Tag Archives: Patrick McGorry

Psychiatry’s Billing Bible Prompts ‘Bickering, Contention, Organized Revolt and finally, A Backdown’

EFFORTS to update the psychiatrists’ bible – the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – have led to bickering, contention, organised revolt and, finally, a backdown.

The association announced it has abandoned plans to class so-called attenuated psychosis syndrome and internet addiction as psychiatric disorders.

And four disputed additional criteria for diagnosing attention deficit hyperactivity disorder (ADHD) have been dumped: “impatience”, “acting without thinking”, “uncomfortable doing things slowly and systematically” and “finds it difficult to resist temptations or opportunities”.

Politics and mental health a poor mix

Imagine a tribunal where the public could challenge clinical decisions by neurosurgeons or cardiologists. It would be ridiculous. But mental health is different. Unlike other medical specialties, it resembles law or politics: fields where subtle variations in the interpretation of a word can alter the entire trajectory of a patient’s treatment.

That’s why the right to appeal clinical decisions by mental health professionals through a tribunal, announced recently by the NSW government, met with public approval. Mental health possesses a built-in capacity for abuse that is greater than in other areas of medicine. A patient’s psychiatric diagnosis has enormous cultural power in many other fields, from the marketing of antidepressant medications, to general practice, disability claims and legal proceedings.