ABC Radio National’s Background Briefing has a good programme on the issues and debates about the new version of the DSM that is currently being prepared and causing much flailing of handbags in the process.
The radio show is not particularly focused but touches on some contentious diagnoses and the problems with defining mental illness.
But there is one surprising part where they ask Australian psychiatrist and DSM-V committee member Gavin Andrews to respond to criticisms by ex-committee chief Robert Spitzer over the lack of openness in the process.
His answer, like an earlier response from American Psychiatric Association to their critics, is remarkable for the fact it contains a personal attack:
Well, he was the guy that wrote DSM-III, and we all owe him a considerable debt because someone had to be strong-willed and very strongly opinionated to pull that off. He’s saying, something’s going on and no-one’s telling me everything. Well, there’s no need for him to be told everything day by day. I’m sure he probably hasn’t read all those books that we’ve already published, and he certainly hasn’t written to me about the research planning conference that I ran. So I presume it’s a sense of not being on the centre of the stage, as he once sensibly and gloriously was.
Believe it or not, it actually sounds more patronising when you hear the original audio. Either these ad hominem attacks are a sign of the committee being rattled or they are evidence for exactly what the critics accuse them of, and neither is particular promising.
And if anyone thinks that the squabbling was just a bit of internal politicking, you might be interested to know that it’s featured as one of the major news stories in this week’s Nature.
However, while the DSM is often described as the psychiatric ‘bible’, it’s probably more accurate to call it the American psychiatrists’ ‘bible’.
While it’s widely used in the US and Latin America, much of the rest of the world uses the slightly less barmy (pun intended) International Classification of Diseases (ICD) from the World Health Organisation.
The danger is not so much that the DSM will become ridiculous, but that it will become irrelevant.
Link to Background Briefing on ‘Expanding mental illness’.