‘Unspecified Mental Disorder’? That’s Crazy!

The newest edition of DSM, the Diagnostic and Statistical Manual that classifies and defines psychiatric conditions, has eliminated some fairly well-known conditions, like Aspergers syndrome, but also added new ones. Some of the newer ones border on the normal, like not being able to stop reading the newspaper when your spouse is talking…

The Wall Street Journal has a well written letter to the editor by Dr Leonard Sax about this:

But what if your symptoms are too vague even to nudge the compass, however sluggishly, in any direction, toward any particular diagnosis whatsoever? What if you’re just feeling down because you’re not “living your best life,” to borrow Oprah’s phrase, and you want your doctor to fix the problem? No worries. The DSM-5 offers a completely new diagnostic category “Unspecified Mental Disorder” (see page 708). The only requirement is that you “do not meet the full criteria for any mental disorder.”

How do the authors of DSM-5 justify such fuzziness? They invoke the analogy of high blood pressure and high cholesterol. As Dr. David Kupfer, chairman of the American Psychiatric Association’s DSM-5 Task Force, and two of his colleagues wrote in the April 24 Journal of the American Medical Association, there is no sharp dividing line between normal and high blood pressure or between normal and high cholesterol, there is merely a “continuum of normality.” A similar continuum, they argue, exists for mental health. “Thus DSM-5 provides a model that should be recognizable to nonpsychiatrists.”

In other words, everybody’s a little bit crazy, it just depends where you are on the “continuum of normality.”


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