Does ‘Psychiatry’s Bible’ Need to Be Rewritten?

During the development and now the release of the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there has been a lot of debate among those in the neuroscience community about how disorders should be diagnosed and whether certain categorizations are too far-reaching.

Dana Alliance member and Director of the National Institutes for Mental Health Tom Insel recently argued:

The DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever… Patients with mental disorders deserve better.

Dana grantee and bioethicist Art Caplan came to the defense of the manual, offering a rebuttal to Insel’s argument:

The view that the only medical classifications that are valuable are those grounded in molecular biology can be dismissed out of hand. Meteorologists predicting the weather, climate scientists studying global warming, forestry experts, and those dealing with earthquakes do not have coherent explanations in atomic physics for their categories or for their causes. But their categories are accepted because they work—giving us predictable and actionable knowledge about the world. The same ought be the test of DSM 5.

Clearly there are strong opinions surrounding the DSM-5, and the debate will surely continue. And you can participate, or at least listen in:  Tomorrow (Thursday), Science Magazine will host a live chat at 3 pm, featuring three experts with varying opinions. Submit your questions to them in the comments section here.

– Ann L. Whitman

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