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Opening Arguments

Crazy for you

More people than ever are likely to be classified as mentally ill in the next few years, but not because more of us are really going off the rails. The definition of what mental illness is keeps getting expanded:

In May, the American Psychiatric Association will publish the latest edition of its diagnostic manual, known as DSM-5. Changes to the text approved in December mean, for example, that some people grieving after a bereavement could soon be diagnosed with depression. And Asperger's syndrome is to be subsumed into autism spectrum disorder.

That change is likely to decrease the number of children diagnosed with some form of autism, because not all those who might have been diagnosed with Asperger's would meet autism criteria. But overall, critics fear an expansion of the boundaries of mental illness. "The phrase I use is the 'sickening of society'," says Frank Farley of Temple University in Philadelphia, Pennsylvania, one of the organisers of a petition that tried unsuccessfully to open DSM-5 up to wider scientific review.

Regular readers will know I've been complaining about this for years. The more broadly we define mental illness, the more trouble people really suffering from serious forms of it will have getting the treatment they need.

From the comments: "While it is possible that many mental illnesses (autism and schizophrenia especially) have a genetic component, symptoms are the important part of a diagnosis (especially for conditions like schizophrenia, mood disorders, and anxiety/stress disorders that have an environmental factor). If we drugged everyone who was genetically predisposed to mental illness, many people would be drugged unnecessarily for conditions that they did not have or with which they were coping without treatment."