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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Kind regards,<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Lauren<o:p></o:p></span></p>
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<p class="MsoNormal"><b><span lang="EN-US" style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span lang="EN-US" style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> Chamberlain, Kerry [mailto:K.Chamberlain@massey.ac.nz]
<br>
<b>Sent:</b> Monday, 3 December 2012 3:31 AM<br>
<b>To:</b> ischp@lists.massey.ac.nz<br>
<b>Subject:</b> DSM 5 Is Guide Not Bible<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><o:p> </o:p></span></p>
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<h1 style="mso-line-height-alt:15.0pt;background:white"><span style="font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes" title="http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes"><span style="font-size:10.0pt">http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes</span></a><o:p></o:p></span></h1>
<h1 style="mso-line-height-alt:15.0pt;background:white"><span style="font-size:16.5pt;font-family:"Arial","sans-serif";color:#333333;font-weight:normal">DSM 5 Is Guide Not Bible—Ignore Its Ten Worst Changes</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></h1>
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<p class="MsoNormal" style="line-height:15.0pt;background:white"><span style="font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666">APA approval of DSM-5 is a sad day for psychiatry.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<p class="MsoNormal" style="line-height:15.0pt;background:white"><span class="submitted"><span style="font-size:8.5pt;font-family:"Arial","sans-serif";color:#666666">Published on December 2, 2012 by</span></span><span class="apple-converted-space"><span style="font-size:8.5pt;font-family:"Arial","sans-serif";color:#666666"> </span></span><span class="submitted"><span style="font-size:8.5pt;font-family:"Calibri","sans-serif";color:#666666"><a href="http://www.psychologytoday.com/experts/allen-j-frances-md" title="View Bio"><span style="font-family:"Arial","sans-serif"">Allen
J. Frances, M.D.</span></a></span></span><span class="apple-converted-space"><span style="font-size:8.5pt;font-family:"Arial","sans-serif";color:#666666"> </span></span><span class="submitted"><span style="font-size:8.5pt;font-family:"Arial","sans-serif";color:#666666">in</span></span><span class="apple-converted-space"><span style="font-size:8.5pt;font-family:"Arial","sans-serif";color:#666666"> </span></span><span class="submitted"><span style="font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/blog/dsm5-in-distress"><span style="font-size:8.5pt;font-family:"Arial","sans-serif";color:#666666">DSM5
in Distress</span></a></span></span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<p style="line-height:15.0pt;background:white"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">This is the saddest moment in my 45 year<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/career" title="Psychology Today looks at Career"><span style="font-family:"Arial","sans-serif";color:#333333">career</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">of
studying, practicing, and teaching<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/psychiatry" title="Psychology Today looks at Psychiatry"><span style="font-family:"Arial","sans-serif";color:#333333">psychiatry</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">.
The Board of Trustees of the American Psychiatric Association has given its final approval to a deeply flawed DSM 5 containing many changes that seem clearly unsafe and scientifically unsound. My best advice to clinicians, to the press, and to the general
public - be skeptical and don't follow DSM 5 blindly down a road likely to lead to massive over-diagnosis and harmful over-medication. Just ignore the ten changes that make no sense.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
<p style="line-height:15.0pt;background:white"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">Brief background. DSM 5 got off to a bad start and was never able to establish sure footing. Its leaders initially articulated a premature
and unrealizable goal- to produce a paradigm shift in psychiatry. Excessive ambition combined with disorganized execution led inevitably to many ill conceived and risky proposals. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
<p style="line-height:15.0pt;background:white"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">These were vigorously opposed. More than fifty mental health professional associations petitioned for an outside review of DSM 5 to provide
an independent judgment of its supporting evidence and to evaluate the balance between its risks and benefits. Professional journals, the press, and the public also weighed in- expressing widespread astonishment about decisions that sometimes seemed not only
to lack scientific support but also to defy common sense.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
<p style="line-height:15.0pt;background:white"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">DSM 5 has neither been able to self correct nor willing to heed the advice of outsiders. It has instead created a mostly closed shop-
circling the wagons and deaf to the repeated and widespread warnings that it would lead to massive misdiagnosis. Fortunately, some of its most egregiously risky and unsupportable proposals were eventually dropped under great external pressure (most notably
'psychosis risk', mixed anxiety/</span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/depression/symptoms" title="Psychology Today looks at Symptoms of Depression"><span style="font-family:"Arial","sans-serif";color:#333333">depression</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">,
internet and<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/conditions/sex-and-love-addiction" title="Psychology Today looks at Sex and Love Addiction"><span style="font-family:"Arial","sans-serif";color:#333333">sex
addiction</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">, rape as a mental disorder, 'hebephilia', cumbersome<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/personality" title="Psychology Today looks at Personality"><span style="font-family:"Arial","sans-serif";color:#333333">personality</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">ratings,
and sharply lowered thresholds for many existing disorders). But APA stubbornly refused to sponsor any independent review and has given final approval to the ten reckless and untested ideas that are summarized below.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<p style="line-height:15.0pt;background:white"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">The history of psychiatry is littered with fad diagnoses that in retrospect did far more harm than good. Yesterday's APA approval makes
it likely that DSM 5 will start a half or dozen or more new fads which will be detrimental to the misdiagnosed individuals and costly to our society. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">The motives of the people working on DSM 5 have often been questioned. They have been accused of having a financial conflict of interest because some have (minimal) drug company ties
and also because so many of the DSM 5 changes will enhance Pharma profits by adding to our already existing societal overdose of carelessly prescribed psychiatric medicine. But I know the people working on DSM 5 and know this charge to be both unfair and untrue.
