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If you thought Binge-eating, Caffeine Use and Internet Gambling were just bad habits...Think again!

The new DSM 5 - the latest version of the Diagnostic and Statistical Manual of Mental Disorders, released in May 2013, by the American Psychiatric Association - has considered classifying these as disorders to be included in future versions of the DSM.

(The DSM is the primary reference book for psychiatry that lists all mental disorders and is used worldwide.)

Some of the updates and highlights pinpointed by Judith Anser of Shrinkrap at a recent gathering of mental health professionals included the following:

- The new DSM refers to ‘disorders’ rather than ‘illnesses’. This is a fundamental shift in thinking. One either has an illness or not – one can’t have half a temperature or a bit of an HIV-virus. A disorder on the other hand is a cluster of symptoms that can be experienced at different levels of severity. The DSM 5 refers to this as a spectrum. Mental disorders are thus not seen as absolute conditions but rather viewed dimensionally on a continuum that also looks at the person's coping, functioning and adaptability. For example, where Aspergers used to be a specific category, the term is now not used anymore and the condition falls within the Autism spectrum.

- Another change is, where the previous DSMs described mental illness in terms of different axes (eg the specific category, personality disorder – if applicable, social functioning, prevalence of a related medical condition and general functioning) which attempted to give a comprehensive picture, the DSM 5 identifies certain specifiers on every spectrum and focusses more on the functioning of the individual.

- Indicating that each edition is a work in progress and that there may be many revisions in store as conditions are re-assessed and re-defined over the years, the new edition has changed notation from Roman letters to Arabic numerals - indicated as 5.1, 5.2. etc. To my mind, this seems to indicate that the ostensible gurus of psycho-pathology and mental disease now believe that how we understand our mental health, is time- and culture- specific (The American Psychiatric Association who publishes the DSM consists of 36 000 professional members). A case in point is that homosexuality was until the early 1980’s viewed as an illness. What is also different is that process of compiling the DSM 5 was discursive in that it was open to comment and discourse.

- Some inclusions and exclusions that shed an interesting light on how mental issues are viewed are: Histrionic Personality disorder is no more – perhaps we have our new ‘crazy’ role models like Lady Gagga to thank for this new-normal. The scrapping of Narcissistic Personality Disorder was apparently also discussed at length – the normalising of which we have to thank the ’me-me’ generation of the 70s and 80s for – but for now it is still viewed as not healthy to be completely self-centred. Dementia has fallen away and is now called Major or Mild Neurocognitive Disorder. And now we have 'Internet Gaming Disorder'....

Next on the list has to be online shopping for self-diagnosis: The DSM5 made it to the Amazon bestseller list for a while and is currently in 33rd place on the list – at R1800.00 a copy!


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