the psych lobby strikes again: DSM-5 v. WHO's ICD in the US

[beckster]

Hi Marie,
yes, and we might have to do most of the work, as most clinicians are overbooked and over worked. It afffects them too though because we wouldnt be able to see them, insurance wouldnt pay, visits cannot be prn, it limits tests, etc . . .

 

[beckster]

Also,
anyone know how the DSM actually affects regular docs--what if they keep coding pain disorder, back pain, etc as they always have. Is there a matter of jurisdiction here? Any professionals have input?

 

[mezombie]

Also,
anyone know how the DSM actually affects regular docs--what if they keep coding pain disorder, back pain, etc as they always have. Is there a matter of jurisdiction here? Any professionals have input?

Non-psychs generally code to ICD-9CM (the US clinical version of the WHO's ICD). They don't use DSM.

BUT if someone with ME/CFS goes to a psych to deal with the emotional impact of having a physical illness, that person would get a DSM code and could easily end up with a " Somatic Symptom Disorder" on top of ME/CFS.

And don't forget that, in the US, we are all moving toward having all our medical records available electronically. It's all covered under "Health Information Technology" which was slipped in the Recovery Act. So now it's the law.

Which means what we are coded with will follow us everywhere.

Then there is also the "harmonization" project (see ealier posts on this thread)-- at some point, ICD and DSM have to make sense together.

----------------------------------
There is so much more to say, but I really must get off this machine! I am on the "burnout bench"!

 

[beckster]

Hmmm, that's the guts of it, then.

Marie, in a sentence, can you tell me when the ICD and DSM have to come together, and who instigiated this (is we know who).

Thanks (maybe i'll see you at the bench . . .)

 

[starryeyes]

Hey all. Sorry for going MIA, y'all know how it is. I so appreciate folks keeping tabs on this topic - wish I had the brainpower to formulate an opinion on the proposed content, but I just don't right now. Thought you guys might like to check out this article, about the controversy over the DSM within the psychiatric community:

http://www.newscientist.com/article/mg20427381.300-psychiatrys-civil-war.html?page=1

((((((((((fresh eyes)))))))))))) So good to see you! Of course we all understand. Sorry you've been having a hard time. Thanks for this link.



tee

 

[starryeyes]

I second that. I can only hope that my former shrink, who suffered from CFIDS too and had to quit work while I was his patient, is able to comment. He and I both knew that I had been assigned to him for CBT and that it was BS, just to keep the powers that be happy (state laws regarding my disability). So we had great conversations about whatever was on our minds that day and he renewed my prescription for the cheapest antidepressant drug on the market, which I bought using co-pay, and then flushed down the toilet, not wanting to "treat" the depression I didn't have, and having tried it to see if it would help with fatigue. It didn't.

Marie, a question: When they mention "pain syndrome" does that cover fibromyalgia or is that something else?

Hi oerganix,

That was a cool psych you had. I was wondering if you knew that flushing your meds down the toilet puts them into the drinking water and our medicines have ended up in rivers and lakes too. The best way to dispose of them is to throw them in the trash.

tee

 

[gracenote]

Hi oerganix,

That was a cool psych you had. I was wondering if you knew that flushing your meds down the toilet puts them into the drinking water and our medicines have ended up in rivers and lakes too. The best way to dispose of them is to throw them in the trash.

tee

Hi tee,

I've been told the best way to dispose of medication is to take it to select pharmacies who will dispose of it as a toxic substance, not put it into our landfills. You will need to call first to find out who will accept unneeded and outdated medication.

 

[mezombie]

Hmmm, that's the guts of it, then.

Marie, in a sentence, can you tell me when the ICD and DSM have to come together, and who instigiated this (is we know who).

Thanks (maybe i'll see you at the bench . . .)

Hi again, Beckster,

I am a bit brainfogged ATM, but this might help answer your question (from post #27 on this thread, by MEAgenda):

It needs to be pointed out that the "harmonization" commitment is a joint commitment between the WHO and DSM and is set out as such on the summaries of the meetings of the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders.

