Nonino Francesco, Magrini Nicola
Recenti Prog Med. 2014 Feb;105(2):51-5. doi: 10.1701/1417.15696.
In May 2013 the American Psychiatric Association approved the 5th revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), that since 1958 has been a reference document for the classification of psychiatric conditions. Even before its publication the DSM-5 has raised a controversy widely covered by media, the strongest argument of its critics being the fact that DSM-5 favors the medicalization of conditions that belong to ordinary human experiences. Using DSM-5 as a diagnostic tool in clinical practice may favor over-diagnosis and over-treatment, for example by labeling many healthy people experiencing forgetfulness as affected by "cognitive impairment", while grieving after the death of a loved one may be diagnosed as a "major depressive disorder". Moreover, the scientific integrity of the committee that produced the DSM-5 has been questioned, arguing that the tendency to expand the boundaries of mental illness may have been driven by financial and intellectual conflicts of interest and by ties with drug companies of some of its members.
2013年5月,美国精神病学协会批准了《精神疾病诊断与统计手册》(DSM)第5版修订本,自1958年以来,该手册一直是精神疾病分类的参考文件。甚至在其出版之前,《精神疾病诊断与统计手册》第5版(DSM - 5)就引发了一场媒体广泛报道的争议,批评者最强烈的论点是,DSM - 5倾向于将属于普通人类经历的状况医学化。在临床实践中使用DSM - 5作为诊断工具可能会导致过度诊断和过度治疗,例如,将许多经历健忘的健康人标记为受“认知障碍”影响,而在亲人去世后悲痛可能被诊断为“重度抑郁症”。此外,编写DSM - 5的委员会的科学诚信受到质疑,有人认为扩大精神疾病边界的倾向可能是由经济和学术利益冲突以及其一些成员与制药公司的关系所驱动的。