The revised edition is a good three years away from publication – if not more so. Yet, even as early as that, there are already debates raging about the content of the book. Psychiatrists the world over have engaged in arguments on what should and should not end up as recognized conditions in the next edition of the Diagnostic and Statistical Manual of Mental Disorders. The outcome of the debates and questions could determine changes to existing policies regarding insurance reimbursement, research, and even how to classify people's psychological profiles and histories. So it comes down to more than just which apparent mental illness gets to join conditions like depression, anxiety, and schizophrenia in the text.
Should compulsive shopping be considered a mental problem? Is the so-called “post-nuptial depression” a real mental disorder, or just part of the transition from single life to married life? Should this fetish or that be considered a mental disorder, as many of them currently are? These questions need to be answered before the revised edition of the manual – arguably the main authority psychiatrists consult on mental illnesses – is put to the printers. It has become so contentious in some areas that contributors are being made to agree to a nondisclosure agreement for the first time since the book's inception.
The debates rage because the book is not merely a manual, but also serves as a medical guidebook and, according to some, a bit of a cultural institution. The text is designed to help doctors make an accurate diagnosis, provides insurance companies with codes that would help them reimburse for a patient's treatment claims, and serves as reference material for many mental health professionals. The manual typically organizes conditions under evocative names, with labels such as obsessive-compulsive disorder and clinical depression having strong connotations outside of the mental health profession.
One concern of the people behind the manual is that their field is not like other medical fields, where the conditions are relatively well-known. For the most part, prior to the introduction of Prozac, psychiatrists were uncertain about what, exactly, caused most mental disorders. The manual doesn't address all those concerns, but it does provide a good framework for the ones that medical science does have an understanding of.
Should compulsive shopping be considered a mental problem? Is the so-called “post-nuptial depression” a real mental disorder, or just part of the transition from single life to married life? Should this fetish or that be considered a mental disorder, as many of them currently are? These questions need to be answered before the revised edition of the manual – arguably the main authority psychiatrists consult on mental illnesses – is put to the printers. It has become so contentious in some areas that contributors are being made to agree to a nondisclosure agreement for the first time since the book's inception.
The debates rage because the book is not merely a manual, but also serves as a medical guidebook and, according to some, a bit of a cultural institution. The text is designed to help doctors make an accurate diagnosis, provides insurance companies with codes that would help them reimburse for a patient's treatment claims, and serves as reference material for many mental health professionals. The manual typically organizes conditions under evocative names, with labels such as obsessive-compulsive disorder and clinical depression having strong connotations outside of the mental health profession.
One concern of the people behind the manual is that their field is not like other medical fields, where the conditions are relatively well-known. For the most part, prior to the introduction of Prozac, psychiatrists were uncertain about what, exactly, caused most mental disorders. The manual doesn't address all those concerns, but it does provide a good framework for the ones that medical science does have an understanding of.
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