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Although I was heartened to see more and more people discussing the real-world issues and challenges--for patients, families, clinicians and caregivers-within mental health care, for which the book offers an up-to-the-minute diagnostic GPS, I was also alarmed at the harsh criticism of the field of psychiatry and the APA. DSM-5 has ignited a broad dialogue on mental illness and opened up a conversation about the state of psychiatry and mental healthcare in this country. These are real people who don't want to improve mental healthcare, unlike the dozens of psychiatrists, psychologists, social workers and patient advocates who have labored for years to revise the DSM, rigorously and responsibly. Being "against" psychiatry strikes me as no different than being "against" cardiology or orthopedics or gynecology--which most people, I think, would find absurd. This relatively small "anti-psychiatry" movement fuels the much larger segment of the world that is prejudiced against people with disorders of the brain and mind and the professions that treat them. We have, as a nation, aggressively taken on racism, sexism, homophobia and other prejudices.
I do understand how anti-psychiatry ideas first developed and why they have been so difficult to combat.
For this reason, I am especially shocked when other clinicians--psychologists, social workers, even, in some cases, primary care docs who would rather just dispense psychiatric meds themselves--side with anti-psychiatry forces without realizing these people are "against" them, too.
But, when it comes to medical illness, the "enemy of your enemy" is not always your friend. For all the overt anti-psychiatry we see out there, I'm also concerned about the more subtle forms of prejudice among less radicalized segments of our society.
Only recently, I was at a meeting of medical school leadership at my university, where we discussed how to counsel medical students about choosing which specialty to pursue.
The urgency of his request belied any awareness that the joke he made at psychiatry's expense in that meeting undermined our ability to deliver the kind of quality care that his wife now needed. Image: American Psychiatric AssociationThe views expressed are those of the author(s) and are not necessarily those of Scientific American.
AbstractWhen the American Psychiatric Association releases the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) next month, children currently diagnosed with autism may lose access to services. Questions have already been raised about the appearance of a new diagnosis, SCD, that describes children with difficulties in the pragmatics of verbal and nonverbal communication, leading to impaired social function. Overall, the changes should result in more reliable and valid diagnoses, with estimates of individual severity and associated conditions. Improved ability to identify a more homogenous group of ASD should help those researching the condition by improving the ability to detect etiologies, endophenotypes, genetic markers, and by strengthening treatment and outcome data.
Is it ethical to use genetically modified mosquitos to prevent transmission of vector-borne diseases?
A recent medical report predicts that the latest iteration of the criteria required to assign a formal diagnosis of ASD will result in a decreased number of reported cases.
Parents and practitioners need to understand the landscape because useful interventions might not be afforded to those who can benefit most.
Diatomaceous Earth as Autism Treatment?Practitioners should listen carefully to parents who discover supplements that improve their children with ASD. The release of the Diagnostic and Statistical Manual Version 5 (DSM-5) marked one of the biggest changes to the field of mental health diagnosis in over 20 years. Consequently, I believe that as you read and watch this increased coverage, it's important to understand the difference between thoughtful, legitimate debate, and the inevitable outcry from a small group of critics --made louder by social media and support from dubious sources --who have relentlessly sought to undermine the credibility of psychiatric medicine and question the validity of mental illness..
Critiques have ranged in focus from the inclusion of specific disorders in DSM-5, to the concern over a lack of biological measures which define them. Instead, they are against the diagnosis and treatment of mental illnesses--which improves, and in some cases saves, millions of lives every year--and "against" the very idea of psychiatry, and its practices of psychotherapy and psychopharmacology.

