Thursday, April 19, 2007

DSM System is WHA?

The DSM system of diagnosing mental disorders is dehumanizing. Not my words (though I think it's largely true), but the words of Nancy Andreasen, a rather big-name psychiatry researcher at the University of Iowa. Here's a quote [emphases added]...
The DSM has had a dehumanizing impact on the practice of psychiatry. History taking—the central evaluation tool in psychiatry—has frequently been reduced to the use of DSM checklists. DSM discourages clinicians from getting to know the patient as an individual person because of its dryly empirical approach. Third, validity has been sacrificed to achieve reliability. DSM diagnoses have given researchers a common nomenclature—but probably the wrong one. Although creating standardized diagnoses that would facilitate research was a major goal, DSM diagnoses are not useful for research because of their lack of validity.
Ouch. Training in psychiatry programs as well as (sigh) some psychology programs has often been reduced to memorizing symptoms and asking yes-no questions from a checklist. See what diagnosis a person has by asking a bunch of structured questions then whip out a prescription pad. Talk with the patients about their problems, develop a relationship? Nah, we never learned about that in our graduate/medical training.

Hat tip: AHRP.

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