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A few years ago, one of the mental health charities had a poster campaign on the tube which aimed to bring home just how many people had problems with the slogan "More people in the UK suffer from mental health problems than watch Big Brother".
The only effect this had on me was to make me wonder, every time I saw it, what a Venn diagram of the two groups would look like.
Back when I was a student I would idle away the hours (sometimes days) between lectures in the library, reading the psychiatric literature. As it was a psychology course we had plenty of the stuff and you'd be surprised how entertaining some of it was - like all medical practitioners psychiatrists quickly develop a very black sense of humour which comes out strongly in the stuff which isn't produced for publication in offical journals.
Amongst the stuff which I read for actual research rather than just merriment was the bible of psychiatric diagnosis, the Diagnostic and Statistical Manual (DSM), which is produced by American Psychiatrists and is used internationally to try and generate consistent diagnoses of mental illness. This is periodically updated to reflect current thinking in mental illness and so we had copies of several editions; the DSM II, the DSM III and the DSM III (revised), and one thing I noticed as I read was how the definitions and diagnostic criteria appeared to have expanded with every edition. It kinda seemed like in the original DSM you needed to dress up as Napoleon and stalk the streets of Whitechapel with an axe before you got diagnosed as having something wrong with you, but with every subsequent edition it took less and less to be identified as insane and needing treatment or even medication.
Now, leaving aside any pithy comments about whether it's a good idea for the leading diagnostic manual to be written by the same people whose financial interests are served by finding as many insane people as possible, it struck me at the time that this was a long term trend which might not be good and so I was interested to learn last week that the latest edition of the DSM - the DSM V - is on its final draft now. I wondered if the trend had continued, and when I looked into it I found that it has already generated a good deal of controversy. You see the DSM V now contains not only criteria for diagnosing people who have a mental illness, but also people who don't.
It's called "Psychosis Risk Syndrome" (or possible the less catchy "Attenuated Psychotic Symptoms Syndrome"), and basically anyone - anyone at all, even if they've never had any sign or symptom of mental illness in their life - can be diagnosed with it. Things which were once considered not unusual or at worst a bit eccentric are now grounds for diagnosis of being at risk of psychosis, and even the doctors involved admit that there is a 70 - 90% chance of false positives, meaning that people who do not have and will never have any sort of mental illness in their entire lives can still be diagnosed as having a problem and be liable for - gosh! - expensive treatment.
Other possible new critieria for mental illness include "Binge Eating", which comes as a a relief to me as that means I wasn't a greedy little bugger last weekend but instead just had a psychotic episode with a box of florentines, so at least there's something good come out of it.
The only effect this had on me was to make me wonder, every time I saw it, what a Venn diagram of the two groups would look like.
Back when I was a student I would idle away the hours (sometimes days) between lectures in the library, reading the psychiatric literature. As it was a psychology course we had plenty of the stuff and you'd be surprised how entertaining some of it was - like all medical practitioners psychiatrists quickly develop a very black sense of humour which comes out strongly in the stuff which isn't produced for publication in offical journals.
Amongst the stuff which I read for actual research rather than just merriment was the bible of psychiatric diagnosis, the Diagnostic and Statistical Manual (DSM), which is produced by American Psychiatrists and is used internationally to try and generate consistent diagnoses of mental illness. This is periodically updated to reflect current thinking in mental illness and so we had copies of several editions; the DSM II, the DSM III and the DSM III (revised), and one thing I noticed as I read was how the definitions and diagnostic criteria appeared to have expanded with every edition. It kinda seemed like in the original DSM you needed to dress up as Napoleon and stalk the streets of Whitechapel with an axe before you got diagnosed as having something wrong with you, but with every subsequent edition it took less and less to be identified as insane and needing treatment or even medication.
Now, leaving aside any pithy comments about whether it's a good idea for the leading diagnostic manual to be written by the same people whose financial interests are served by finding as many insane people as possible, it struck me at the time that this was a long term trend which might not be good and so I was interested to learn last week that the latest edition of the DSM - the DSM V - is on its final draft now. I wondered if the trend had continued, and when I looked into it I found that it has already generated a good deal of controversy. You see the DSM V now contains not only criteria for diagnosing people who have a mental illness, but also people who don't.
It's called "Psychosis Risk Syndrome" (or possible the less catchy "Attenuated Psychotic Symptoms Syndrome"), and basically anyone - anyone at all, even if they've never had any sign or symptom of mental illness in their life - can be diagnosed with it. Things which were once considered not unusual or at worst a bit eccentric are now grounds for diagnosis of being at risk of psychosis, and even the doctors involved admit that there is a 70 - 90% chance of false positives, meaning that people who do not have and will never have any sort of mental illness in their entire lives can still be diagnosed as having a problem and be liable for - gosh! - expensive treatment.
Other possible new critieria for mental illness include "Binge Eating", which comes as a a relief to me as that means I wasn't a greedy little bugger last weekend but instead just had a psychotic episode with a box of florentines, so at least there's something good come out of it.
