Mental illness manual updated — but still relevant?

The Diagnostic and Statistical Manual of Mental Disorders, or DSM, is considered by many in the field to be the “bible” of psychiatry.

The guide is used primarily by mental health professionals for the purpose of making a diagnosis.

But some new revisions are causing some controversy in the medical field.

The American Psychiatric Association re-wrote the DSM, which for 60 years has been considered the source for mental illness evaluation.

There have been four versions of the guide and next year, DSM-5 will be published — but not without some controversy.

“I think it’s a document that has virtually no reliability or validity,” Bend psychologist, Dr. Michael Conner, said Wednesday “It’s a categorization system that doesn’t actually allow us to determine what the best treatments are.”

Conner has been in the mental health field for more than 20 years. He is also author of an article titled “Criticism of America’s Diagnostic Bible-The DSM.”

“The criticisms back when I first wrote that are the same criticisms that still exist today in the current DSM,” Conner said.

Connor’s main points of criticism: 1. Not much credibility. 2. It was written by a small group of providers. 3. The book isn’t used by most physicians.

“It’s just one of these extra books that we have to buy and use because it’s required in order to control insurance,” Conner said.

Among the new changes, kids with Asperger’s syndrome, a neuro-biological disorder, will no longer be called that but rather autism spectrum disorder.

“The issue of Apserger’s vs autism is important because it depends on what insurance companies are willing to pay for,” Conner said.

Another example: The term “gender identity disorder” will be changed to “gender dysphoria” when diagnosing transgender people.

“That really upsets people who really believe there’s a mismatch genetically between what’s going on in their brain and the body that they are inhabiting,” Conner said.

A new chapter will focus on post-traumatic stress disorder, expanding the criteria to include people that aren’t exposed to a life-threatening event.

“So people who are sexually abused, raped, threatened, hurt in car accidents, gunshots — they are all different. But all those people can have the same disabling consequences if they don’t get treatment,” Conner said.

Another problem, according to Conner, is that if someone thinks they have a disorder, under DSM if they don’t meet one specific criteria, the professional can’t justify it.

“We are still diagnosing people using a system that nobody believes is current or is completely out of date with their research — but we have been doing that for years,” Conner said.

Conner says the book doesn’t fly because 90 percent of the world of health care isn’t using it.