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	<title>Symptom Advice .com &#187; chairs</title>
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		<title>Two proposed changes dropped from psychiatric guide</title>
		<link>http://symptomadvice.com/two-proposed-changes-dropped-from-psychiatric-guide/</link>
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		<pubDate>Sat, 19 May 2012 21:17:14 +0000</pubDate>
		<dc:creator>Symptom Advice</dc:creator>
				<category><![CDATA[anxiety symptoms]]></category>
		<category><![CDATA[chairs]]></category>
		<category><![CDATA[dsm 5]]></category>
		<category><![CDATA[psychiatric illness]]></category>
		<category><![CDATA[public outcry]]></category>
		<category><![CDATA[task force]]></category>

		<guid isPermaLink="false">http://symptomadvice.com/two-proposed-changes-dropped-from-psychiatric-guide/</guid>
		<description><![CDATA[Two proposed psychiatric diagnoses failed to make the &#108;&#097;&#115;&#116; &#114;&#111;&#117;&#110;&#100; of cuts in the laborious process of revising the Diagnostic &#097;&#110;&#100; Statistical Manual of Mental Disorders &#8212; &#097;&#110; exhaustive catalog of symptoms used &#098;&#121; doctors to diagnose psychiatric illness. Gone from the latest revision are &#8220;attenuated psychosis syndrome,&#8221; intended to &#104;&#101;&#108;&#112; identify individuals at risk [...]]]></description>
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<p>Two proposed psychiatric diagnoses failed to make the &#108;&#097;&#115;&#116; &#114;&#111;&#117;&#110;&#100; of cuts in the laborious process of revising the Diagnostic &#097;&#110;&#100; Statistical Manual of Mental Disorders &#8212; &#097;&#110; exhaustive catalog of symptoms used &#098;&#121; doctors to diagnose psychiatric illness.</p>
<p>Gone from the latest revision are &#8220;attenuated psychosis syndrome,&#8221; intended to &#104;&#101;&#108;&#112; identify individuals at risk of full-blown psychosis, &#097;&#110;&#100; &#8220;mixed anxiety depressive disorder&#8221;, &#097; blend of anxiety &#097;&#110;&#100; depression symptoms. Both performed badly on field tests &#097;&#110;&#100; in public comments gathered &#098;&#121; the group in &#105;&#116;&#115; march toward the May 2013 publication deadline.</p>
<p>Both &#104;&#097;&#118;&#101; &#098;&#101;&#101;&#110; tucked into Section III of the manual &#8212; the place reserved for ideas &#116;&#104;&#097;&#116; do not &#121;&#101;&#116; &#104;&#097;&#118;&#101; &#101;&#110;&#111;&#117;&#103;&#104; evidence to make the cut &#097;&#115; &#097; full-blown diagnosis.</p>
<p>What &#104;&#097;&#115; survived, &#100;&#101;&#115;&#112;&#105;&#116;&#101; fierce public outcry, is &#097; change in the diagnosis of autism, which eliminates the milder diagnosis of Asperger syndrome in favor of the umbrella diagnosis of autism spectrum disorder.</p>
<p>But &#116;&#104;&#097;&#116;, &#116;&#111;&#111;, &#099;&#111;&#117;&#108;&#100; &#115;&#116;&#105;&#108;&#108; be altered &#098;&#101;&#102;&#111;&#114;&#101; the final manual is published, the group &#115;&#097;&#121;&#115;. The APA opened the final comment period for &#105;&#116;&#115; fifth diagnostic manual known &#097;&#115; DSM-V on May 2, &#097;&#110;&#100; &#105;&#116; &#119;&#105;&#108;&#108; accumulate comments through June 15.</p>
<p>Dr. David Kupfer, &#119;&#104;&#111; chairs the DSM-5 Task Force, &#115;&#097;&#105;&#100; in &#097; statement &#116;&#104;&#097;&#116; the changes reflect the latest research &#097;&#110;&#100; input from the public.</p>
<p>Dr. Wayne Goodman, professor &#097;&#110;&#100; chairman of the department of psychiatry at Mount Sinai Medical Center in New York, &#115;&#097;&#105;&#100; he&#8217;s glad the task force is responding to feedback from professionals &#097;&#110;&#100; the public.</p>
<p>&#8220;I &#116;&#104;&#105;&#110;&#107; they are &#116;&#114;&#121;&#105;&#110;&#103; to listen,&#8221; &#104;&#101; &#115;&#097;&#105;&#100;.</p>
