Mental health experts ask: Will anyone be normal?

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Mental health experts ask: Will anyone be normal?

By Kate Kelland Kate Kelland Tue Jul 27,

11:28 am ET

LONDON (Reuters) – An updated edition of a mental health bible for

doctors may include diagnoses for "disorders" such as toddler tantrums

and binge eating, experts say, and could mean that soon no-one will be

classed as normal.

Leading mental health experts gave a briefing on Tuesday to warn

that a new edition of the Diagnostic and Statistical Manual of Mental

Disorders (DSM), which is being revised now for publication in 2013,

could devalue the seriousness of mental illness and label almost

everyone as having some kind of disorder.

Citing examples of new additions like "mild anxiety depression,"

"psychosis risk syndrome," and "temper dysregulation disorder," they

said many people previously seen as perfectly healthy could in future

be told they are ill.

"It's leaking into normality. It is shrinking the pool of what is

normal to a puddle," said Til Wykes of the Institute of Psychiatry at

Kings College London.

The DSM is published by the American Psychiatric Association (APA)

and contains descriptions, symptoms, and other criteria for diagnosing

mental disorders. It is seen as the global diagnostic bible for the

field of mental health medicine.

The criteria are designed to provide clear definitions for

professionals who treat patients with mental disorders, and for

researchers and pharmaceutical drug companies seeking to develop new

ways of treating them.

Wykes and colleagues Felicity Callard, also of Kings' Institute of

Psychiatry, and Nick Craddock of Cardiff University's department of

psychological medicine and neurology, said many in the psychiatric

community are worried that the further the guidelines are expanded, the

more likely it will become that nobody will be classed as normal any

more.

"Technically, with the classification of so many new disorders, we

will all have disorders," they said in a joint statement. "This may

lead to the belief that many more of us 'need' drugs to treat our

'conditions' -- (and) many of these drugs will have unpleasant or

dangerous side effects."

The scientists said "psychosis risk syndrome" diagnosis was

particularly worrying, since it could falsely label young people who

may only have a small risk of developing an illness.

"It's a bit like telling 10 people with a common cold that they are

"at risk for pneumonia syndrome" when only one is likely to get the

disorder," Wykes told the briefing.

The American Psychiatric Association did not immediately respond to

a request for comment.

The scientists gave examples from the previous revision to the DSM,

which was called DSM 4 and included broader diagnoses and categories

for attention deficit hyperactivity disorder (ADHD), autism and

childhood bipolar disorders.

This, they said, had "contributed to three false epidemics" of these

conditions, particularly in the United States.

"During the last decade, how many doctors were harangued by worried

parents into giving drugs like Ritalin to children who didn't really

need it?," their statement asked.

Millions of people across the world, many of them children, take

ADHD drugs including Novartis' Ritalin, which is known generically as

methylphenidate, and similar drugs such as Shire Plc's Adderall and

Vyvanse. In the United States alone, sales of these drugs was about

$4.8 billion in 2008.

Wykes and Callard published a comment in The Journal of Mental

Health expressing their concern about the upcoming DSM revision and

highlighting another 10 or more papers in the same journal from other

scientists who were also worried. DSM 5 is due to be published in May

2013.

(Editing by Graff)