Understanding Psychiatric Diagnoses
Psychiatric diagnoses can be very confusing. In the past labeling of people was considered to be an evil imposed by the psychiatric community. These days many individuals are anxious to know what they "have". It is crucial to understand the issues in psychiatric nomenclature in order for an individual to receive appropriate help.
Promoting student centred emotional well-being
Diagnostic Criteria for Post-Adolescent Unstable Obsessive Mood Disorder:
A: At least two periods yearly of increased stress and anxiety lasting a minimum of one week
B: Unstable behaviour or mood indicated by at least two of the following
(1): inconsistent sleep patterns characterized by late nights or excessive daytime sleeping.
(2): binge drinking
(3): illicit drug use
(4): highly variable moods
(5): irregular work habits
(6): irregular eating habits
C: Obsessive thoughts or behaviour indicated by at least two of the following:
(1): overconcern with achievement:
(2): excessive concern for future goals
(3): excessive concern for appearance or body image
(5): "binge" working
What is the DSM?
The Diagnostic and Statistical Manual of Mental Disorders is a guide to help mental health practitioners and researchers in their
work. It evolved from a need to standardize psychiatric diagnoses so that researchers and practitioners would be using the same criteria
for specific disorders.
Prior to the DSM, diagnoses were based on presumed etiologies, or underlying causes, of mental health problems.
The DSM replaced this with symptom criteria that do not imply etiology. DSM diagnoses are therefore simply based on clusters
of symptoms that have been investigated statistically, and agreed to by committee, to represent a valid disorder. It is crucial
to understand that DSM diagnoses, for the most part, do not represent disease entities. For example: a group of college mental health
professionals could postulate the disorder shown on the right.
A serious problem that has resulted is that many practitioners use the
DSM as if it's a sacred text, and treat the various disorders as if they are actual disease entities. Many insurers base payment on
these diagnoses and may insist on particular treatments. In actual practice, it is rare to find someone who fits neatly into one diagnosis.
Dual diagnoses have developed, partially to meet the demand from insurers for serious indications for treatment. These issues can
lead to a cycle that ends up distorting treatment.
Once a diagnosis like PAUOMD is established, pharmaceutical research would likely show a positive, statistical response to certain
drugs as compared to placebo. Marketing by special interest groups may then promote the use of medication in all individuals
showing the signs of this health care crisis. The "fact" that this "disorder" shows a statistical response to a treatment modality
would be seen as validating the diagnosis.