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Thursday 27th June 2019

Asperger's syndrome edited away

4th December 2012

Major revisions to the diagnostic "bible" of the psychiatric profession in the US will do away with some diagnostic labels - among them Asperger's syndrome - while adding in new ones.


The American Psychiatric Association (APA) has given its approval to the final draft of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.

However, the new edition, due for publication in May 2013, has drawn criticism from a top psychologist who helped to edit the last version, Allen Frances.

Frances hit out at the DSM-5 in an editorial in the journal Psychology Today, calling it "deeply flawed," and slamming the changes as unsafe and without scientific backing.

However, the APA has said that the new manual is the result of a collaborative effort between more than 1,500 experts in the field in 39 countries.

According to APA president Dilip Jeste, that taskforce had produced a manual that is representative of current scientific knowledge in the field of mental health.

Jeste said the DSM-5 would be of use to patients and healthcare professionals alike.

Among the developmental disorders to go are Asperger's, childhood disintegrative disorder, and pervasive developmental disorder.

People with these conditions will receive diagnoses of "autism spectrum disorder" with different degrees of severity instead.

New diagnoses have also been entered into the book, including "binge-eating disorder," defined as excessive eating 13 times in three months, and disruptive mood dysregulation disorder, for children with three or more tantrums a week for more than a year.

However, editors decided to drop a proposed new disorder, "psychotic risk syndrome," along with "hypersexual disorder," or sex addiction.

However, "behavioural addictions" - compulsive attachment to certain activities - do make it into the new version.

One of the most controversial changes involves the diagnosis of depression in people who have lost a loved one and experience symptoms of depression lasting less than two months.

According to the APA, the changes were designed to recognise that bereavement can precipitate a major depressive episode.

But Frances said that traditional consolations of friends, family, religion and a maturing outlook on life, along with its limitations and endings, would be replaced with medicalised rituals and pills.

In DSM-IV, grief is seen as normal in people with symptoms of depression lasting less than two months after the death of a loved one.

Now, the bereaved may receive a psychiatric diagnosis.


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