DSM Under Scrutiny

It is a very serious issue when a doctor or psychiatrist makes a diagnostic error and it becomes even more serious when the mistake results in such detrimental repercussions for the patient. An article by Paula Caplan describes this sort of situation where a young mother was diagnosed with bipolar disorder. Caplan claims that the symptoms of distress that the woman displayed could be explained by the excessive stress the woman was experiencing in her home life. Caplan places the blame for the woman’s misfortune on the psychiatrist who diagnosed her and how the DSM is used to diagnose mental illness. According to Caplan, the DSM should be done away with immediately in order to avoid situations similar to the young woman’s.One of Caplan’s criticisms of the DSM is that psychiatrists attempt to fit a patient with a disorder instead of finding a disorder that fits the patient. It is valid concern that this kind of clinical behavior can occur and that using a guide such as the DSM can lead to such dangers. This issue however has more to do with how the DSM is perceived and used by psychiatrists and does not indicate a problem with the DSM itself. Perhaps the problem could be helped if the issue were to be properly addressed in the training of psychiatrists. Other criticism Caplan makes of the DSM is that poor quality research is used to support certain categories favored by the editors while pertinent high-quality research is ignored or distorted. Whether these claims are valid or not I do not know, yet it is improbable that such a highly esteemed psychiatric resource would not be thoroughly scrutinized for accuracy.

However unfortunate Caplan’s story is, it does not validly discredit the DSM. There is a large amount of variables that could have affected this woman’s life and caused all her grief. Take how the woman in the article is diagnosed after a quick assessment by a doctor. She could have had a very bad doctor who often made irrational decisions, or perhaps she did actually have bipolar disorder. The article makes no mention of whether the woman was correctly diagnosed or not. It certainly makes no mention of the DSM being consulted by the doctor. The woman’s problems after being diagnosed with bipolar disorder could not necessarily have all been due to her diagnosis cut could have stemmed from other problems. I feel as though Caplan’s criticisms should be directed to problems in psychiatric diagnosing procedure instead of at the DSM. Perhaps the diagnosing procedure should be better regulated. Similarly, due to the negative connotations often associated with mental illnesses, several psychiatrists should be consulted to ensure that a person is not diagnosed unnecessarily. I feel as though these measures would more efficiently reduce mistreatment of patients than disregarding the DSM would.

What Caplan does not mention are the benefits that are provided by having such a standardize method of diagnosing mental disorders. The DSM provides psychiatrists consistency in diagnosing and recognizing mental illness. Although the system is still susceptible to human error, it can still be considered better than a system where psychiatrists have isolated and potentially differing opinions on mental illnesses. The APA should work towards making the DSM as accurate and scientifically based as possible as well as work to eliminate the effects of racism, sexism, and classism in the modern diagnosing of mental illnesses.

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