Social considerations not accounted for in DSM-5

(HealthDay)—Social and population variations in mental diagnosis are not accounted for in the newly revised fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), according to an editorial published in the May issue of Health Affairs.

Helena B. Hansen, Ph.D., from New York University in New York City, and colleagues argue that the most recent revision process has missed several issues, including the social determinants of mental health disorders and their diagnosis; environmental factors triggering biological responses that manifest themselves in behavior; 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. