The New DSM is here!
A new (fifth) edition of the Diagnostic & Statistical Manual of Mental Disorders will be published in 2013 - the DSM-V. This diagnostic manual published by the American Psychiatric Association not only influences how doctors diagnose and treat their patients, but it also sways how insurance companies decide which conditions to cover, how pharmaceutical companies design clinical trials, and how funding agencies decide which research to fund.
For a new section on Addiction and Related Disorders, vocabulary is being overhauled, according to an article in Science, Vol. 327, 770-1, Feb. 12, 2010. The DSM designations of "dependence" and "abuse" are out. ("Dependence" is too easily confused with physical and sometimes psychological dependence; "abuse" is unsupported scientifically.) Instead, varying degrees of "use disorder", as in "alcohol use disorder", are proposed. "Gambling disorder" has achieved the status of addiction, based on behavioral and biological similarities to substance addiction. "Internet addiction" is under consideration but hasn't yet made the grade. Under Eating Disorders, a new addition is "binge eating", which has been moved from the Appendix to become a full-fledged disorder. Many other changes in psychiatric disorders are being proposed, which can be viewed on the organization website.
Our Center feels strongly about the loss of a category that identifies non-pathological drinking and drugging, as the old category of "drug abuse" did (although we too do not like the word abuse). We are also dubious about a "substance use disorder" properly representing the overwhelming neurobiological and genetic evidence for "addiction (formerly dependence) as a brain disease". Finally, the inclusion of the subjective phrase "addiction and related disorders" is not supported by the available research literature, and will almost certainly increase stigma against alcoholics and addicts, in addition to confusing the public about the differences between (for example) "cocaine addiction" and (for example) "cell-phone addiction". Please feel free to make comments to the DSM committee about "substance use disorder" at the organization website.
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11 November 2013