<p>Goodman agrees &#119;&#105;&#116;&#104; the decisions to drop both of the two disorders in the latest revision.</p>
<p>With the &#8220;mixed anxiety &#097;&#110;&#100; depressive disorder,&#8221; &#104;&#101; &#115;&#097;&#105;&#100; there &#119;&#097;&#115; &#097; risk &#116;&#104;&#097;&#116; &#105;&#116; &#119;&#111;&#117;&#108;&#100; capture &#097; number of people &#119;&#104;&#111; did not qualify &#117;&#110;&#100;&#101;&#114; &#097; diagnosis of depression &#111;&#114; anxiety &#097;&#108;&#111;&#110;&#101;.</p>
<p>&#8220;It &#099;&#111;&#117;&#108;&#100; lead to overdiagnosis,&#8221; Goodman &#115;&#097;&#105;&#100;.</p>
<p>He &#115;&#097;&#105;&#100; the &#8220;attenuated psychosis syndrome&#8221; diagnosis &#119;&#111;&#117;&#108;&#100; &#104;&#097;&#118;&#101; &#098;&#101;&#101;&#110; useful for research purposes to &#104;&#101;&#108;&#112; identify &#116;&#104;&#111;&#115;&#101; at risk of psychosis, but there &#119;&#097;&#115; &#097; concern &#116;&#104;&#097;&#116; &#105;&#116; might label people &#119;&#104;&#111; &#119;&#101;&#114;&#101; just &#097; bit different &#097;&#115; mentally ill.</p>
<p>&#8220;The predictive value is not clear &#121;&#101;&#116;,&#8221; &#104;&#101; &#115;&#097;&#105;&#100;. &#8220;I &#116;&#104;&#105;&#110;&#107; it&#8217;s reasonable not to codify &#105;&#116; &#117;&#110;&#116;&#105;&#108; &#119;&#101; &#104;&#097;&#118;&#101; better definition of &#105;&#116;&#115; predictive value.&#8221;</p>
<p>Goodman, &#119;&#104;&#111; worked on DSM-4, the &#108;&#097;&#115;&#116; revision of the manual published in 1994, &#097;&#110;&#100; is working on the Obsessive Compulsive Disorder section of the current revision of DSM-5, &#115;&#097;&#105;&#100; the strength of the process is &#116;&#104;&#097;&#116; &#105;&#116; can offer &#097; reliable way for psychiatrists &#097;&#099;&#114;&#111;&#115;&#115; the country to identify patients &#119;&#105;&#116;&#104; the same sorts of disorders.</p>
<p>The weakness, &#104;&#101; &#115;&#097;&#105;&#100;, is &#116;&#104;&#097;&#116; &#105;&#116; largely lacks biological evidence &#8212; blood tests, imaging tests &#097;&#110;&#100; the like &#8212; &#116;&#104;&#097;&#116; can validate these diagnoses.</p>
<p>&#8220;DSM-5 is &#097; refinement of &#111;&#117;&#114; diagnostic system, but &#105;&#116; doesn&#8217;t add to &#111;&#117;&#114; ability to understand the underlying illness,&#8221; &#104;&#101; &#115;&#097;&#105;&#100;.</p>
<p>Dr. Emil Coccaro, chairman of the Department of Psychiatry &#097;&#110;&#100; Behavioral Neuroscience at the University of Chicago Medicine, &#115;&#097;&#105;&#100; typically changes in the DSM occur because of new data.</p>
<p>Coccaro, &#119;&#104;&#111; is contributing to the new section in the DSM-5 on Intermittent Explosive Disorder, &#115;&#097;&#105;&#100; there is no question &#116;&#104;&#097;&#116; &#109;&#097;&#110;&#121; people aren&#8217;t convinced &#116;&#104;&#097;&#116; &#115;&#111;&#109;&#101; of the diagnoses need to be changed, &#111;&#114; &#116;&#104;&#097;&#116; there need to be new &#111;&#110;&#101;&#115; added.</p>
<p>&#8220;This &#097;&#108;&#115;&#111; happened the &#108;&#097;&#115;&#116; time when they did DSM-4,&#8221; &#104;&#101; &#115;&#097;&#105;&#100;, but &#116;&#104;&#097;&#116; &#119;&#097;&#115; &#110;&#101;&#097;&#114;&#108;&#121; 20 years &#097;&#103;&#111;.</p>
<p>&#8220;You can keep waiting but at certain point you &#104;&#097;&#118;&#101; to fish &#111;&#114; cut bait &#097;&#110;&#100; actually &#099;&#111;&#109;&#101; &#111;&#117;&#116; &#119;&#105;&#116;&#104; &#097; new edition. &#116;&#104;&#097;&#116; is &#119;&#104;&#097;&#116; is happening &#110;&#111;&#119;,&#8221; &#104;&#101; &#115;&#097;&#105;&#100;.</p>
<p>Comments to the manual can be submitted at DSM5.org</p></p>
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