Just a quick note here, as psychiatry and psychology are not fields I engage with frequently (my last post on this topic was over two years ago). The Diagnostic and Statistical Manual of Mental Disorders is undergoing the final public comment period for the new edition, targeted for a May 2013 publication. This will be the fifth edition of the DSM (DSM-V), and it serves as a guide toward defining and determining the presence of disease. Comments are accepted until June 15th, and you must register at the DSM-V website. The process is administered by the American Psychiatric Association (APA). According to those with a greater knowledge of the changes being discussed (preview only, full article requires payment), DSM-V represents the most significant adjustments to diagnostic criteria in 30 years.
While not exactly a hot topic in general science policy circles, redefining diseases certainly has policy implications. As many of the diseases considered in the DSM deal with mental illnesses, something for which there is still a serious stigma in society, the impact of changing what counts as autism (which may be folded into a broader autism spectrum disorder), or whether or not something qualifies as an addiction can be profound. Insurance is affected, health care providers will adapt practices to the new criteria and/or the resulting changes in diagnoses. It’s important that the changes have a reliable research basis underneath them – something that’s harder to accomplish in some mental illnesses as we still don’t know a lot about the brain.
So there’s a bit of concern over a report that some initial tests suggest that proposed changes may not prove particularly reliable in the field. The concern is compounded by the relatively small window of time remaining for the APA to adjust and re-test criteria. Yes, this revision has taken 11 years. As it could well take that long to correct any problems that get enacted into the DSM-V, I’d rather a publication deadline slip and get things right (or at least better).