Critiques of the diagnostic and statistical manual

¶ … American Psychiatric Association released the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DMS-IV). The manual has been referred by the mental health professionals and physicians to verify and ascertain the causes of the mental disorders. The DMs-IV has explained more than two hundred mental health conditions, and every condition has been elaborated through the assessment techniques required for the appropriate diagnosis. A modified and revised version of the DSM-IV was published in 2000, however no major changes has been introduced, and there is no alteration to the classification. The symptoms and remedial measures for the prevention of the major depression have been highlighted in the DSM-IV. It has been researched that the diagnostic criteria for the mental disorders fall into either of the following categories i.e. 'in major depressive disorder for example, affective or mood symptoms include depressed mood and feelings of worthlessness or guilt, behavioral symptoms include social withdrawal and agitation, cognitive symptoms, or problems in thinking include difficulty with concentration or making decisions, and somatic or physical symptoms include insomnia or hyper-somnia which is excessive sleeping' (James, 2000).

Discussion: Significance, Categorization & Explanation

The DMS-IV has been of clinical significance, and effective tool towards the diagnoses of depression of major and minor intensity. The communication about the mental health conditions has been possible through DMs-IV, which has been often used as a guide by the mental health professionals and physicians. The manual has allowed 'mental health professionals to reach consensus on which symptoms or groups of symptoms should define which disorders' (James, 2000), the manual has provided the physicians with an opportunity to decide on the basis of the 'empirical evidence i.e. research results, usually by a multidisciplinary staff of professionals' (Michael, 2000). The manual has been used as educational tool and reference guide for conducting relevant research studies; the applicable subjects include clinical trials, prevalence studies, outcome research. The categorization of the people is not within the domain of the DSM-IV, rather the manual is effective and applicable for the categorization of the conditions, disorders, and symptoms carried or reflected by the persons. DSM-IV has been the last revision of the DSM, and has been the 'culmination of a six-year effort that involved over 1000 individuals and numerous professional organizations' (Michael, 2000), and has resulted in the establishment of the firm empirical basis for the modifications and alterations (House, 2000).

The DMS-IV has supported the classification of the psychiatric diagnoses, the relevant and expected mental health disorders related to the children and adults are discussed, the manual helps in the identification of causes of these disorders, and provide 'statistics in terms of gender, age at onset, and prognosis as well as some research concerning the optimal treatment approaches' (James, 2000). The improved and better understanding of the illness and potential treatments has been elaborated, and such recommendations have been often referred by the mental health professionals during the diagnosis of their patients. The manual has also assist the third party payer i.e. insurance company and/or employers in better understanding of the requirements and needs of the patients. The DSM has adopted multi-axial or multidimensional approach to serve the diagnosis purpose, the reason for the application of such varied and comprehensive techniques had been the ineffectiveness of the 'other factors in a person's life' (Michael, 2000) for the creation of the impact on their mental health. The dimensions discussed by the DMS-IV include clinical syndromes. developmental disorders and personality disorders, physical conditions such as brain injury or HIV / AIDS that can result in symptoms of mental illness are included, the severity of the psychosocial stressors have been discussed, and lastly the manual has provided the detailed description of the highest level of functioning (House, 2000).

The clinical symptoms have been highlighted and possible disorders have been elaborated, which includes depression, schizophrenia, and social phobia. The detailed study of these disorders has revealed that the personal mental health disorders are not due to the personal weakness or lacking, rather the disorder is due to the bias and unrealistic attitude and approach of the forces of society towards the patient. The social phobia is not considered an individual or personal disorder, rather the disorder is generated by the society, the concentration of which develops significantly in the unfortunate individual. 'The developmental disorders include autism and mental retardation, disorders which are typically first evident in childhood' (Thomas, 2001), the source of such disorder has been linked to any of the mysterious incident experienced by the patient during his/her childhood. According to the manual, the personality disorder 'is clinical syndrome which has more long lasting symptoms and encompass the individual's way of interacting with the world; the mental disorder includes paranoid, antisocial, and borderline personality disorders' (House, 2000). The deterioration of the physical condition is considered to be likely cause of the development, continuance, or exacerbation of clinical syndromes, developmental disorders and personality disorders. The DMS-IV manual has elaborated the conditions experienced by the patients in particular those under sever psychological trauma, and the physicians have been provided with the best possible technique to address the psychological pains and mental sufferings. The mental sufferings have their origin which is socially, politically, and naturally motivated or self-imposed (James, 2000).

The occurrences of the tragic events due the life span has the potential to create mental disorder, there have been cases where the patients have reflected their vulnerability of the mental dissatisfaction and discontent after the occurrence of the tragic events, which in most of the cases resulted in the irreparable loss of friend or family members. The manual has linked the occurrences of the events including 'death of a loved one, starting a new job, college, unemployment, and marriage' responsible for the severity of psychosocial stressors (House, 2000).

As discussed previously, the loss or death of the children, relative or close affiliate causes mental health disorders, classified as developmental disorders. The loss of any individual is considered to be extremely tragic, and the life of the grieved person is beyond comprehension. The developmental disorder is much common among parents, for whom the loss of their children is beyond estimation and consolation. There have been cases where the child was born healthy and happy, but the unfortunate loss of the precious and valuable life resulted in the mysterious disorder which had unknown cause or cure having no ground, the developmental disorder is the example of such situation. Similarly there have been cases of Childhood Disintegrative Disorder, common among the children. The cause of the disorder is related to the loss of the member or associate deeply attached to the child, the child due to his less-sustainable strength is always vulnerable towards such disorders. The death of the parents at very young age, or the witness to the horrific incident is expected to create deep mark on the memory of the child, and this is will result in the autism i.e. The worst type of the developmental disorder, 'this malady differs from typical autism in that it afflicts children after one to three years of apparently normal development, and long-term deterioration may lead to even poorer behavioral and developmental functioning' (Michael, 2000).