Re: The DSM

[Anonymous]

Just in case you feel like switching brands or flavors of Kool-Aid...............

DSM-5 Internet Addiction Disorder? Armageddon and Keeping the Troops in Line

http://http://www.beforeyoutakethatpill.com/index.php/2009/07/10/dsm-5-internet-addiction-disorder-and-keeping-the-troops-in-line/

We have been following the process of writing the DSM, which will establish the new diagnostic criteria for psychiatric disorders, through the DSM-5 Shadow Team, which has created quite a broo-haha, as you can see here and here. One of the diagnoses that has been proposed is internet addiction disorder. This is apparently an addition to disorders for addictions to sex, food, gambling, whatever you name it, but we don’t have time to cover everything. Fact is it is pretty hard to know what they are doing as the head of DSM-5, David Kupfer MD, has required all members to sign a nondisclosure agreement and not take any notes. He runs a pretty tight ship.

The behavior of the committee members has gotten pretty mean and nasty, and the DSM Anxiety Disorders, OCD, PTSD and Dissociative Disorders committee retaliated against me for writing about the DSM here. I mean, those dudes are pretty thin skinned. And what would you think about a bunch of guys that signs a confidentiality agreement before they even know what they are getting into? Now David Kupfer is herding them toward a deadline of 2010 for completion of the DSM-5 and many are starting to balk. Are they headed toward a precipice? (click the link above to see the cool picture Dr. Bremner made in his Photoshop)

Nice group shot guys! Baaaa!!!

Almost a third of the committee is from foreign countries, which my guess is that they had to go abroad to find people who actually wrote papers but weren’t up to their necks in consulting arrangements with pharmaceutical companies. Part of the attempt to add credibility which seems to characterize this process, like telling members not to consult during the process of working on the DSM.

This week things are fraying more around the cracks. Dr Jane Costello from Duke University resigned from the Workgroup on Children’s and Adolescent Disorders; the reasons outlined in the letter include an overly hasty rush to change things when there is little scientific evidence to support the changes. Hmmm I wonder where I have heard that before? Dan Carlat MD reports on Armegeddon and the developments and on a letter from Robert Spitzer MD and Allen Frances MD to the American Psychiatric Association (APA) Board of Trustees warning of “disastrous unintended consequences” and asking for an outside review panel.

The problem is that the APA is a million or two dollars in debt, and has become addicted to having these new DSM books come out, because then everyone has to throw out the old one and buy the new one, and since they are the publisher they get the profit. With the pipeline of psychiatric drugs drying up there is less advertising from the pharmaceutical industry for their journals and meetings, therefore things are getting tight, and hence the pressure to hurry up the process. However I don’t think that generating income for the APA is a good reason to change diagnostic criteria for mental disorders, and their behavior is going to call into question their rights to do that. Not all psychiatrists (including me) are members of the APA, and there are many other mental health professionals who must live with the DSM.

Anyhoo back to internet addiction disorder, which I guess we should call IAD, it is of course compulsive use of the internet, with hourse spent trolling on line, with disruption of work and social life.

You can read an editorial advocating for its inclusion here.

It is considered to be a big problem in many Asian countries. The other side of this is people who get into Real-life or other online games like that and develop relationships where they start having sex with other peoples avators and then they get caught and kicked out of the house.

I have a treatment for my 12 year olds computer game addiction. It is…

…GET OFF THE COMPUTER!!!

Seriously if anyone wants to know my opinion about IAD, it is that I agree with Allen Frances MD head of DSM-4 that we should shun any new and suspicious looking psychiatric diagnoses as we don’t want to add to the throngs of people who feel like they have been labelled with a psychiatric diagnosis. My opinion is that the DSM process should be put on hold, that the text can be revised but diagnostic criteria should not be revamped until there has been the time to collect more data.

Cheers!

:shamrock:  :shamrock:
That's me know doubt. lol  Felice takes this please in good humor.  :shamrock:

[Froderik]

What about DMT?