Diagnostic and Statistical Manual of Mental Disorders (DSM)

The Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, (DSM-IV) is a reference manual widely used internationally, particularly for statistical research and to a lesser extent for diagnosing psychiatric disorders. Its clinical value is the object of more and more pressing criticism from psychiatrists and psychologists concerned with reasoned psychopathology.

This manual is published by the American Psychiatric Association (APA). The diagnoses of psychiatric pathology made using the DSM-IV are based on the clinical identification of syndromes and on the paraclinical data provided by the additional examinations (biological examinations, medical imaging, etc.) These diagnoses are categorical and identify a number minimum criteria so that a person is considered to have a psychiatric or neuropsychiatric pathology.

The International Classification of Diseases (ICD-10) of the World Health Organization (WHO) is the most commonly used alternative.

History

It consists of a sort of taxonomy of psychiatric disorders and is of real use in statistical terms. As previously conceived, psychiatric pathologies were systematically considered as a continuum from normal to severe pathology. As a result, there were no clear distinctions between what was considered normal and what was pathological. Therefore a considerable part of the general population was likely to be diagnosed as a carrier of a psychiatric disorder. We then insisted on the intensity of the disorder judged on personal or interpersonal difficulties.

The DSM was the subject of many controversies, particularly with regard to homosexuality which was withdrawn from the diagnostic manual in 1973 after three years of demonstrations by associations of homosexual representatives ( see in particular: Kameny (Frank) ).

The third edition of the DSM in 1980 was the subject of major changes. She abandons the psychiatric model in favor of a biomedical model. However, it retains the categorical approach delimiting populations carrying pathologies defined on the basis of clinical criteria.

The fourth edition (DSM-IV) was published in 1994 and recognized 410 psychiatric disorders. Currently a revised version from 2000 is used. A fifth edition is announced for 2011 and working groups were set up in 2007.

Limits and interest

The interest of the DSM is to propose a rigorous classification of pathologies which allows the constitution of a common language among clinicians. In addition, it allows statistical research to be carried out on the frequency of a disorder to guide public health research.

Its limits are those inherent in categorization. He asks questions in terms of locking people into a diagnosis at the risk of giving in to an excessive medicalization of the state of suffering.

Criticisms of the psychoanalytic movement

The psychoanalytic movement takes a critical view of the DSM. They consider that the symptom is the inappropriate and / or symbolic expression of a disorder and an anxiety which is partly unconscious. They refute the exclusively descriptive point of view of the DSMs. For them, establishing reliable diagnoses on disorders of which only the visible side is taken into account is questionable because it promotes ignorance of the origin of the disorders in question.

The DSM is also accused of conflict of interest with the pharmaceutical industry.

The DSM and the zoo

The zoophilia or bestiality appears among the mental pathologies in the DSM among the paraphilias s under the heading "Other unspecified paraphilias" under the code [302.9] (in the same way as fetishism or masochism). As such, the DSM does not consider the zoophile to be irresponsible.

Interpretation

Like the WHO classification, the DSM is first and foremost a psychiatric taxonomy and is characterized by a certain pathologization of all human behavior. Some behaviors that appear in this list do not necessarily have the effect of causing problems in social life. It is sometimes even society which tends to consider them as disorders can be at the origin of manifestations of pathological types.

Moreover, this list of mental disorders is not definitive. The homosexuality having been removed from this list in 1973 at the end of the fight initiated by Frank Kameny, it is not forbidden to consider that one day bestiality may be removed from this list.

external links

• The official DSM-IV site

• Article written according to the French wiki article:
  Template:Fr http://fr.wikipedia.org/wiki/Manuel_diagnostic_et_statistique_des_troubles_mentaux