Yes, those devious and evil greedy clowns in Modern Psychiatry are already on the promotion tour to make sure “You” get a diagnosis and are expensively treated for whatever they happen to make up in the APA’s new fantasy adventure “Alice in Pharmaland” DSM-V “the pre-sequel”.
There is really only one practical and rational change that really needs to be made to the DSM manual (Besides using it for tinder/kindling at a campfire marsh mellow roast) that could make a marked improvement in usability/believability, that has mounting heaps of hard scientific evidence, and also makes undeniable/logical sense; that the sociopath and psychopath criteria/diagnosis needs to be revamped to include Psychiatry and those practicing its voodoo medicine in this latest addition.
I won’t go into my favorite and most recommended treatment options for this despicable incurable illness in this particular post, so not to skew the DSM-5 committee’s pristine unbiased Pharma funded/tainted scholastic process.
off the AP news wires and @ seattletimes
The American Psychiatric Association is proposing major changes Wednesday to its diagnostic bible, the manual that doctors, insurers and scientists use in deciding what's officially a mental disorder and what symptoms to treat.
The Associated Press
WASHINGTON — Don't say "mental retardation" — the new term is "intellectual disability." No more diagnoses of Asperger's syndrome — call it a mild version of autism instead. And while "behavioral addictions" will be new to doctors' dictionaries, "Internet addiction" didn't make the cut.
The American Psychiatric Association (APA) is proposing major changes Wednesday to its diagnostic bible, the manual that doctors, insurers and scientists use in deciding what's officially a mental disorder and what symptoms to treat. In a new twist, it is seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them.
The manual suggests some new diagnoses. So far, gambling is the lone identified behavioral addiction, but in the new category of learning disabilities are problems with both reading and math. Also new is binge eating, distinct from bulimia because the binge eaters don't purge.
Sure to generate debate, the draft also proposes diagnosing people as being at high risk of developing some serious mental disorders — such as dementia or schizophrenia — based on early symptoms, even though there's no way to know who will worsen into full-blown illness. It's a category the psychiatrist group's own leaders say must be used with caution because scientists don't yet have treatments to lower that risk but also don't want to miss people on the cusp of needing care.
Another change: The draft sets scales to estimate both adults and teens most at risk of suicide, stressing that suicide occurs with numerous mental illnesses, not just depression.
But overall the manual's biggest changes eliminate diagnoses that it contends are essentially subtypes of broader illnesses — and urge doctors to concentrate more on the severity of their patients' symptoms.
The psychiatric group expects that overarching change could actually lower the numbers of people thought to suffer from mental disorders.
"Is someone really a patient, or just meets some criteria like trouble sleeping?" said APA President Dr. Alan Schatzberg, a Stanford University psychiatry professor. "It's really important for us as a field to try not to over diagnose."
The update of this manual called the DSM-5 — the Diagnostic and Statistical Manual of Mental Disorders, fifth edition — is the first update since 1994, and brain research during that time period has soared.
That work is key to give scientists new insight into mental disorders with underlying causes that often are a mystery and that cannot be diagnosed with, say, a blood test or X-ray.
Comment made @ Seattle Times on this article:
If you were able to read this article and have not become nauseous, irritated, or questioned where the real madness actually resides; you are probably almost maybe showing the beginning serious signs of an undetectable made up major mental illness.
Please rush in to see your doctor, where you will get placed on very expensive mind altering medications that can behaviorally control your normality and quash any lingering remnant fragments of common sense for goodness sake.
The following article comes right out of the dangerous and crippling Dr. Biederman “Boy Boobs” and “We must aggressively treat children with poison anti-psychotics before any illness presents itself, this isn’t therapeutic Tushy Massage after all damn it”.
The Notorious Dr. Biederman camp @ Harvard, CABF, and Big Pharma keeps coming up with this new way to package an old/new made up disease with the Big bucks conflict of interest gravy train and Key Opinion leaders propaganda written all over it once more.
“Where have all the Flowers gone, long time passing. When will we ever learn, when will we ever learn”
From NPR News
Children Labeled 'Bipolar' May Get A New Diagnosis
by Alix Spiegel
February 10, 2010
Since the mid-1990s, the number of children diagnosed with bipolar disorder has increased a staggering 4,000 percent. And that number has caused a lot of controversy in the world of child psychiatry.
Doctors faced with kids struggling with explosive moods felt the diagnosis was appropriate and said that the bipolar medications they gave to children worked. Research psychiatrists worried that the children were being given a label that wasn't right for them, and saddled with the sentence of a serious mental illness for the rest of their lives.
