Saturday, 31 July 2010

Personality Disorders - The must have diagnoses for 2013

The American Psychiatric Association are busy preparing the fifth edition of their Diagnostic and Statistical Manual. The Manual whist claiming to be scientific is in fact the result of a series of heavily lobbied meetings which have widened the remit of the definition of mental illness to the point where nearly everyone could be considered a sufferer and appropriate for the prescription of medication.

For Big Pharma the Manual is a potential goldmine.  Every new condition will require treatment, normally in the form of a pill. Nikolas Rose has written in detail on this relationship. His article Disorders Without Borders? The Expanding Scope of Psychiatric Practice is well worth a read.

From when I worked at Penrose I have been concerned at both the lack of scientific back-up to the the concept of "Personality Disorders" and the misuse of the concept in the Criminal Justice System.  I am therefore horrified that the new draft lists at the end of the new lists of so-called Personality Disorders a brand new catch all one is being considered.
Personality Disorder Not Otherwise Specified

This category is for disorders of personality functioning that do not meet criteria for any specific Personality Disorder. An example is the presence of features of more than one specific Personality Disorder that do not meet the full criteria for any one Personality Disorder (“mixed personality”), but that together cause clinically significant distress or impairment in one or more important areas of functioning (e.g., social or occupational). This category can also be used when the clinician judges that a specific Personality Disorder that is not included in the Classification is appropriate. Examples include depressive personality disorder and passive-aggressive personality disorder (see Appendix B in DSM-IVTR for suggested research criteria
If it wasn't for the serious consequences of such a diagnoses it would be comic to invent a personality disorder for those of us that cannot quite squeeze into their other (very broad) categories.

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