ease of use and succinctness of results. The commercials feature someone trying to communicate with a friend who has turned into a spacy automaton spewing out stream-of-consciousness media babble in a trance-like state. The question posed is: “What has search overload done to us? Find the cure at Bing.com. It’s not just a search engine. It’s Bing, the first ever decision engine from Microsoft.”
Bing advertisers boast a more user-friendly and aesthetically pleasing interface. Internet users can decide to for themselves. There is a site out now www.bing-vs-google.com that makes it easier for the searcher to make their comparison. It pulls up both engines’ results on a split screen so users can decide for themselves which produces the best results.