A UK study has analyzed key components of a classic mental health handbook, questioning whether mental health diagnosis to identify distinct psychological conditions has any scientific meaning.
Researchers from the University of East London and the University of Liverpool examined the “heterogeneous nature of categories” in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
They found the lack of uniformity across key chapters of the DSM-5, which “has important implications for research, clinical practice, and the provision of care that is specific to a person’s individual needs.”
Lead study author Dr. Kate Allsopp of the University of Liverpool said, “Although diagnostic labels create the illusion of an explanation, they are scientifically meaningless and can create stigma and prejudice.”
The DSM-5 is the diagnostic bible for psychiatrists or psychologists.
According to the American Psychiatric Association, mental health specialists in the United States refer the DSM-5 for the “standard classification of mental disorders.”
Dr. Allsopp and other authors analyzed five chapters of the manual, covering a wide range of psychiatric disorders, including “schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, and trauma- and stressor-related disorders.”
The researchers found that there is a high degree of inconsistency and contradiction across the diagnostic criteria of the DMS-5. They also noted that a diagnosis does not say much about the person, and which treatment could be useful.
In addition, they observed that almost all diagnoses underestimate the impact of distressing events and trauma.
The investigators said, “By making reference to trauma or stressors only in one dedicated chapter, the DSM-5 implies that other diagnostic categories are unrelated to trauma.”
Study author Peter Kinderman of the University of Liverpool said, “The diagnostic system wrongly assumes that all distress results from disorder and relies heavily on subjective judgments about what is normal.”
Furthermore, the authors observed that the DSM-5 has “almost 24,000 possible symptom combinations for panic disorder compared with just one combination for social phobia.”
They noted that there is a remarkable contrast between diagnostic criteria. The authors have called for a more practical approach to mental health assessment that can allow recognizing individual experience, as it could be the most effective way of understanding psychological distress.
