The Art of Psychiatry

January 13, 2007 11:48 AM

Dictionary of Disorder - shaping the DSM
posted by Gyan (12 comments total)

That's good. That's a start. Let's go with that. Give me more than just the one link to work with here. Tell me how you feel about the DSM.
posted by hal9k at 12:04 PM on January 13, 2007

AAFP Using DSM-IV Primary Care Version: A Guide to Psychiatric Diagnosis in Primary Care
DSM-IVTR Quick Reference now available for your PDA. Handy for quick diagnoses at the holiday dinner table.
Extra credit: Original plans to build your own Orgone Accumulator or buy an assembled smaller case-mod version which apparently converses with your house plants about what's in the refrigerator.
posted by hal9k at 12:22 PM on January 13, 2007 [1 favorite]

or buy an assembled smaller case-mod version which apparently converses with your house plants about what's in the refrigerator.

$600!!!
posted by delmoi at 12:25 PM on January 13, 2007

$600!!!

Indeed. You'd be crazy not to buy it.
posted by hal9k at 12:31 PM on January 13, 2007

Interesting article; thanks. More on Spitzer.
posted by weapons-grade pandemonium at 12:36 PM on January 13, 2007

Indeed. You'd be crazy not to buy it.

yeah but exactly what type of crazy?
posted by edgeways at 12:38 PM on January 13, 2007

Caffeinism was always my favourite bit of DSM IIIR madness. We used to sit around at college, skimming for diagnoses, and laughing at the particularly nutty ones.

I mean, how is drinking too much coffee a mental illness? Especially when you are an overly-caffeinated college student?
posted by QIbHom at 1:05 PM on January 13, 2007

Caffeinism was always my favourite bit of DSM IIIR madness

Personally I like Body Dysmorphic Disorder. When you have such a common "disorder", you vastly increase the potential profits of the pharmaceutical industry.
posted by Tube at 2:29 PM on January 13, 2007

The money quotes are in the last few paragraphs:
"There are lots of studies which show that clinicians diagnose most of their patients with one particular disorder and really don’t systematically assess for other disorders. They have a bias in reference to the disorder that they are especially interested in treating and believe that most of their patients have."

That was my experience with a school psych and one of my kids. The guy was totally tone-deaf to the actual kid. He just wanted to prescribe. A witch doctor with a rattle and a bone through his nose could do better.
posted by hexatron at 3:21 PM on January 13, 2007

The article is a nice background piece on the evolution of the DSM over the years, but I think the central point really needs to be emphasized, because so many people take it for granted:

Psychiatric diagnoses are not as reliable as traditional medical diagnoses. I believe this is at least partially because there are no physical, widely used laboratory tests to help aid in the subjective judgments both the client and therapist are asked to make in the DSM criteria.

And diagnosis is usually far more helpful when you have a set of reliable, empirical treatments you can then apply systematically. Here, psychiatry and mental health treatment are worse off than their medical counterparts. Treatment is far from systematic, even from the same therapist, and there is little differentiation to help a doc determine what drug would suit an individual best (e.g., there are more than 2 dozen different antidepressant medications available).
posted by docjohn at 3:46 PM on January 13, 2007

Personally I like Body Dysmorphic Disorder. When you have such a common "disorder", you vastly increase the potential profits of the pharmaceutical industry.

Actual BDD is a lot more scary and less common than you think. It's like the difference between a nervous person and someone who suffers from an anxiety disorder.
posted by TypographicalError at 4:03 PM on January 13, 2007

I'd say the art and the science of psychiatry. That's what makes it such a complex and subtle field.

Thanks for your post Gyan. This subject, the DSM and its history, interests me intensely. I'm curious why you posted this New Yorker article published 2 years ago?

Alix Spiegel's Eighty-One Words.

On NPR about self mutilation.

On Freud's Nephew and the Origins of Public Relations.

Robert Spitzer (Wikipedia), Google video.

"Spitzer’s lasting contribution to modern psychiatry was his effort to standardize the detection and quantification of all emotional disorders. There’s the rub."

"Because insurance companies now require a DSM diagnosis for reimbursement, the manual is mandatory for any mental-health professional seeking compensation. It’s also used by the court system to help determine insanity, by social-services agencies, schools, prisons, governments"...

"In the course of defining more than a hundred mental diseases, he not only revolutionized the practice of psychiatry but also gave people all over the United States a new language with which to interpret their daily experiences and tame the anarchy of their emotional lives. "

That said the DSM has a lot of room for improvement in the quantifying.
posted by nickyskye at 8:34 PM on January 13, 2007