CHICAGO * In the new psychiatric manual of mental disorders,
grief soon after a loved one's death can be considered major
depression. Extreme childhood temper tantrums get a fancy name. And
certain "senior moments" are called "mild neurocognitive disorder."
Those changes are just some of the reasons prominent critics say
the American Psychiatric Association is out of control, turning
common human problems into mental illnesses in a trend they say will
just make the "pop-a-pill" culture worse.
Says a former leader of the group: "Normal needs to be saved from
powerful forces trying to convince us that we are all sick."
At issue is the fifth edition of the Diagnostic and Statistical
Manual of Mental Disorders, widely known as the DSM-5. The DSM has
long been considered the authoritative source for diagnosing mental
The psychiatric association formally introduces the nearly 1,000-
page revised version this weekend in San Francisco. It's the
manual's first major update in nearly 20 years, and a backlash has
taken shape in recent weeks:
* Two new books by mental health experts, "Saving Normal" and
"The Book of Woe," say the world's most widely used psychiatric
guide has lost credibility.
* A British psychologists' group is criticizing the DSM-5,
calling for a "paradigm shift" away from viewing mental problems as
a disease. An organization of German therapists also attacked the
* Even the head of the U.S. National Institute of Mental Health
complained that the book lacks scientific validity.
This week, the NIMH director, Dr. Thomas Insel, tried to patch
things up as he and the psychiatrists group issued a joint statement
saying they have similar goals for improving the diagnosis and
treatment of mental illness.
The manual's release comes at a time of increased scrutiny of
health care costs and concern about drug company influence over
doctors. Critics point to a landscape in which TV ads describe
symptoms for mental disorders and promote certain drugs to treat
"Way too much treatment is given to the normal 'worried well' who
are harmed by it; far too little help is available for those who are
really ill and desperately need it," Dr. Allen Frances writes in
"Saving Normal." He is a retired Duke University professor who
headed the psychiatry group's task force that worked on the previous
He says the new version adds new diagnoses "that would turn
everyday anxiety, eccentricity, forgetting and bad eating habits
into mental disorders."
Previous revisions were also loudly criticized, but the latest
one comes at a time of soaring diagnoses of illnesses listed in the
manual including autism, attention deficit disorder and bipolar
disorder and billions of dollars spent each year on psychiatric