DSM stands for The Diagnostic and Statistical Manual of Mental Disorders. It is often referred to as the The Bible of mental disorders because it’s what health care practitioners use to decide if their patients have a psychiatric disorder or not. The DSM-5—its 5th edition—is about to go to the printers and will be released in May 2013. It is published by the American Psychiatric Association (APA) which gave final approval to the DSM-5 even though more than fifty mental health professional associations petitioned for an outside review, and even though professional journals, the press, and the public vehemently objected to several changes that were made to this edition.
In this piece, I want to discuss Somatic Symptom Disorder or SSD—a new diagnosis that’s been added to the DSM-5. It has garnered little attention. One exception is a recent article written by Allen Frances, M.D., “Mislabeling Medical Illness as Mental Disorder.” In my opinion, Somatic Symptom Disorder is a dangerous addition to the DSM-5. For an update on the status of SSD and the DSM-5, see my article of January 17, 2013: "Your Physical Illness May Now Be Labeled a Mental Disorder."
The word “somatization” refers to psychological stress that manifests in the form of physical symptoms. In other words, a person’s physical symptoms are traceable to a mental or emotional cause rather than to a physical one. The current edition of the DSM—DSM-4—has a category called “Somatoform Disorder,” but it is so different in criteria from this new Somatic Symptom Disorder, that I won’t take the time to compare them. And Somatoform Disorder is being replaced by SSD anyway.
Here is the new DSM’s definition of Somatic Symptom Disorder. (Warning: you may have trouble believing what you’re about to read.)
People can be diagnosed with SSD if, for at least six months, they’ve had one or more symptoms that are distressing and/or disruptive to their daily life, and if they have one of the following three reactions:
Criteria #1: disproportionate thoughts about the seriousness of their symptom(s);
Criteria #2: a high level of anxiety about their symptoms or health; or
Criteria #3: devoting excessive time and energy to their symptoms or health concerns.
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