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Psychiatry's New Diagnostic Manual: "Don't Buy It. Don't Use It. Don't Teach It."

That's what psychiatrist Allen Frances, chair of the DSM-IV task force, has to say about DSM-5.

| Tue May 14, 2013 6:00 AM EDT

The 11 Most Harmful Changes in DSM-5

(According to psychiatrist Allen Frances)

1. Disruptive Mood Dysregulation Disorder: DSM-5 turns temper tantrums into a mental disorder—a puzzling decision based on the work of only one research group.

2. Normal grief will become Major Depressive Disorder, thus medicalizing and trivializing our expectable and necessary emotional reactions to the loss of a loved one. 

Allen Frances, M.D.
Dr. Allen Frances Donna Manning

3. The forgetfulness of old age will now be misdiagnosed as Minor Neurocognitive Disorder, creating a huge false positive population of people who are not at special risk for dementia.

4. DSM-5 will likely trigger a fad of Adult Attention Deficit Disorder, contributing to the already large illegal secondary market in diverted prescription drugs. 

5. Excessive eating 12 times in three months is no longer just a manifestation of gluttony. Now it's a psychiatric illness called Binge Eating Disorder.

6. Changes in the definition of autism will result in lowered rates—10 percent according to estimates by the DSM-5 work group, perhaps 50 percent according to outside research groups. This may be seen as beneficial, but advocates fear a disruption in needed school services.

7. First-time substance abusers will be lumped in by definition with hardcore addicts, despite their very different treatment needs.

8. DSM-5 creates a slippery slope by introducing the concept of behavioral addictions that eventually can spread to make a mental disorder of everything we like to do a lot.

9. DSM-5 obscures the already fuzzy boundary between Generalized Anxiety Disorder and the worries of everyday life. Small changes in definition can create millions of anxious new "patients." 

10. DSM-5 opens the gate further to the existing problem of misdiagnosis of PTSD in forensic settings. 

11. Somatic Symptom Disorder makes worrying about your medical illness a psychiatric problem. It would affect 25 percent of chronic pain patients and 15 percent of cancer patients, who may be stigmatized as a result.

The first 10 items are excerpted from a list Frances put together previously for Psychology Today.

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Photoillustration: Sam Baldwin

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