Act now to prevent physical illnesses from being categorized as mental illnessesDSM stands for The Diagnostic and Statistical Manual of Mental Disorders. It is often referred to as the The Bible of mental disorders because it’s what health care practitioners use to decide if their patients have a psychiatric disorder or not. The DSM-5—its 5th edition—is about to go to the printers and will be released in May 2013. It is published by the American Psychiatric Association (APA) which gave final approval to the DSM-5 even though more than fifty mental health professional associations petitioned for an outside review, and even though professional journals, the press, and the public vehemently objected to several changes that were made to this edition.
In this piece, I want to discuss Somatic Symptom Disorder or SSD—a new diagnosis that’s been added to the DSM-5. It has garnered little attention.
One exception is a recent article written by Allen Frances, M.D., “Mislabeling Medical Illness as Mental Disorder.” After you read this piece, I hope you’ll click on the link to Dr. Frances’ article. He has the best chance (via the number of "page views" on his piece and any comments you leave) to get your feedback to the APA before the DSM-5 goes to press.In my opinion, Somatic Symptom Disorder is a dangerous addition to the DSM-5.
The word “somatization” refers to psychological stress that manifests in the form of physical symptoms. In other words, a person’s physical symptoms are traceable to a mental or emotional cause rather than to a physical one. The current edition of the DSM—DSM-4—has a category called “Somatoform Disorder,” but it is so different in criteria from this new Somatic Symptom Disorder, that I won’t take the time to compare them. And Somatoform Disorder is being replaced by SSD anyway.
Here is the new DSM’s definition of Somatic Symptom Disorder. (Warning: you may have trouble believing what you’re about to read.)
People can be diagnosed with SSD if, for at least six months, they’ve had one or more symptoms that are distressing and/or disruptive to their daily life, and if they have one of the following three reactions:
Criteria #1: disproportionate thoughts about the seriousness of their symptom(s);
Criteria #2: a high level of anxiety about their symptoms or health; or
Criteria #3: devoting excessive time and energy to their symptoms or health concerns.
Are you doing the same double take that I am? That double take warrants repeating this information. Once again, here’s the recipe for SSD. Take only one six-month-old bodily symptom that is distressing or disrupts your daily life. Add to it one of the following: disproportionate thoughts about the seriousness of the symptom or a high level of anxiety about the symptom or about your health or devoting excessive time and energy to the symptom or to health concerns.
Can you see how this diagnosis potentially includes everything from a stomach ache to Cancer?
One more repeat, this time using a hypothetical: For six months, you’ve had bad gastrointestinal symptoms that have been disruptive to your daily life because you can’t be far from a bathroom. In the subjective view of a diagnosing health practitioner, you’ve spent excessive time and energy “devoted” to trying to figure out what to do about it (criteria #3)—SLAM—you are now suffering from a mental illness: Somatic Symptom Disorder.
In addition to well-recognized illnesses such as Cancer, Diabetes, Heart Disease, here are some physical illnesses that could easily come under this new criteria: Chronic Fatigue Syndrome, Fibromyalgia, Irritable Bowel Syndrome, Chronic Lyme Disease, Chronic Migraines, Neuropathy, Rheumatoid Arthritis, Interstitial Cystitis, Systemic Lupus, Ehlers-Danlos Syndrome, RSD, Gulf War Syndrome and other chemical injuries… the list could go on and I’m sure you who are reading this could add to it.
What’s the problem with all of this? I recognize that there could be a plus side to being diagnosed based on the DSM. Some health insurance companies won’t cover mental health treatments (from therapy to psychotropic drugs) unless the patient has a diagnosis from the DSM.
So if you wished to seek therapy or try these medications to help you adjust to the drastic life changes brought about by chronic pain or illness, it’s possible that this expanded definition of somatic disorders will allow you to get these services paid for by your insurance company. But the downsides of including Somatic Symptom Disorder in the DSM-5 far outweigh the benefits.
What about illnesses that can take years to diagnose, such as Lyme Disease, Fibromyalgia, Multiple Sclerosis, Systemic Lupus and other autoimmune diseases? If a patient is given a Somatic Symptom Disorder diagnosis early on after reporting symptoms, it’s highly possible that further testing and investigation into physical causes will be put on hold and a person would never get the proper diagnosis and treatment. I thought the rule of thumb in medicine was to rule out physical causes before settling on psychological ones.
Hmmmm.....Can't say that i like where this is going, my first thought is if they can put it in a different CAT of disease then probably compensation and or medication cost can be limited or reduced.Call me a fool but my guess it's a financial 'scam' to limit Obamacare costs.AND YOU WONT GET A GUN PERMIT!Read the Full story here.