Like most prejudice, this one is largely based on ignorance or fear-no different than racism, or society's initial reactions to illnesses from leprosy to AIDS. Perhaps the occasion of this new DSM revision (and in the aftermath of the passage of the Mental Health and Addiction Parity Act) is the right time to grapple with the prejudice against mental illness and its caretakers--which every day makes it a little harder for people suffering from mental illnesses to live their lives, and makes it harder for those of us who treat mental illnesses to do our jobs. There is historical fear of mental illness, stemming from when these diseases were viewed first as demonic possessions and later as character or moral defects, before we had any scientific understanding for the biological basis of, say, schizophrenia, bipolar disorder, autism or Alzheimer's disease.
It's a relatively new discipline which branched from neurology in the 19th century, whose early practitioners were alienists and analysts, superintendents of asylums and Freudian therapists.
The scientific foundation of psychiatric medicine has grown by leaps and bounds in the last fifty years.
These strange anti-mental health bedfellows include a series of contemporary psychiatrists and psychologists who have fashioned platforms for self-promotion from their critical positions on psychiatry and DSM-5.
Modifications to the proposed criteria have been suggested to address concerns of sensitivity.
In addition, the vague diagnosis of pervasive developmental disorder not otherwise specified (PDD-NOS) has been replaced, in part, by social communication disorder (SCD) (see Table 1). It will remain important for clinicians to take a thoughtful and complete history and combine information from multiple sources with clinical observation to diagnose children with ASD with improved specificity. Though Aspergers’ patients may be upset that there is no longer a defining nomenclature, communication disorders are now included in a much broader sense, actually. Because PDD-NOS is now incorporated, developmental interventions should become available for a wider variety of conditions, which may not have been supported in DSM-IV. Documenting the level of impairment requiring support is imprecise and quite subjective.¬†Pointing professionals in the right direction will help ensure that services are ordered. In this highly fluid environment, the doctors, teachers, administrators, therapists, and other professionals involved in your child’s care need to stay up-to-date, so that they can steer you in the right direction.
Never before has a thick medical text of diagnostic nomenclature been the subject of so much attention.
Some have even questioned the entire diagnostic system, urging us to look with an eye focused on the impact to patients. They are, to my mind, misguided and misleading ideologues and self-promoters who are spreading scientific anarchy. And many people made uncomfortable by mental illness and psychiatry, don't recognize their feelings as prejudice. The brain is a complex organ, slow to reveal its secrets, and the effort to understand its myriad functions goes to the core of each individual's self-identity. But, at the time, asylums were little more than humane warehouses, and Freudian theory turned out to be a brilliant fiction about personality and behavior.
The emergence of psychopharmacology, neuroimaging, molecular genetics and biology, and the disciplines of neuroscience and cognitive psychology have launched our field into the mainstream of medicine and on a course for future growth and success. The question then becomes whether insurance companies and educational systems continue to accept these diagnoses for coverage.
Peter Tanguay, MD, is the Spafford Ackerly Endowed Professor of Child and Adolescent Psychiatry (Emeritus) in the Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine. Try to familiarize yourself with the pertinent changes in the new criteria as they apply to your child. Supporting information appears to be more than 3 years old; so, in an evolving epidemic, we still might be missing the mark. These are the kinds of debate that I hope will continue long after DSM-5's shiny cover becomes warn and wrinkled.

Patients are challenged by the intimate aspects of their relationship with any doctor--a caregiver for whom you have to disrobe, and who pokes and pries. When psychiatry did make its first forays into medical treatment, it used crude instruments like strait jackets, cold packs, fever induction, insulin shock therapy and psycho-surgery. Though not everyone, including ourselves, is satisfied with the rate of our field's progress, no one can argue with one simple fact; if you or a loved one suffers from a mental illness, your ability to receive effective treatment, recover and lead a productive life is better now than ever in human history. The good news is that the powers-that-be seem to demonstrate an open mind, at least in the conferences that I have attended.
Such meaningful discourse only fuels our ability to produce a manual that best serves those touched by mental illness. But in psychiatric treatment you "disrobe" in an even more profound way, revealing yourself psychologically.
The underlying theories for the causes of these illnesses at the time were also wrong; it was largely about blaming the parents. Moreover, we have every reason to believe that there will continue to be unprecedented scientific progress, which will enhance our clinical capacity and benefit our patients. Formal evaluations may require frequent revisions to stay up to speed on this moving target.
Lieberman's work has advanced the understanding of the natural history and pathophysiology of schizophrenia and the pharmacology and clinical effectiveness of antipsychotic drugs. He is the recipient of many national and international honors and awards, including the Lieber Prize for Schizophrenia Research from the National Association for Research in Schizophrenia and Affective Disorders, the Adolph Meyer Award from the American Psychiatric Association, the Research Award from the National Alliance on Mental Illness, and the Neuroscience Award from the International College of Neuropsychopharmacology.
He is a member of numerous scientific organizations, including the National Academy of Sciences Institute of Medicine. Mental health professionals as well as laymen interested in a deeper understanding of emotional well-being will appreciate the synthesis of theoretical psychology and modern diagnosis.Dr. Steven Buser has taught principles of psychiatric diagnosis to medical students and residents in family medicine.
His effort to provide an easy to remember schema led him to develop the idea of diagnoses along a spectrum long before DSM-5 introduced this concept.
Buser’s earlier efforts while making sure to incorporate specific changes that characterize the DSM-5. Buser is the Publisher of Chiron Publications and is the co-founder of the Asheville Jung Center. He admits that over the years his tastes progressed from Archie Comics and Mad Magazine to Freud for Beginners. Naturally, the opportunity to co-author a serious book on DSM-5 and ICD-10 utilizing cartoons was irresistible.
Cruz is the Editor-in-Chief of Chiron Publications and is the co-founder of the Asheville Jung Center.Luke Sloan was a 5th grade student in Asheville, NC when he completed the illustrations for this book.
When he’s not drawing, Luke enjoys playing soccer, reading books, snow-skiing, and just plain having fun!DSM-5 is a registered trademark of the American Psychiatric Association (APA).

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