Why Does the DSM Continually Add, Change, or Remove Mental Illnesses?

Many people wonder why the Diagnostic and Statistical Manual of Mental Disorders (DSM) is always changing or updating its criteria for mental illnesses. It is often seen as a product of psychiatrist's whims and subjective definitions. However, like many other medical classifications and guidelines, the DSM evolves with advances in research and evidence-based practices. This article will explore the reasons behind these changes and examine the process through which the DSM is developed and updated.

The Evolutionary Nature of Medical Classifications

The dynamics of classifying and diagnosing mental illnesses are similar to those in other fields of medicine. For example, the International Classification of Diseases (ICD) has been undergoing continuous revisions in response to evolving medical knowledge and practices. In the realm of psychiatry, the changes to the DSM reflect the ongoing pursuit of improved diagnostic accuracy and practical application in clinical settings.

Just as guidelines for high blood pressure or fasting blood sugar levels are regularly updated based on new research and evidence, so too do the diagnostic criteria for mental health conditions. This continuous evolution ensures that the classification and treatment of mental illnesses remain consistent with the latest scientific understandings. It is a testament to the dynamic nature of medical science and its commitment to improving patient care.

Developing the DSM Through Conference and Research

The DSM is not handed down from a divine authority but is the result of extensive collaboration among experts in the field. National conferences of psychiatrists, psychologists, and researchers play a critical role in developing and revising the DSM. These conferences serve as platforms for presenting and discussing the latest research findings, comparing case notes, and engaging in vibrant discussions to refine diagnostic criteria.

This process of constantly evaluating and revising diagnostic criteria ensures that the DSM remains relevant and useful in the clinical setting. For instance, the removal of homosexuality from the list of sexual disorders in the early 1970s was a significant milestone. It not only corrected erroneous classifications driven by religious prejudices but also set a precedent for the inclusion of other subjective or culturally specific conditions in the DSM.

Skepticism and Controversies: Scientologists and Religious Prejudices

While the evolving nature of the DSM is generally accepted within the medical community, it has faced skepticism and criticism from various quarters. Some religious groups, such as Christians, have been vocal in their opposition to the removal of certain diagnoses from the DSM, often based on their religious beliefs.

However, these criticisms do not negate the importance of evidence-based medicine and the continuous pursuit of scientific accuracy. For instance, the removal of homosexuality from the DSM in the 1970s was a step towards ensuring that the classification of mental illnesses was no longer influenced by prejudiced views and was instead based on scientific evidence.

Sci-fi guru Dianetics and its derivative, Scientology, have also been vocal critics of psychiatry. Many members of the Scientology community dismiss psychiatry as a pseudoscience, partly because of their belief in their own unique explanations for mental health conditions. However, such dismissal does not alter the fact that the DSM continues to evolve through rigorous scientific scrutiny and empirical validation.

Conclusion

Overall, the continuous changes and updates to the DSM reflect the ongoing efforts to improve the accuracy, reliability, and practical utility of mental health diagnosis. While there will always be critics and controversies surrounding the DSM, these changes ultimately benefit patients by ensuring that their conditions are accurately diagnosed and appropriately treated.