Analysis & commentary independent review of social and population variation in mental health could improve diagnosis in DSM revisions

Helena B. Hansen, Zoe Donaldson, Bruce G. Link, Peter S. Bearman, Kim Hopper, Lisa M. Bates, Keely Cheslack-Postava, Kristin Harper, Seth M. Holmes, Gina Lovasi, Kristen W. Springer, Julien O. Teitler

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

At stake in the May 2013 publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are billions of dollars in insurance payments and government resources, as well as the diagnoses and treatment of millions of patients. We argue that the most recent revision process has missed social determinants of mental health disorders and their diagnosis: environmental factors triggering biological responses that manifest themselves inbehavior; differing cultural perceptions about what is normal and what is abnormal behavior; and institutional pressures related to such matters as insurance reimbursements, disability benefits, and pharmaceutical marketing. In addition, the experts charged with revising the DSM lack a systematic way to take population-level variations in diagnoses into account. To address these problems, we propose the creation of an independent research review body that would monitor variations in diagnostic patterns, inform future DSM revisions, identify needed changes inmental health policy and practice, and recommend new avenues of research. Drawing on the best available knowledge, the review body would make possible more precise and equitable psychiatric diagnoses and interventions.

Original languageEnglish (US)
Pages (from-to)984-993
Number of pages10
JournalHealth Affairs
Volume32
Issue number5
DOIs
StatePublished - May 2013

All Science Journal Classification (ASJC) codes

  • Health Policy

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