In a move that could potentially change mental health practice all over America, the American Psychiatric Association has announced that it intends to include a new diagnosis in its upcoming fifth edition of the Diagnostic and Statistical Manual — and hopes that new label will be used by clinicians instead of the bipolar label. The condition will be called temper dysregulation disorder, and it will be seen as a brain or biological dysfunction, but not as a necessarily lifelong condition like bipolar.
Reworking The Book Of Mental Disorders
When clinicians see a patient with mental health issues, part of their job is to determine if the patient is experiencing temporary emotional struggles or if the patient has an illness. To do this, doctors rely on the bible of psychiatry, a book called the Diagnostic and Statistical Manual of Mental Disorders. The DSM lists all the mental disorders recognized by the American Psychiatric Association.
The book is also used by insurance companies to decide which treatments they'll pay for, and by courts to help determine insanity or other mental conditions.
The APA is releasing a new draft of the DSM Wednesday, the first major revision since 1994. This latest version of the book, the DSM-V, proposes some significant changes to the following disorders:
The DSM is the official dictionary of mental disorders recognized by the American Psychiatric Association. Doctors use the DSM to diagnose patients, and insurance companies use it to decide on reimbursement, so it's incredibly important in the profession of psychiatry.
By adding this new entry, the American Psychiatric Association is trying to use the considerable institutional power of the DSM to curb use of the pediatric bipolar label.
But it will take some time to determine whether psychiatrists and psychologists will actually change their ways. "I don't know what they'll do," said Dr. David Shaffer, one of the psychiatrists on the DSM-V childhood committee that is behind this change. "Maybe the practitioners will be such firm believers in it that they'll continue to use [bipolar]. But, you know, I guess there are a lot of people that have been involved in reviewing this."
The Beginning Of 'Bipolar' Children
The notion that children might suffer from bipolar disorder in large numbers is new, dating back only to the mid-1990s.
Dr. Janet Wozniak, an assistant professor of psychiatry at Harvard Medical School, was one of the people who first popularized this idea.
Wozniak says that when she was starting out, most psychiatrists placed the prevalence of bipolar disorder in children somewhere between "never" and "vanishingly rare."
"Papers about bipolar disorder in children would usually start out with the phrase, 'Here's a disorder that's so rare maybe you'll see one or two in your entire lifetime in practice,' " Wozniak says.
Wozniak herself only started thinking about pediatric bipolar disorder when she got a job as a researcher in the clinic of a famous Harvard child psychiatrist named Dr. Joseph Biederman. Biederman was studying kids with attention deficit hyperactivity disorder and felt that there was a portion of the kids in his clinic whose problems with anger seemed to go way beyond normal ADHD. So he asked Wozniak to look into it.
She did. And what she found were kids who continued to struggle with intense, uncontrollable outbursts of anger — violent hitting and screaming and kicking — even after they passed through the preschool years.
She felt these outbursts were substantively different from the kind of outbursts you saw among ADHD kids, who often had problems regulating their impulses. Then one day, she says she had an insight.
"This child that I was thinking of as having really difficult-to-treat ADHD and a lot of parent-child interaction problems, I really was ignoring the serious mood component of their problem." In other words, it wasn't that the kids just had problems with their impulse control; there was a more serious problem of mood. These kids were bipolar.
Redefining A Defining Characteristic
Wozniak wrote all this up in a now famous paper proposing that some of the kids characterized as having ADHD were actually bipolar.
The paper won awards. Clinicians began to approach Wozniak at meetings saying her insights made intuitive sense. She had helped transformed their practice.
But Shaffer says that to see these children as bipolar, Wozniak and her co-author, Joseph Biederman, had to change one critical component of the traditional definition of bipolar disorder. "The defining feature of manic-depression was that it was episodic," says Shaffer. "You had episodes of depression and episodes of mania and episodes of normal mood, and that was really, its defining characteristic."
But the kids Wozniak described rarely, if ever, had these kind of discrete weeklong or month-long episodes. So to make them fit the traditional concept of bipolar disorder, Shaffer says, she and Biederman made the argument that in children, episodes presented themselves in a radically different way.
"They said maybe in childhood the episodes would be very brief and very frequent," says Shaffer. "These are called 'ultra diem,' you know, 'many times a day.' If you regarded every time children changed their mood, every time they lost their temper or became overexcited, as a mood episode, then they were really being misdiagnosed and were really cases of bipolar disorder."
Critics countered that bipolar should look the same in kids and adults, that there wasn't good evidence that these kids grew up to be bipolar, and that if you looked backward at bipolar adults, they didn't necessarily have these uncontrolled anger issues when they were young, Shaffer says.
