Why is the DSM-5 (Diagnostic and Statistical Manaual of Statistical Disorders, Fifth Edition) criticized?

247 views

For those who know not, it is a compendium of psychiatric conditions that are reviewed with every edition with tthe latest edition being DSM-5 TR published by the American Psychiatric Association (APA).

In: 136

13 Answers

Anonymous 0 Comments

My first thought is, criticized by whom?

I don’t know many mental health professionals who are overly critical of DSM-5.
There is always a clinical component to diagnostics. Tools like DSM-x give us data and we interpret that data along with other physical data and personal observations.

There is no single point of data collection that can, on its own, diagnose a psychological condition.

Anonymous 0 Comments

“It isn’t”.

That’s the entire answer, so I’m not sure what else to add there.

The DSM5 is broadly accepted by the professional community. I’m not sure who you believe is criticizing it.

Anonymous 0 Comments

The DSM-5 is often criticized because it simplifies complex mental health conditions into rigid categories, which may not accurately capture the nuances of individual experiences.

Anonymous 0 Comments

The DSM it criticized due to perceived political influence into its classifications and the utterly arbitrary way in which disorders are classified. Basically it’s a largely unscientific manual trying to pretend it has scientific weight.

Anonymous 0 Comments

It’s an arbitrarily compiled “consensus” based diagnostic manual that sucks at diagnosis. Many of the criteria given enable one set of symptoms to fall into a dozen categories depending on who is doing the diagnosis. Previous versions considered female arousal as a mental disorder (hysteria), for example of how Wikipedia like it is.

Anonymous 0 Comments

Criticized by whom? I know a a good half dozen people who work in mental health and neither they nor anyone they know takes serious issue with it.

Anonymous 0 Comments

There have been some political movements and lobbying to change the definitions of certain things. That’s probably one reason at least some people think it’s sus

Anonymous 0 Comments

[deleted]

Anonymous 0 Comments

Psychiatrist here. So most of the issues with the DSM stem from the core issue that we do not have enough understanding about how the brain really works. We are unable in many diagnoses to link the disorder with a clear biological process. This is also why many of our treatments involve trying multiple things to find out what works. The brain is very complex and due to stigma and other such issues neuroscience is in many ways behind other medical fields.

This lack of understanding has lead to psychiatric diagnoses being based on descriptions of symptoms rather than specific biological mechanisms. And this ambiguity has lead to our diagnoses being corrupted by campaign groups wanting things to be defined in specific ways to suit their agendas. Which has in turn made our diagnoses unreliable and constantly getting regrouped based on pressure or fads.

There are some diagnoses that we have a clearer understanding of such as schizophrenia and bipolar. But despite physicians being able to clearly identify both of these diagnoses, unfortunately the diagnoses get tossed into patient notes incorrectly.

For example, schizophrenia the biologic process has a very clear history and progression. However from reading of the DSM, a person with long term brain damage from methamphetamine use can have all the symptoms of schizophrenia and therefore be falsely diagnosed with schizophrenia. They meet the dsm criteria for schizophrenia but the biologic process is completely different. And the treatment/ expected disease course is very different.

Anonymous 0 Comments

Validity and reliability. The criteria for diagnoses are subjective and vague. Different professionals will make difference diagnoses based on the same criteria.

We aren’t even sure if what we are diagnosing is real and we can’t all agree on what constitutes those diagnoses anyway.

Basically the DSM is a compendium of current opinions by groups of people deemed appropriate. It changes significantly every few years based on everything from new research to changing politics and social mores.

It’s vaguely useful but it’s not valid nor reliable in the scientific sense.