systemagazin

Online-Journal für systemische Entwicklungen

Boykott des DSM-V

In den USA hat sich kurz nach der Bekanntgabe der Veröffentlichung der neuen DSM-Version ein„Committee to Boycott the DSM-V“ gegründet, dass die fragwürdige Konstruktion des neuen Diagnostischen Manuals und seine fehlende wissenschaftliche Begründung attackiert (siehe hierzu auch das Buch von Allen Frances: Normal. Gegen die Inflation psychiatrischer Diagnosen). In einer Pressemitteilung vom 6.2. heißt es:

„Little more than 2 weeks after the American Psychiatric Association’s announced that its new Diagnostic and Statistical Manual, DSM-5, was available for “pre-order”, the Committee to Boycott the DSM-5 has called for a boycott of the new Manual by professional mental health practitioners, researchers and all those who might have occasion to use it. Comprised of professionals and activists across the United States and Canada, the Committee is also urging users of mental services and their families to press the psychotherapists and physicians who treat them to neither  purchase nor use the DSM-5. The new edition of the DSM, often referred to as “ psychiatry’s bible”, is scheduled for publication by the American Psychiatric Association in May of this year.
The Committee’s objective is to curtail sales of the new DSM, which, in previous editions, has sold millions of copies throughout the world, and to persuade practitioners who are obliged to use diagnostic codes to utilize those contained in the International Classification  of Diagnoses (ICD).  The Boycott Committee’s opposition to the new DSM is rooted in its concern that the DSM and its several hundred diagnoses or disease categories can do much more harm than good when applied to psychiatric patients. The Committee points to the analytical work of American clinical researchers Stuart Kirk and Herb Kutchins and of Richard Bentall of the U.K. which demonstrates that the DSM’s diagnoses have little scientific evidence to support them. In research terms, they have no construct validity and very poor inter-rater reliability, or agreement among psychiatrists about the definitions of clinical diagnoses. The Committee also cites the admission this past December by Dr. Dilip Jeste, president of the APA, that twenty years of research had revealed that “… most psychiatric disorders lack validated diagnostic biomarkers, and … psychiatric diagnoses are still mostly based on clinician assessment…”
The constant criticism that has accompanied compilation of the new DSM and the resulting skepticism about DSM’s classification system have called into question a range of diagnoses, including those presumably long-established, such as schizophrenia, and those just added to the new DSM by the APA’s DSM-5 Task Force, which number more than fifty. Among these latter is Somatic Symptom Disorder, which is defined in DSM-5 as preoccupation with the symptoms of chronic illnesses by those who suffer from them. Consternation has also been caused by the removal of the bereavement exception from assessment of serious depression. Individuals who experience grieving that extends beyond two weeks will now find themselves, should they visit a psychiatrist or psychotherapist for help, candidates for diagnosis with Major Depressive Disorder.
The great fear among Committee members is that ordinary behavior will now be construed as pathological. Coincidentally, all references to psychosocial, environmental and spiritual issues, integral to clinical assessment in DSM-IV, have been removed from DSM-5. This decision appears to send a clear signal to clinicians that treatment for persons judged to have psychiatric disorders can be reduced to the prescription of psychoactive medications, despite evidence of their toxicity and growing doubt about their effectiveness.
Ultimately, the APA appears to have shrugged off the criticism received from professional, advocacy and lay public stakeholders during the three public reviews of its proposals.  In the estimation of many, the APA has undermined its own credibility, choosing to protect its intellectual property and publishing profits, not the public trust. Allen Frances, editor of the DSM-IV and most widely known critic of the new DSM, recently asserted that the price of $199 per copy of the new DSM will make it the most costly of all DSMs published to date and represents the APA’s attempt to re-coup its $25 million investment in DSM-5’s development and publication“
Weitere Informationen und einen Blog gibt es hier…

 

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