Indeed, they have made some very bad decisions, but they did so with pure hearts and not because they wanted to help the drug companies. Their's is an intellectual, not financial, conflict of interest that results from the natural tendency of highly specialized
experts to over value their pet ideas, to want to expand their own areas of research interest, and to be oblivious to the distortions that occur in translating DSM 5 to real life clinical practice (particularly in primary care where 80% of psychiatric<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/psychopharmacology" title="Psychology Today looks at Psychopharmacology"><span style="font-family:"Arial","sans-serif";color:#333333">drugs</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">are
prescribed).</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">The APA's deep dependence on the publishing profits generated by the DSM 5 business enterprise creates a far less pure<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/motivation" title="Psychology Today looks at Motivation"><span style="font-family:"Arial","sans-serif";color:#333333">motivation</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">.
There is an inherent and influential conflict of interest between the DSM 5 public trust and DSM 5 as a best seller. When its deadlines were consistently missed due to poor planning and disorganized implementation, APA chose quietly to cancel the DSM 5 field
testing step that was meant to provide it with a badly needed opportunity for quality control. The current draft has been approved and is now being rushed prematurely to press with incomplete field testing for one reason only- so that DSM 5 publishing profits
can fill the big hole in APA's projected budget and return dividends on the exorbitant cost of 25 million dollars that has been charged to DSM 5 preparation.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">This is no way to prepare or to approve a diagnostic system. Psychiatric diagnosis has become too important in selecting treatments, determining eligibility for benefits and services,
allocating resources, guiding legal judgments, creating stigma, and influencing personal expectations to be left in the hands of an APA that has proven itself incapable of producing a safe, sound, and widely accepted manual. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">New diagnoses in psychiatry are more dangerous than new drugs because they influence whether or not millions of people are placed on drugs- often by primary care doctors after brief
visits. Before their introduction, new diagnoses deserve the same level of attention to safety that we devote to new drugs. APA is not competent to do this. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">So, here is my list of DSM 5's ten most potentially harmful changes. I would suggest that clinicians not follow these at all (or, at the very least, use them with extreme caution and
attention to their risks); that potential patients be deeply skeptical, especially if the proposed diagnosis is being used as a rationale for prescribing medication for you or for your child; and that payers question whether some of these are suitable for
reimbursement. My goal is to minimize the harm that may otherwise be done by unnecessary obedience to unwise and arbitrary DSM 5 decisions.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">1) Disruptive Mood Dysregulation Disorder: DSM 5 will turn temper tantrums into a mental disorder- a puzzling decision based on the work of only one research group. We have no idea
whatever how this untested new diagnosis will play out in real life practice settings, but my<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/fear" title="Psychology Today looks at Fear"><span style="font-family:"Arial","sans-serif";color:#333333">fear</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">is
that it will exacerbate, not relieve, the already excessive and inappropriate use of medication in young children. During the past two decades, child psychiatry has already provoked three fads- a tripling of<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/adhd" title="Psychology Today looks at ADHD"><span style="font-family:"Arial","sans-serif";color:#333333">Attention
Deficit</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">Disorder, a more than twenty-times increase in Autistic Disorder, and a forty-times increase in<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/child-development" title="Psychology Today looks at Child Development"><span style="font-family:"Arial","sans-serif";color:#333333">childhood</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/conditions/bipolar-disorder" title="Psychology Today looks at Bipolar Disorder"><span style="font-family:"Arial","sans-serif";color:#333333">Bipolar
Disorder</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">. The field should have felt chastened by this sorry track record and should engage itself now in the crucial task of educating practitioners and the public
about the difficulty of accurately diagnosing children and the risks of over- medicating them. DSM 5 should not be adding a new disorder likely to result in a new fad and even more inappropriate medication use in vulnerable children. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">2) Normal<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/grief" title="Psychology Today looks at Grief"><span style="font-family:"Arial","sans-serif";color:#333333">grief</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">will
become Major Depressive Disorder, thus medicalizing and trivializing our expectable and necessary emotional reactions to the loss of a loved one and substituting pills and superficial medical rituals for the deep consolations of family, friends,<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/religion" title="Psychology Today looks at Religion"><span style="font-family:"Arial","sans-serif";color:#333333">religion</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">,
and the resiliency that comes with time and the acceptance of the limitations of life. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">3) The everyday forgetting characteristic 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<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/dementia" title="Psychology Today looks at Dementia"><span style="font-family:"Arial","sans-serif";color:#333333">dementia</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">.
