(Oconomowoc, Wis.) “Recent changes in the guidebook for classifying mental disorders will help clinicians fine-tune diagnoses and help patients get the treatment they need,” said Jerry L. Halverson, M.D., FAPA, medical director of adult services at Rogers Memorial Hospital.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the clinical and diagnostic tool published by the American Psychiatric Association. Considered the authoritative guide by behavioral health professionals throughout the country, the manual provides the common language and standard criteria for the classification of mental disorders. This new edition, however, has prompted discussion about whether the changes hinder or benefit treatment. But Dr. Halverson, who has been speaking extensively on DSM-5 changes to healthcare providers in the Midwest, said all the revisions are intended to benefit both patients and professionals alike.
Why This Matters
A clear set of guidelines helps clinicians diagnose mental disorders that aren’t as easily identified by symptoms as many other health conditions, e.g., a broken arm or a case of pneumonia. As the result of greater insight into these disorders, providers are also able to prescribe more effective treatment and acquire more accurate statistics and research. In addition, the handbook is used by researchers and health insurance companies. All in all, the changes may mean the difference between gaining access to treatment…or not.
Dr. Halverson indicated none of the changes are radical, but simply involve looking at some of the disorders in a new way. “For example, clinicians now have more latitude in the way they can diagnose post-traumatic stress disorder (PTSD). As a result of research and feedback from mental health professionals since the previous edition, the symptoms for diagnosing PTSD have been revised to allow more who have suffered from different forms of trauma to get the treatment needed to live a more enjoyable life without symptoms.” So, where this diagnosis was previously attributed more to those who had been in combat, the new edition is far more inclusive. The DSM-5 is also more explicit about what can be defined as a “traumatic” event; the fourth edition included three major symptom clusters, but the DSM-5 has four with more distinct criteria. Children and adolescents can now be diagnosed with PTSD, and there is a subtype with separate criteria for preschool children.
“All of these changes are definitely an asset,” Dr. Halverson continued. “The DSM-5 takes into consideration the many years of experience that different clinicians and researchers have had with these disorders, and the new language makes it easier to identify conditions like PTSD. These guidelines may even help patients get insurance coverage for syndromes that looked and acted like a particular condition, but did not meet criteria in the previous edition. That means they can now get treatment to recover from their symptoms and live a more meaningful, enjoyable life.”
Dr. Halverson also assured that criteria changes will not hinder treatment. “Everyone who had a diagnosis before DSM-5 will still have a diagnosis, and many who need care will find it’s easier to get treatment. If anything, the new classifications will lead to more specific diagnoses that actually open new pathways to treatment.”
Plus, the DSM-5 doesn’t address specific plans for treatment: “It’s always up to clinicians to work with the patient to determine what’s best. As with any kind of healthcare, it’s important that patients remain active in their treatment through discussion and clarification to ensure they are comfortable with the plan,” Dr. Halverson said.
Statistics on Mental Illness
The National Institute of Mental Health (NIMH) indicates 1 in 4 adults have a diagnosable mental disorder each year, with nearly half experiencing onset by the age of 14. “That’s why it’s important that more people have access to proven-effective treatment,” Dr. Halverson explained. “A mental disorder is defined as a behavior or mood that is caused by a neurobiological change which leads to dysfunction. Therefore, it has to be severe enough to interfere with your ability to get on with life.”
About Dr. Halverson
A recognized expert within the Wisconsin Medical Society and the Wisconsin Psychiatric Association, Dr. Halverson has held key leadership positions within professional organizations both locally and nationally. He has also spoken extensively on mental health disorders and advocacy efforts to academic, legislative and community audiences. Earlier this year, Dr. Halverson was asked to testify for the Task Force on Mental Health regarding some of the challenges for patients and physicians in Wisconsin’s mental health system.
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