“A child who doesn’t like doing math homework may be diagnosed with the mental illness developmental-arithmetic disorder (No.315.4). A child who argues with her parents may be diagnosed as having a mental illness called oppositional-defiant disorder (No.313.8). And people critical of the legislation now snaking through Congress that purports to “end discrimination against patients seeking treatment for mental illness” may find themselves labeled as being in denial and diagnosed with the mental illness called noncompliance-with-treatment disorder (No.15.81).
The psychiatric diagnoses suggested above are no joke. They represent a few of the more than 350 “mental disorders” listed in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the billing bible for mental disorders which commingles neurological diseases with psychiatric diagnoses. (Click here to see more examples of the mental disorders listed in the DSM-IV.) Whether the described diagnoses are real diseases or subjective speculation, science is at the heart of the debate about whether lawmakers will require employers and insurers to cover mental illness on the same level as physical disease…” Insight
I agree with the dubious basis of oppositional-defiant disorder. A preponderance of the following evidence, I teach medical students and psychiatric residents, is necessary for something to qualify as a psychiatric disease: (a) genetic component; (b) demonstrable anatomical, neurochemical or physiological alteration; (c) nonrandom association with other conditions demonstrated to have a physiological basis; (d) response to medication, and degree of response correlates with extent of correction of neurochemical/physiological alterations by the medication; (e) exacerbation of dysfunction when administered agents demonstrated to worsen neurochemical/physiological alterations; (f) animal model with analogous behavioral disturbance may exist, and abnormalities in anatomy, neurochemistry or physiology readily demonstrable in affected animals. A number of the “non-diseases” — by which Insight seems to mean anything treated by psychiatrists — you’ll find if you follow their invitation to “click on” are in fact well-established disease entities. These people are still having difficulty, apparently, accepting that mind and body interact. While I have doubts about conduct disorder, pedophilia disorder, and, as I noted, oppositional-defiant disorder, the remainder on their list are as much diseases, in my opinion, as diabetes or hypertension.