Nevertheless, pediatric bipolar disorder took off. Today, it's estimated that at least 1 million children in the United States have been diagnosed with the disease. Wozniak is convinced that she knows why. "The diagnosis took off because it made clinical sense," she says. "Because we opened our eyes."
A Second Look At Bipolar Diagnoses
Gabrielle Carlson, a child psychiatrist at Stony Brook University, doesn't agree that the bipolar label took off simply because the diagnosis allowed clinicians to finally categorize children in a way that made sense. She points to a host of other reasons.
For example, she says many of the kids now categorized as bipolar were, once upon a time, diagnosed as having conduct disorder. Kids with conduct disorder are seen as very combative, aggressive, and prone to destructive behavior. But the treatments for conduct disorder are woefully limited, says Carlson. "Mostly prayer and fasting," she says. "We don't have good treatments for it. We've got parent-training kinds of treatment, very strict behavioral modification kinds of things, but the evidence that therapy makes a big difference is not wonderful."
Which is why when every day psychiatrists were told that they could now think of this set behaviors as manic-depression, not as conduct disorder, they got so excited, says Carlson. "They thought, 'Heck, if that's what it is, we have a bunch of medicines that are supposed to be helpful for mania — maybe I can make it better,' " she says. This has deep appeal to doctors face to face with parents who are heartbroken over the difficult time their child is having.
Another advantage to the bipolar label, Carlson points out, is that the insurance industry saw bipolar as a biological or medical problem, while conduct disorder was seen more as a parenting problem, so insurance companies were reluctant to reimburse for it.
"If you've got something that says it's not a medical problem," says Carlson, insurance is not going to pay for it. "Conduct disorder is bad parenting, lousy environment, poor supervision, you're a bad seed. It ain't a medical problem. Bipolar they'll pay for."
Finally, Carlson argues, parents themselves were relieved on some level. Because this set of behaviors was no longer seen as conduct disorder, the psychiatrist sitting across the desk from them was no longer blaming them for the terrible things that were happening to their child.
"Part of the acceptance of the bipolar if you're a parent is, 'Hey I'm off the hook on this one. It's not 'cause I'm a bad parent, I've just got this kid with a genetic problem. It's not my fault,' " says Carlson. "You know, there's some pros and cons to that, but the fact remains many people found that liberating."
A Lifelong Label
So clearly there are some real advantages to using the bipolar label. The problem, says Carlson, is that because bipolar disorder is understood as a chronic lifelong problem, you really want to be very careful about how you apply it.
"If you have a child who's got this behavior but you're not sure how it's going to evolve, to say to somebody, 'You've got to be on this medication for the rest of your life' is sentencing someone to something that's premature. And in the case of some of these medications, where we're not sure of some of the metabolic side effects; you may be exposing them to a risk that they don't need to have."
In fact, the problems with medication was foremost in the mind of the people put in charge of the childhood disorder section of the manual, says Shaffer. Particularly, Shaffer says, atypical, anti-psychotic medications, which, he says, "we think have quite profound effects on important mechanisms on the brain that may influence growth and development of the nervous system."
So, Shaffer and his DSM colleagues set out to create a new diagnosis — temper dysregulation disorder — that they hope clinicians will use instead of the bipolar label, he says. "We were trying to find a way to adequately describe the really quite serious behaviors that many of the children who've been given [the bipolar label] have. So what we thought would be valuable would be to carve out a group with the most severe reactions: [children] who when they do lose their temper, do so with great force, and who are having [tantrums] frequently — two or three times a week — and between the big episodes, have an abnormal mood."
Getting The Diagnosis Right
Of course there is no way to predict what practical effects creating the TDD category might have. For instance, Carlson points out that even if they are successful at changing the label that clinicians use, it could be that the kids all get the same medications as before. "They may get many of the same. Absolutely," she says. "But the difference is going to be that you won't have to take this for the rest of your life."
Carlson doesn't necessarily see this as a bad thing. She emphasizes that these children have very serious problems, and though there's been trouble naming it, there's clearly some sort of dysfunction in their brain. Shaffer agrees. "I don't think anyone is arguing that these are perfectly normal children that get the label [bipolar] — far from it," he says. "We're saying these kids are very sick. But they probably don't have bipolar disorder. And they probably do deserve a name that adequately describes what they're doing."
And one pill makes you small
And the ones that mother gives you
Don't do anything at all
Go ask Alice
When she's ten feet tall
Further reading @ soulful sepulcher