Dissatisfaction with psychiatric diagnoses is at a fever pitch

There has been a great deal of dissastisfaction with the state of affairs in psychiatry by activists over the years. Activist groups such as the Citizens Commission on Human Rights, MindFreedom , and The Harold Mandel, MD Natural Mental Health Care Reform Association have evolved to help people address these issues. And in Alaska an activist attorney, Jim Gottstein, has founded PsychRights to help people address the legal issues which can ruin their lives associated with psychiatry.

It appears there has been no progress in psychiatric practices over the years with many activists feeling the discipline is hopeless and should simply be abolished and replaced with a new humanistic mental health paradigm. In fact Diane Swanbrow has reported for the University of Michigan News Service "Psychiatric diagnoses: Why no one is satisfied." Swanbrow has reported that as the Diagnostic and Statistical Manual of Mental Disorders is revised for the first time since 1994, the controversy about psychiatric diagnosis has been reaching a fever pitch.

Although suggested changes to the definitions of autism spectrum disorders and depression, among others, have been eliciting great concerns, Swanbrow points out there are larger concerns about the DSM as a whole. Randolph Nesse, a psychiatrist himself with the University of Michigan, has commented “Almost no one likes the DSM, but no one knows what to do about it.”

Nesse has also said “A huge debate over when depression is abnormal seems likely to be resolved by removing the so-called ‘grief exclusion". At the moment, depression is not diagnosed in the two months after loss of a loved one. The result of this proposed change would be that people experiencing normal grief will receive a diagnosis of major depression. Doing this would increase consistency in diagnosing depression, but at the cost of common sense. It’s clear that bereavement is not a mental disorder.”

Nesse has co-authored with University of Cape Town psychiatrist Dan Stein an article in the current issue of BMC Medicine titled “Towards a genuinely medical model for psychiatric nosology.” The authors anticipate that their diagnosis of the difficulty of categorizing mental disorders will displease many of their colleagues. Nesse has said “The problem is not the DSM criteria. The problem is that the untidy nature of mental disorders is at odds with our wish for a neat, clean classification system.” And so as the DSM is revised once again, Nesse has urged his colleagues and concerned members of the public to adopt realistic expectations.