By LAURAN NEERGAARD
Associated Press
WASHINGTON -- Don't say "mental retardation" -- the new term is "intellectual disability." No more diagnoses of Asperger's syndrome -- call it a mild version of autism instead. And while "behavioral addictions" will be new to doctors' dictionaries, "Internet addiction" didn't make the cut.
The American Psychiatric Association is proposing major changes Wednesday to its diagnostic bible, the manual that doctors, insurers and scientists use in deciding what's officially a mental disorder and what symptoms to treat. In a new twist, it is seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them.
The manual suggests some new diagnoses. Gambling so far is the lone identified behavioral addiction, but in the new category of learning disabilities are problems with both reading and math. Also new is binge eating, distinct from bulimia because the binge eaters don't purge.
Overall the manual's biggest changes eliminate diagnoses that it contends are essentially subtypes of broader illnesses -- and urge doctors to concentrate more on the severity of their patients' symptoms. Thus the draft sets "autism spectrum disorders" as the diagnosis that encompasses a full range of autistic brain conditions -- from mild social impairment to more severe autism's lack of eye contact, repetitive behavior and poor communication -- instead of differentiating between the terms autism, Asperger's or "pervasive developmental disorder" as doctors do today.
The psychiatric group expects that overarching change could actually lower the numbers of people thought to suffer from mental disorders.
Psychiatry has been accused of overdiagnosis in recent years as prescriptions for antidepressants, stimulants and other medications have soared. So the update of this manual called the DSM-5 -- the Diagnostic and Statistical Manual of Mental Disorders, fifth edition -- has been anxiously awaited. It's the first update since 1994, and brain research during that time period has soared.
The draft manual, posted at http://www.DSM5.org, is up for public debate through April, and it's expected to be lively.
