Daniel BuenoThis May, amid some controversy, the American Psychiatric Association (APA) released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is used around the world. In a public statement, Thomas Insel, director of the National Institute of Mental Health (NIMH), voiced criticism about the fact that there are no biomarkers that can be used to validate the diagnosis of mental illnesses, which continues to be based solely on signs and symptoms and not on any objective laboratory measure. The NIMH and APA, in a joint statement, declared that the manual reflects the most up-to-date knowledge in this field and that diagnostic improvements would be highly welcome. Allen Frances, editor of the previous edition of the DSM, warned that the new manual has increased the likelihood that a problem previously seen as falling within the realm of normality will be classified as a mental disorder. Eating excessively 12 times over the course of three months, for example, is no longer a sign of gluttony but is now indicative of a mental disorder. Miguel Jorge, professor of psychiatry at the Federal University of São Paulo (Unifesp), is concerned about this seeming exaggeration and pointed out that any cranky child could now be diagnosed with a mood disorder. The definition of depression has also been broadened, so a person suffering from grief for at least two weeks may receive this diagnosis. Premenstrual dysphoric disorder (PMDD), a severe form of premenstrual tension, has been classed as a mental disorder as well. And now there is only one name – autism spectrum disorder – to designate the four forms of this disease.
