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That's what DSM-5 needs: One more diagnosis

Nassir Ghaemi, MD, Psychiatry/Mental Health, 09:29PM Sep 19, 2012 Maybe I j st !"n#t n!erstan!, b t s pp"se y" a$ree %ith all the %"rl! that hates the !ia$n"sis "& bip"lar !is"r!er in chil!ren' ()actly h"% !"es it ma*e sense &"r DSM+, t" speci&icially try t" !isc" ra$e the !ia$n"sis "& bip"lar !is"r!er in chil!ren by a!!in$ an"ther !ia$n"sis + -emper Dysre$ lati"n Dis"r!er .-DD/, s"methin$ in bet%een "pp"siti"nal !e&iant !is"r!er .0DD/ an! attenti"n !e&icit hyperacti1ity !is"r!er .2DHD/ + s" that i& a chil! is a$$ressi1e an! hyperacti1e y" can $i1e him "ne, "r all "& these "ther !ia$n"ses + an! n"t bip"lar !is"r!er3 Pe"ple c"mplain ab" t DSM: they say it has ab" t 400 !ia$n"ses + that#s t"" m ch' Pe"ple c"mplain ab" t the pharmace tical in! stry: they say they create !ia$n"ses &"r their !r $s' S" h"% is it a s"l ti"n t" ma*e p "ne m"re !ia$n"sis, thin*in$ %e can " tsmart the pharmace tical in! stry s" that %e !"n#t se their !r $s anym"re &"r bip"lar !is"r!er3 I ha1e a h nch the pharmace tical in! stry %ill j st t rn t" !"in$ clinical trials in -DD, an! they#ll $et 5D2 in!icati"ns, an! %e#ll be ri$ht bac* %here %e %ere' -here are s"me !ata t" s pp"rt -DD, s"me %ill say' 6 t all th"se !ata c"me &r"m "ne researcher#s $r" p, %h" happene! t" be "n the DSM+, c"mmittee an! str"n$ly p she! &"r the ne% !ia$n"sis' Isn#t that a c"n&lict "& interest, especially &"r a t"tally ne% !is"r!er3 -hese th" $hts came t" min! %hen I rea! a NIMH+sp"ns"re! c"n&erence at the Hastin$s 7enter in Ne% 8"r* "n chil!h""! bip"lar !is"r!er' M"st "& th"se in1"l1e! %ith chil! psychiatry in relati"n t" this c"n!iti"n a$ree! %ith the i!ea "& -DD' I %asn#t c"n1ince!, %hich I#ll e)plain in & t re bl"$ p"sts' 2n! I %"n#t be s rprise! i& many %h" %ill c"mment here %ill a$ree %ith the -DDites' -r th is n"t a matter "& maj"rity 1"te, h"%e1er, an! I ha1e a h nch that in the & t re %e %ill l""* bac* "n this -DD mania %ith inc"mprehensi"n' -hat#s the %h"le pr"blem %ith DSM, as I#1e sai! be&"re' 9hy !"n#t %e j st all"% the !ia$n"sis "& bip"lar !is"r!er in chil!ren .there are $""! !ata that it happens, e1en $"in$ bac* t" 1:4, 5rance in (s; ir"l#s te)tb""*/, an! then e! cate clinicians ab" t h"% t" !ia$n"se it, a1"i!in$ "1er!ia$n"sis, an! h"% t" treat it, a1"i!in$ "1er se "& !r $s %ith the m"st ris*s, s ch as anti!epressants an! antipsych"tics3 Instea! "& bein$ scienti&ically h"nest in " r n"s"l"$y an! ta*in$ p"n " rsel1es the pr"&essi"nal resp"nsibility "& a!e; ate e! cati"n, %e se the ne)t re1isi"n "& DSM t"

ma*e p an entirely ne% !ia$n"sis s" that %e can, m"re "r less, &"rce clinicians t" !" %hat %e %ant' D"n#t !ia$n"se that c"n!iti"n .an! se !r $ </= y" m st !ia$n"se this c"n!iti"n .an! se !r $ 8/' -hat#s h"% %e re1ise DSM= n" %"n!er %e ma*e s" little pr"$ress %ith DSM >!is"r!ers> in scienti&ic research "n bi"l"$y, ca ses, an! treatments' http://b"ar!s'me!scape'c"m/&"r ms/312:?:0@'tc12aSAb*bB?'2aB4&e:!C c"mmentD1EcatD2llEsrcDmpE acD1FB,4PG

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