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Will anyone be normal?

28 July 2010

An updated edition of international mental health guidelines may include diagnoses for ‘disorders’ such as toddler tantrums and binge eating, say experts from the Institute of Psychiatry (IoP) at King’s, and would mean that normal, healthy people could be diagnosed with a mental health condition.

Professor of Clinical Psychology and Vice-Dean of the IoP, Til Wykes, led a study which warns that a new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is being revised now, could label almost everyone as having some kind of disorder, with possible serious negative implications.

Wykes and colleagues Dr Felicity Callard, also of the IoP, and Nick Craddock of Cardiff University, believe that 'mild anxiety depression', 'psychosis risk syndrome', and 'temper dysregulation disorder', are new conditions whereby perfectly healthy people could in future be told they are ill.

The scientists said 'psychosis risk syndrome' diagnosis was particularly worrying, since it could falsely label young people who may only have a small risk of developing an illness. Commenting on this, Dr Callard said: 'Tagging teenagers as ‘at risk’ will blight their lives.'

'It's a bit like telling ten people with a common cold that they are 'at risk of pneumonia syndrome' when only one is likely to get the disorder,' added Wykes.

The DSM is published by the American Psychiatric Association (APA) and contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It is seen as the international diagnostic bible for mental health medicine.

The criteria aim to provide clear definitions for professionals and for researchers and pharmaceutical drug companies seeking to develop new ways of treating disorders.

'Technically, with the classification of so many new disorders, we will all have disorders,' the scientists said in a joint statement. 'This may lead to the belief that many more of us 'need' drugs to treat our 'conditions' (and) many of these drugs will have unpleasant or dangerous side effects.'

They gave examples from the previous revision to the DSM, which was called DSM 4 and included broader diagnoses and categories for attention deficit hyperactivity disorder (ADHD), autism and childhood bipolar disorders.

This, they said, had 'contributed to three false epidemics' of these conditions, particularly in the United States.

Wykes and Callard’s concerns about the upcoming DSM revision are published in the Journal of Mental Health. They alsohighlight in the same journal another ten or more papers from other scientists who were also worried. DSM 5 is due to be published in May 2013.



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