Individuals with mental illness have higher risks of developing physical health issues leading to reduced life expectancy. There has been an ongoing debate on the relevance of DSM in the wake of the development of more efficient alternatives with less false positive issues. The changes that were conducted on DSM were due to corrections of constant false positive problems that were unnoticed in the previous versions. Audits down on conceptual validly have contributed to the reduction of false positives. One of the most publicly discussed controversial DSM-5 revisions concerned lack of full information on documentation and was a significant hindrance given that previous versions were available (Wakefield, 2016; Wakefield & Schmitz, 2014). The paper seeks to identify some notable, controversial DSM diagnosis on mental illness and provide insightful information that can aid other researchers to fulfill the necessary knowledge gaps in this domain.
The epidemiology of psychiatry has long been concerned with the need for reducing the false positives problems in diagnosis (Wakefield, 2015). In contemporary society, there are myriad of support towards the revision of the DSM. The domain of psychiatry is composed of controversial debates over-diagnoses such as these. The debate has spanned from identity disorder to childhood mood alterations (Ewart et al., 2016). One of the most prevalent debates on DSM disorders is gender identity disorder. According to DSM-IV, people who feel like they are having trouble matching their physical to true gender are herein diagnosed as having Gender Identity Disorder (GID). On the other hand, there have been proposals for changing the names to a more gender-sensitive alternative of gender incongruence by DSM-5. The problem with the paradoxical situation occurs when a patient is wrongfully assessed or diagnosed (Wakefield & Horwitz, 2016).
Another controversial DSM diagnosis is those that pertain to Asperger’s disorder which is not only marked as normal language and intelligence abilities but weak social skill, this is the DSM-IV. In 2013, when DSM-5 was published, the disorder may get averted. The reason for the aversion is because the studies conducted on autism and Asperger’s have yielded no results in identifying the difference between the two. Consequently, the overlap of diagnosis between the two disorders is rampant in many healthcare systems. If the proposed changes are implemented, people diagnosed with Asperger’s will be recategorised as exhibiting high-functioning autism (Fombonne, 2020). However, some experts disagree, pointing out the argument that the label mentioned above is generalising and does not always fit individuals with Asperger’s. Hence, people with Asperger’s are going to be left out of differential diagnosis evaluation criteria that are not looked into.
Adult Attention Deficit Hyperactivity Disorder (ADHD) is a typical childhood cardiovascular-related condition. Prior research by Baller et al. (2015) found out that except hypertension and cardiovascular-related diseases, screening is inadequate and unreliable. As such, this observation is dire, given that atypical antipsychotic intervention as an option at point-of-care. The atypical antipsychotic medical interventions have been shown to cause severe metabolic repercussions. For example, second-generation antipsychotics are known to cause undesirable metabolic events. The recent DSM-5 update on ADHD includes changes to each of the prior diagnostic approaches (A-E). Besides the terminological changes, there were additions to the modifiers of ADHD. There are changes in Criterion A (Symptoms) and Criterion B (Age of onset).
There is a change in nomenclature from DSM-IV to DSM-5 from subtypes to presentation. The idea was, hyper-reactivity or impulsivity varies across age, in many children with ADHD, but attention is generally stable across the population (Epstein). While there have been notable transformations to make the ADHD approach more helpful to older adolescents and adults, the DSM-5 diagnosis of ADHD fails to produce general developmental milestones. Specifically, people classified as exhibiting “predominantly inattentive presentations” may include both children who meet the criteria for both “combined presentment” and hyperactive-impulsive Syndrome. Future research in this area should look into segmenting the sub-population of children that have ADHD, as it may address the heterogeneity that is inherent in the market as well as address coping inconsistencies in diagnosing depression (Park & Kim, 2018). The changes over time warrant regular reclassification strategies to capture the whole population.
For effective care for mental health patients. The health practitioner should correctly diagnose the presented condition and establish a professional contributions network. The practitioner should also access relevant information about how to conduct themselves properly. Diagnosis of mental healthcare problems is supposed to be done by professional psychiatrists with contributions from other healthcare professionals. Mental healthcare professionals are legally constrained by the need for maintaining confidential information of their patients. Caregivers and family members have witnessed the doctor failing to provide diagnosis information without the patient’s consent. The consent that is solicited from the patient before the diagnosis through informational materials they can understand.
An example of consumer qualitative experience is Alice, a young woman who had been struggling with depression and self-esteem issues in 2015, stumbled upon an article online that provided her with insightful information on how to cope with depression. Her comment clearly illustrates the value of easy accessibility of personal stories of other people. Close to five million people visited healthtalk website in 2015, where half of them were looking for mental health information. Moreover, 8 out of 10 people agreed that they felt better educated after viewing the information on the website. 7-10 strongly agreed that they felt better prepared and less alone to whatever they were dealing with. Moreover, approximately 85% of the people reported that they agreed that the educational content in the healthtalk website is better than what they had gotten elsewhere (Kidd & Ziebland, 2016). The information obtained from sources like this help in bridging information gaps and help in the continuity of care.
Access to educational resources and information for people with mental health problems is vital given the impact it has on essential healthcare promotion. Healthtalk is one of the most respected UK online mental health information serving a population of an internet user who goes online to seek information and people diagnosed with mental health problems. The changes on DSM from the naming convention, to the controversies pertaining secrecy to being closed-source, have taken the debate limelight.
Baller, J. B., McGinty, E. E., Azrin, S. T., Juliano-Bult, D., & Daumit, G. L. (2015). Screening for cardiovascular risk factors in adults with serious mental illness: a review of the evidence. BMC Psychiatry, 15(1), 55.
Ewart, S. B., Bocking, J., Happell, B., Platania-Phung, C., & Stanton, R. (2016). Mental health consumer experiences and strategies when seeking physical health care: a focus group study. Global Qualitative Nursing Research, 3, 2333393616631679.
Fombonne, E. (2020). Epidemiological controversies in autism. Swiss Archives of Neurology, Psychiatry and Psychotherapy, 171(01).
Kidd, J., & Ziebland, S. (2016). Narratives of experience of mental health and illness on healthtalk. Org. Bjpsych Bulletin, 40(5), 273-276.
Park, S. C., & Kim, Y. K. (2018). Depression in Dsm-5: changes, controversies, and future directions. In Understanding Depression (pp. 3-14). Singapore: Springer.
Wakefield, J. C., & Schmitz, M. F. (2014). Uncomplicated depression, suicide attempt, and the DSM-5 bereavement exclusion debate: An empirical evaluation. Research on Social Work Practice, 24(1), 37-49.
Wakefield, J. C. (2015). DSM-5, psychiatric epidemiology and the false positives problem. Epidemiology and Psychiatric Sciences, 24(3), 188-196.
Wakefield, J. C. (2016). Diagnostic issues and controversies in DSM-5: return of the false positives problem. Annual Review of Clinical Psychology, 12, 105-132.
Wakefield, J. C., & Horwitz, A. V. (2016). Psychiatry’s continuing expansion of depressive disorder. In Sadness or Depression? (pp. 173-203). Dordrecht, Netherlands: Springer.
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