Thursday, December 6th, 2012
A new diagnosis that would give the name “disruptive mood dysregulation disorder,” or DMDD, to severe and recurrent temper tantrums is the source of hot debate in the medical community in the wake of the announcement Monday of a number of changes to the manual psychiatrists use to diagnose mental health issues. The announcement also revealed the American Psychiatric Association’s decision to drop “Asperger’s disorder” as a diagnosis distinct from “autism spectrum disorder.”
The debate over DMDD relates to doctors’ concerns that it may be over-diagnosed in children who simply have a harder time learning to regulate their emotions. More from MyHealthNewsDaily:
“Although detailed criteria for the diagnosis have not been released, an APA statement said the condition could apply to “children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.” The addition is intended in part to reduce the number of kids misdiagnosed as having bipolar disorder, who may be treated with powerful drugs.
But some experts say the new condition was added to the manual too soon.
“I think it’s premature to put it in as a full diagnosis,” said Dr. David Axelson, an associate professor of psychiatry at University of Pittsburgh School of Medicine, referring the condition’s inclusion in the front of the manual with other well-accepted diagnoses, rather than in the appendix, which includes provisional diagnoses requiring further research.
Some are concerned that a label of disruptive mood dysregulation disorder would turn normal kid behavior into a medical condition.
But Axelson said the diagnosis requires severe and frequent behavior problems, and if properly applied, kids without a true mental condition would be unlikely to be diagnosed. In addition to frequent outbursts for more than a year, children need to be at least 6, but younger than teenagers, to be given the diagnosis, according to early versions of the criteria.
However, parents might overestimate how often their child behaves badly, because they focus on recent outbursts, and inaccurately reporting behavior to a mental health professional may lead to mislabeling, Axelson said.”
Image: Child having tantrum, via Shutterstock
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Monday, December 3rd, 2012
In a move that is sure to elicit strong opinions in parents of autistic children, the American Psychiatric Association has approved proposed changes to the new edition of the Diagnostic Statistical Manual (DSM) that will eliminate an independent diagnosis of “Asperger’s Disorder” and include Asperger’s kids within the diagnostic label of “autism spectrum disorder.” The Associated Press has more:
“One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger’s disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.
And some Asperger’s families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.
But the revision will not affect their education services, experts say.
The new manual adds the term “autism spectrum disorder,” which already is used by many experts in the field. Asperger’s disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don’t talk or interact, as well as those with milder forms.”
The Asperger’s changes are not the only ones that will appear in the new edition of the DSM, which will be published in May. Another major change is the addition of the diagnosis of DMDD, or disruptive mood dysregulation disorder, which will be given to children who have severe and recurrent temper tantrums.
The new edition is the 5th for the DSM. The last edition was published in 1994.
Image: Girl with psychiatrist, via Shutterstock
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Friday, November 2nd, 2012
The American Psychiatric Association, publisher of the Diagnostic and Statistical Manual of Mental Disorders (DSM), is considering naming a new disorder within the category of obsessive-compulsive disorders (OCD)—nail biting. From MSNBC.com:
OCD is most-commonly characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). It’s important to note that only certain types of nail biters–the extreme cases–fit into this category. “As with hair pulling and skin picking, nail biting isn’t a disorder unless it is impairing, distressing, and meets a certain clinical level of severity,” says Carol Mathews, M.D., a psychiatrist at the University of California, San Francisco. “That is not the vast majority of nail bitters,” she says. “It is a very small minority of people.”
What counts as clinical severity? “They have bitten so much that they are getting infections,” Mathews says. “There is physical damage that is impairing their ability to use their hands.”
Experts say that even non-OCD nail biting is unhealthy, as it can spread viruses and bacteria, lead to infections of the nail bed, and contribute to skin infections.
Image: Boy biting nails, via Shutterstock
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