Since there is no effective treatment for this 'condition' (or for dementia), the label provides absolutely no benefit (while creating great anxiety) even for those at true risk for later developing dementia. It is a dead loss for the many who will be mislabeled. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">4) DSM 5 will likely trigger a fad of Adult Attention Deficit Disorder leading to widespread misuse of stimulant drugs for performance enhancement and recreation and contributing to
the already large illegal secondary market in diverted prescription drugs. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">5) Excessive eating 12 times in 3 months is no longer just a manifestation of gluttony and the easy availability of really great tasting food. DSM 5 has instead turned it into a psychiatric
illness called<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/eating-disorders" title="Psychology Today looks at Eating Disorders"><span style="font-family:"Arial","sans-serif";color:#333333">Binge
Eating</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">Disorder. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">6) The changes in the DSM 5 definition of<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/conditions/autism" title="Psychology Today looks at Autism"><span style="font-family:"Arial","sans-serif";color:#333333">Autism</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">will
result in lowered rates- 10% according to estimates by the DSM 5 work group, perhaps 50% according to outside research groups. This reduction can be seen as beneficial in the sense that the diagnosis of Autism will be more accurate and specific- but advocates
understandably fear a disruption in needed school services. Here the DSM 5 problem is not so much a bad decision, but the misleading promises that it will have no impact on rates of disorder or of service delivery. School services should be tied more to educational
need, less to a controversial psychiatric diagnosis created for clinical (not educational) purposes and whose rate is so sensitive to small changes in definition and assessment.
</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">7) First time substance abusers will be lumped in definitionally in with hard core addicts despite their very different treatment needs and prognosis and the stigma this will cause. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">8) DSM 5 has created 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. Watch
out for careless overdiagnosis of internet and<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/conditions/sex-and-love-addiction" title="Psychology Today looks at Sex and Love Addiction"><span style="font-family:"Arial","sans-serif";color:#333333">sex
addiction</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">and the development of lucrative
treatment programs to exploit these new markets. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">9) DSM 5 obscures the already fuzzy boundary been<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/conditions/generalized-anxiety-disorder" title="Psychology Today looks at Generalized Anxiety Disorder"><span style="font-family:"Arial","sans-serif";color:#333333">Generalized
Anxiety Disorder</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">and the worries of
everyday life. Small changes in definition can create millions of anxious new 'patients' and expand the already widespread practice of inappropriately prescribing addicting anti-anxiety medications.
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">10) DSM 5 has opened the gate even further to the already existing problem of misdiagnosis of<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/post-traumatic-stress-disorder" title="Psychology Today looks at Post-Traumatic Stress Disorder"><span style="font-family:"Arial","sans-serif";color:#333333">PTSD</span></a></span><span class="apple-converted-space"><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black"> </span></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">in
forensic settings. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">DSM 5 has dropped its pretension to being a paradigm shift in<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/psychiatry" title="Psychology Today looks at Psychiatry"><span style="font-family:"Arial","sans-serif";color:#333333">psychiatric</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">diagnosis
and instead (in a dramatic 180 degree turn) now makes the equally misleading claim that it is a conservative document that will have minimal impact on the rates of psychiatric diagnosis and in the consequent provision of inappropriate treatment. This is an
untenable claim that DSM 5 cannot possibly support because, for completely unfathomable reasons, it never took the simple and inexpensive step of actually studying the impact of DSM on rates in real world settings. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">Except for<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/conditions/autism" title="Psychology Today looks at Autism"><span style="font-family:"Arial","sans-serif";color:#333333">autism</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">,
all the DSM 5 changes loosen diagnosis and threaten to turn our current diagnostic inflation into diagnostic hyperinflation. Painful experience with previous DSM's teaches that if anything in the diagnostic system can be misused and turned into a fad, it will
be. Many millions of people with normal<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/grief" title="Psychology Today looks at Grief"><span style="font-family:"Arial","sans-serif";color:#333333">grief</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">,
gluttony, distractibility, worries, reactions to<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/stress" title="Psychology Today looks at Stress"><span style="font-family:"Arial","sans-serif";color:#333333">stress</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">,
the temper tantrums of<span class="apple-converted-space"> </span></span><span style="font-size:10.5pt;font-family:"Calibri","sans-serif";color:black"><a href="http://www.psychologytoday.com/basics/child-development" title="Psychology Today looks at Child Development"><span style="font-family:"Arial","sans-serif";color:#333333">childhood</span></a></span><span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">,
the forgetting of old age, and 'behavioral addictions' will soon be mislabeled as psychiatrically sick and given inappropriate treatment. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">People with real psychiatric problems that can be reliably diagnosed and effectively treated are already badly shortchanged. DSM 5 will make this worse by diverting attention and scarce
resources away from the really ill and toward people with the everyday problems of life who will be harmed, not helped, when they are mislabeled as mentally ill. </span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">Our patients deserve better, society deserves better, and the mental health professions deserve better. Caring for the mentally ill is a noble and effective profession. But we have
to know our limits and stay within them.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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<span style="font-size:10.5pt;font-family:"Arial","sans-serif";color:black">DSM 5 violates the most sacred (and most frequently ignored) tenet in medicine- First Do No Harm! That's why this is such a sad moment.</span><span style="font-family:"Calibri","sans-serif";color:black"><o:p></o:p></span></p>
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