HAVING IT OUT ONCE AND FOR ALL WITH THE DSM
MENTAL HEALTH SHOULD NO LONGER REFER TO A SINGLE TEXTBOOK REQUIRED BY THE WHO.
The nomenclature of the DSM, on which WHO’s ICD-10 has been modeled, has progressively become the single and obligatory classificatory reference of “mental disorders”:
- in epidemiology;
- in the field of research and scientific publications;
- for social protection systems and insurances;
- in order to collect statistical data for care policy and financing;
- as an unique reference manual in the teaching of psychiatry in medical and psychology schools, for the training of professionals and lecturers in health, social and special education fields;
- finally, for physicians, who, having no other relevant training, prescribe more and more psychotropic drugs, based on questionable diagnostic criteria.
With the purpose of responding to specific and distinct requirements, the widespread use of this unique classification becomes a confusion, inadequacy and risks source. Especially since the WHO is not empowered to take decisions on scientific research, but instead it should recommend independence, diversity and promote the coexistence of different approaches.
Moreover, far short of scientific rigor, the DSM is based on unambiguously partial conceptions. It neglects the clinical data, multiplies the pathological categories and lowers the threshold of diagnostic criteria for inclusion, which leads to false-positives and pseudo-outbreaks (as, for example, hyperactivity, bipolar disorder or autism). It is misused for predictive purposes in children and adolescents, taking the risk of harming their development and integration. It also promotes what has become, for a large part of the population, a real addiction to psychotropic drugs.
We are on the threshold of the DSM-V’s edition, which will increase again the number of categories, already overcrowded, and extend the scope of prediction. We cannot let it establish such an orientation, designed to increase artificially the number of pathologies.