DSM-5 If You Don't Like the Effects, Look at the Causes - Psychiatricanswers

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If You Don't Like the Effects, Look at the Cause.

The Problems of DSM-5 Were Caused by DSM-III and DSM-IV

By S. Nassir Ghaemi, MD, MPH
January 17, 2013

Comments on the Psychiatry times web as a respond to the article.

Manuel Mota-Castillo said:
I watch this “Clash of the Titans” with rejoice because it could have a positive outcome for the future of a psychiatric field where specialists would formulate diagnoses based on observations, unbiased history-gathering and clinical skills. I am not an enthusiast of the American Psychiatric Association (APA) but I have been polite when I refer to this organization out of respect for the very same voices involved in this discussion and also my illustrious friend Hagop Akiskal. They all show respect for the APA and I respect them.
Even though I believe that the APA and the American Academic of C&A Psychiatry (AACAP) will have to do more explaining than those responsible for the Tuskegee experiment, I have restrained my desire to say that the APA is “guilty by omission” because many mistakes of the past should have been fixed but they failed to do so. These are some examples:
Lives that could have been productive and happy are spoiled because of misdiagnosed during childhood, i.e., the over-diagnosed ADHD and the retention of Oppositional-Defiant Disorder as a diagnosis to explain why a wrongly labeled “ADHD child” does not behave well.
The absurd use of SSRIs in patients with Borderline Personality Disorders who never improve, unless the medication is accompanied by mood stabilizers and CBT.
The negligent endorsement of prescribing antidepressants on a continue basis to patient with co-morbid PTSD (or OCD) and bipolar disorder. No even the highly publicized suicide rate among soldiers has moved the APA to take a look at this issue, from this perspective.
Closing eyes and ears to the irrational practice of diagnosing ADHD in autistic patients. Even if the DSM-IV would not ban such nonsense, simple reasoning indicates that autistic children have a clear reason for been inattentive and that another diagnosis is unnecessary. Equally scientifically-challenged is the decision to diagnose autistic children with Social Anxiety Disorder but nevertheless is happening in some of the most prestigious psychiatric training program in the USA, as can be corroborated in their podcasts. And the problem is not just misdiagnosing but, as Dr. Ghaemi accurately quoted Hippocrates, we should “at least do not harm” . Stimulants, by increasing dopamine, are a poison to obsessive or nervous people.
Having the knowledge that many doctors diagnose 80 to 90% of their patients with the same disease (ADHD) and no questioning such statistical impossibility is something that leaves the APA and the AACAP in a very hard to defense position.  
The list could go on and I don’t want to lose the attention of the readers but I hope that more colleagues will join this discussion and maybe then the APA will take the bull by the horns.

Manuel Mota-Castillo, M.D
Lake Mary, Florida  

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