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Back to January Ed Reporter

Education Reporter
NUMBER 276 THE NEWSPAPER OF EDUCATION RIGHTS JANUARY 2009

Psychiatrists Struggle to Revise Manual
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Revision of the manual that draws the line between normal and abnormal human behavior has become a contentious, secretive process. The Diagnostic and Statistical Manual of Mental Disorders (DSM) includes the name, description and symptoms of every mental disorder recognized not only by its publisher, the American Psychiatric Association, but also by insurance companies. The tensest debates among revisionists are areas addressing gender identity, diagnosing children with mental disorders, and addictions to shopping and eating.

Politics has worked its way into the revision process, as outside groups try to influence the behaviors dropped and added to the new edition, which is still three years away from publication. A group of homosexual activists circulated an online petition objecting that two members whose work they consider demeaning were assigned to the group revising the sexual and gender identity section. In 1973, homosexual activists successfully lobbied to drop "homosexuality" and substitute "sexual orientation disturbance," which later was changed to "ego-dystonic homosexuality" before being dropped altogether in 1987.

Pharmaceutical interests covet inclusion of behaviors treated by their drugs in the DSM because insurance companies will not reimburse patients unless a diagnostic code from the manual is submitted with their claims. Some parent groups and some researchers want to see more behaviors, like those associated with pediatric bipolar, added to force insurance companies to extend coverage.

The first manual, published in 1952, recognized only about 100 mental disorders. The current DSM-V describes almost three times as many — 283 mental disorders. According to the American Psychiatric Association, all doctors and researchers who helped revise the manual must sign nondisclosure agreements. Scientists working on DSM's new edition have agreed to limit their pay to $10,000 a year from drug makers and other sources. (New York Times, 12-18-08)


 
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