DSM diagnostic criteria and reliability in psychiatric practice

¶ … Changing the DSM (Diagnostic and Statistical Manual of Mental Disorders)

Diagnostic and statistical manual of mental disorder is crucial for psychiatry. The importance of such manual, assists psychiatrist classify mental disorder and in diagnosis of such disorders. The manual provides a standard classification and common language in the diagnosis of mental disorders. The manual provides a classification of mental disorders and provides results when used by researchers, as well as clinicians. The manual also assist in bringing the gap between psychiatrist and drug regulation agencies, insurance, pharmaceutical companies, legal entities, and policy makers. This manual assists all practicing psychiatrist practice within their area of authority, interacting with all other stakeholders in the mental disorder management field (American Psychiatric Association, 2000).

The diagnostic manual for mental disorders, on the other hand, collects statistical data from various hospitals. The manual also has had information from the United States Army. In relation to mental disorders, the World Health organization's manual provides criteria for classification of mental disorders. The mode of coding in the Diagnostic and statistical Manual of Mental Disorders provides a unique view of the manual. The code corresponds to those of the International Statistical Classification of Disease and Related Health Problems of the World Health Organization. The manual has made psychiatric diagnosis into one perspective. However, the development of the manual has its share of critics who include, the National institute of Mental Health who are of the opinion that DSM is a subjective system of diagnosis and it further ignores scientific principles. There have also been concerns on the reliability and the validity of data collected from the Diagnostic and Statistical Manual of Mental Disorders (Tandon & Carpenter, 2012).

History of DSM

"Diagnostic and Statistical Manual of Mental Disorders," has history that dates back to 1840 when it undertook its first census. During the census, the category of mental disorder was insanity. The American Statistical Association protest three years after the first categorization, however, had a tremendous influence on categorization of mental disorders. Members of this association found errors in the first classification. At this period, African-American populations were considered insane thus, the classification lacked scientific prove (Tandon & Carpenter, 2012). In the year 1844, the organization, "The Association of Medical Superintendents of American Institutions for the Insane" which later changed its name to "The American Medico- Psychological Association" came into operation. The organization now bears the name American psychiatric Association (APA).

In the year 1917, the organization while united with the National Commission of Mental hygiene designed a guide known as (Statistical Manual for the Use of Institutions for the insane). The APA provided a guide for all psychiatrists and subsections on the United States of America general medical manuals. During the years after 1952, psychiatrist had vast assignments in the selection, treatment, and assessment of soldiers. This development on the mental disorder from soldiers meant that a psychiatrist had to move from their traditional mode of practice. Soldiers returning from duty provided a different perspective of mental disorders to psychiatrists. In this period, there was the categorizing of these mental disorders as personality disturbance; a difference from neurosis. These researchers looked at homosexuality as a personality disorder. However, Evelyn Hooker's study made lesbian and gay individuals happy. The psychologist studied homosexuals comparing with heterosexual men and found no mental difference between the two groups of individuals (Frances & Widiger, 2012).

Goal of DSM

For one to realize the importance of DSM, one need to clearly understand the first intentions of such a manual. 'Diagnostic and Statistical Manual of Mental Disorders', came into operation in order to create a workable comprehensive system of evaluating and diagnosis of physiatrist problems. The manuals goal was to provide reliable, consistent and a valid system that would assist psychiatrist diagnose and treat patients (American Psychiatric Association, 2000). The approach, however, has suffered certain setbacks overtime, but the main goal of the system was to have a system of treating psychiatric patients according to standards and at par with international standards. One the other hand, the goal of DSM was to offer training programs to students that concentrate on training students on health delivery systems. Students get to apply their skills while practicing as opposed to present students who memorize it.

Implication of Changes in DSM of Counselors

The contents of the latest edition of the DSM-5 manual as well as any other changes, has an effect on the performance of the workforce and patients. These changes in policy have an implication on how medical practitioners practice their skills and at times of insurance reimbursement. Since mental disorders are on a constant state of change, medical practitioners and professionals need to expect various changes on the way of diagnosis as well as treatment. The newly released manual has clear implications on patients as well as counselors. Counselors need to gain more knowledge on diagnosing new mental disorders. These counselors need to be conversant of new researches and methods of diagnosis.

On the other hand, mental disorder practitioners need to employ evidence based approaches in treating mental disorders. Counselors need to use other types of researches from diverse medical fields such as neuroscience and genetics. Changes on the Diagnostic and statistical manual of mental disorder, would eventually, influence the way counselors perform their duties. This would mean that counselors would have to counsel their patients in accordance to their professional standards and considering international standards (Rounsaville et. al., 2002). There have been some suggestions that with changes in the DSM, there should also be a change in the rate of payment for their work. This would mean that counselors would start advocating for higher pay.

Furthermore, there are critics of changes in DSM who argue that these changes would increase work related challenges. They argue that these changes would impair the performance of a workforce since sick leaves would gradually increase. These extend in sick leave by various workers might be a result of psychological imbalance. Changes in the Diagnostic and Statistical Manual of Mental Disorders include change in diagnosis of bipolar disorders and schizophrenia, which have a significant effect on the performance of workforce. This is a new phenomenon in mental disorders, and it means that further research would be the only solution for counselors. These changes may also affect the working populations in a society (First, 2005). Most of those in the population do earn their living from employment and portray anxiety and depression disorders. The changes would definitely have an impact on their mental disorder and for those counseling them in a clinic.