July 28, 2009
Britain’s newspapers have been full of predictions this week about 2012, when London will host the Olympics. There is a sense both of excitement over potential success and trepidation over potential failure, both on and off the sporting field. It is too early to predict with any confidence whether the London Games will be a success or not, but one thing I can predict, with utmost confidence, is that by 2012 many more of us will be defined as mentally ill.
This will not be related to the Olympics, but because 2012 is when the fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (usually referred to by the shorthand DSM-V) is expected to be published. If previous revisions are anything to go by, then many more people will fall within the parameters required for a diagnosis of mental disorder (1).
It does not require a PhD in psychiatric history to be fairly certain that DSM-V will be more extensive than its predecessors. For example, between the first and fourth editions, published in 1952 and 1994, the number of pages grew from 130 to 886 and the number of diagnostic categories more than tripled. This led some sceptics to suggest, tongue only slightly in cheek, that at such a rate of growth we can reasonably expect the fifth edition to contain some 1,256 pages and 1,800 diagnostic criteria (2).
We have a few years to wait before finding out the exact contents. But it has been revealed in the US this week that there are already tortured discussions amongst those preparing DSM-V as to whether such things as overuse of the internet, ‘excessive’ sexual activity, compulsive shopping and apathy should be contained within the parameters of clinically diagnosable mental disorder in the next edition of the manual (3).
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