Dr Charles Parker

Diagnostic Bible: Scientific Heresy

If you are lost, forget being found with this bible.
You may be thinking the new, long awaited DSM5 psychiatric diagnostic manual would herald pointed improvements in the evolution of psychiatric science – …like new information, new perspectives, new treatment strategies. Don’t be worried, you won’t have to change anything you are doing… it’s the same old 19th Century stuff, trimmed up to tweak the descriptive language, with no improvements there for patient care, and no new science. Boring. But Freud is happy.

The DSM5 is not categorically ineffective
On a brief positive note you will appreciate this NPR review of the diagnostic evolution with childhood bipolar diagnosis – a significant problem addressed repeatedly here at CorePsych Blog as kids are regularly, automatically slammed with atypical antipsychotics rather than considering the biologic underpinnings of emotional explosions. Been there, done that.

Labels, not science, still prevail
See this brief description in the LA Times and you will catch the drift and controversy on these new, already outdated diagnostic maps. Our books are outdated simply because we aren’t learning how to read the brain images and the lab reports. All the names will change when we recognize gluten sensitivity, bowel dysfunction, and the abundance of metabolic imbalances that effect brain function.

The Earth is Flat! DSM 5 Points at the Tips of Icebergs – Only What You See.
The tip-toe progress with these new superficial labels for office appearances misses altogether the complexity of new brain and body science. Neuroscience evidence is easily available, often paid for by insurance, and remains almost completely ignored by psychiatry. Real facts, not labels, will foretell the changes necessary for psychiatric practice, for treatment strategies to evolve with the rapidly evolving new science.

Neuroscience evidence changes thinking.
Yes, these refined descriptions may help some talk about psychiatric matters with a bit less confusion, but the new DSM5 conclusions are based almost completely upon 19th century vertical thinking, insufficient feedback with patients in the office, and questions that ignore modern neurophysiology and metabolism.

Psychiatrists will remain speculative with dreams and fantasies, while hard evidence from molecular and cellular physiology remains in the closet – frequently derided as quackery. Interestingly, psychiatry is held to a different standard on evidence than the rest of medicine, as SPECT brain imaging and the measurement of neurotransmitter biomarkers is still derided as non-specific, while patently non-specific biomarkers, such as cholesterol screening, are accepted uniformly in general medicine. It’s time for diagnostic change – but DSM5 is already old news.

Your Comments Count
Let’s see what you think… please comment here and weigh in on your views of psychiatric diagnosis – look forward to hearing from you!
cp

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