The DSM-V Task Force and ICD-11 Revision Steering Group have committed as far as possible “to facilitate the achievement of the highest possible extent of uniformity and harmonization between ICD-11 mental and behavioural disorders and DSM-V disorders and their diagnostic criteria” with the objective that “the WHO and APA should make all attempts to ensure that in their core versions, the category names, glossary descriptions and criteria are identical for ICD and DSM.”

The International Advisory Group mentioned in this post can be found here: http://www.who.int/classifications/icd/TagMH/en/index.html

I'm not sure about any deadlines.

-----------------------

Other points of interest:

Jspotila did some research and found the US agency responsible for updating the ICD-9CM: http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm

The US also has a center that is responsible for collaborating with the WHO (World Health Organization) for the ICD (International Classification of Diseases): http://www.cdc.gov/nchs/icd/nacc.htm

 

[starryeyes]

Hi tee,

I've been told the best way to dispose of medication is to take it to select pharmacies who will dispose of it as a toxic substance, not put it into our landfills. You will need to call first to find out who will accept unneeded and outdated medication.

Ah okay, thank you.

 

[oerganix]

Hi oerganix,

That was a cool psych you had. I was wondering if you knew that flushing your meds down the toilet puts them into the drinking water and our medicines have ended up in rivers and lakes too. The best way to dispose of them is to throw them in the trash.

tee

Yes, I am aware of that issue, hormones being the most dangerous in the water supply. But since the plumbing for my house was connected to a private septic tank, and I lived many miles from the closest creek or lake or neighbor in an area with near desert amounts of rainfall, I made that rather selfish choice. Regarding taking the meds to another pharmacy for disposal, I really didn't live close enough to one to make that a practical solution for me. (400 miles one-way) It would have been a huge expenditure in gas money and personal energy to drive that far just to 'do the right thing'. I had to drive 90 miles one-way just to see a doc that did not disdain me. Rural and small town living is really much different than life in the "big city".

 

[mezombie]

Yeah, I had a cool psych early on as well. The first doc I went to (an internist) suggested what I had was psychological. I didn't believe this, but desperately wanted to get well and had no place else to turn. The psych I saw referred me to an infectious disease specialist after watching me physically decline yet show no signs of depression.

It would be hard to find her now (20 years later) but I may try.

I really do think we need to get doctors like this to comment on the DSM-5 proposals, even if we have to draft a reply for them.

Fresh_Eyes, what do you think about starting a new thread under the Activism section now that we have the DSM-5 proposals?

MeZombie, formerly Marie

 

[MEKoan]

Zombers!

 

[mezombie]

Rafiki/Koan!

 

[mezombie]

New York Times article on DSM-5 revision

Posted by Jean Harrison (of Mothers Against M.E. aka MAME) on Co-Cure:

http://www.nytimes.com/2010/02/10/health/10psych.html?em

One salient paragraph:

But others, including a proposed alternative for bipolar disorder in many
children, were unveiled on Tuesday. Experts said the recommendations, posted
online at DSM5.org for public comment, could bring rapid change in several
areas.

Anything you put in that book, any little change you make, has huge
implications not only for psychiatry but for pharmaceutical marketing,
research, for the legal system, for whos considered to be normal or not,
for whos considered disabled, said Dr. Michael First, a professor of
psychiatry at Columbia University who edited the fourth edition of the
manual but is not involved in the fifth.

And it has huge implications for stigma, Dr. First continued, because the
more disorders you put in, the more people get labels, and the higher the
risk that some get inappropriate treatment.

Jean Harrison

(bold, italics, and underlines added)

MZ

 

[starryeyes]

Yes, I am aware of that issue, hormones being the most dangerous in the water supply. But since the plumbing for my house was connected to a private septic tank, and I lived many miles from the closest creek or lake or neighbor in an area with near desert amounts of rainfall, I made that rather selfish choice. Regarding taking the meds to another pharmacy for disposal, I really didn't live close enough to one to make that a practical solution for me. (400 miles one-way) It would have been a huge expenditure in gas money and personal energy to drive that far just to 'do the right thing'. I had to drive 90 miles one-way just to see a doc that did not disdain me. Rural and small town living is really much different than life in the "big city".

Oh I see oerganix. Not that you have to explain yourself. I figured with your name that you knew what was going on.



tee

 

[oerganix]

:innocent1:

Oh I see oerganix. Not that you have to explain yourself. I figured with your name that you knew what was going on.



tee

Hugs to you, too!
:yinyangYou've forced me to figure out how to use these thingys) :innocent1::innocent1::innocent1Sort of. These just sort of jumped here):innocent1::innocent1:

 

[Dx Revision Watch]

Thread: DSM5 - Ticket back to Reevesville


Post #21

Key documents for DSM-5 draft proposals and the public review process

http://forums.aboutmecfs.org/showth...k-to-Reevesville&p=48972&viewfull=1#post48972

 

[Dx Revision Watch]

Please note that I no longer post on these forums.

Any enquiries should be sent via the Contact forms on my sites.

http://dxrevisionwatch.wordpress.com
http://meagenda.wordpress.com

 

[Angela Kennedy]

Suzy made this excellent comment on the Washington Examiner blog recently:

http://washingtonexaminer.com:80/blogs/opinion-zone/2011/01/corrupting-psychiatry

The previous commenter cautions against invoking members of the "British psych establishment". Two very influential members of the British psychiatry and psychosomatics establishment, Professors Michael Sharpe and Francis Creed, have seats on the DSM-5 "Somatic Symptom Disorders" Work Group.

While many column inches by rightly perturbed journalists and a stream of often acerbic critiques from former DSM Task Force chairs, Allen Frances and Robert Spitzer, have focussed on the implications for introducing new additions into the DSM and broadening the definitions of existing diagnostic criteria, the DSM-5 "Somatic Symptom Disorders" Work Group (Chair, Joel E Dimsdale) has been quietly redefining DSM's “Somatoform Disorders” categories with proposals that if approved would legitimise the application of an additional diagnosis of “Somatic Symptom Disorder” to all medical diseases and disorders.

Radical proposals for renaming the “Somatoform Disorders" category “Somatic Symptom Disorders” and combining a number of existing categories under a new umbrella, "Complex Somatic Symptom Disorder (CSSD)" and a more recently suggested "Simple Somatic Symptom Disorder (SSSD)", have the potential for bringing millions more patients under a mental health banner and expanding markets for psychiatric services, antidepressants, antipsychotics and behavioural therapies such as Cognitive Behavioural Therapy (CBT) for all patients with somatic symptoms, irrespective of cause.

Professor Creed is co-editor of The Journal of Psychosomatic Research. In a June '09 Editorial, titled "The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV - a preliminary report", which expanded on a brief DSM-5 Work Group progress report published on the DSM-5 Development website that April, Joel E Dimsdale and fellow DSM-5 Work Group member, Francis Creed, reported that by doing away with the "controversial concept of medically unexplained symptoms", their proposed classification might diminish the "dichotomy, inherent in the 'Somatoform' section of DSM IV, between disorders based on medically unexplained symptoms and patients with organic disease."

If the most recent "Somatic Symptom Disorders" Work Group proposals gain DSM Task Force approval, all medical conditions, whether "established general medical conditions or disorders" like diabetes or conditions presenting with “somatic symptoms of unclear etiology” will have the potential for a bolt-on diagnosis of "somatic symptom disorder".

Under the guise of "eliminating stigma" and eradicating "terminology [that] enforces a dualism between psychiatric and medical conditions" the American Psychiatric Association (APA) appears hell bent on colonising the entire medical field by licensing the application of a mental health diagnosis to all medical diseases and disorders.

 

[Enid]

"Hell bent on colonising the entire medical field" is exactly where they are. One has to ask them - what's your problem ? They must think we are all (except them) stupid. Not too cool I'm afraid my psyche - going through a series of blackouts and forced onto me after another collapse and ambulanced to Accident & Emergency. All he could say was "what's the day today" ! ...............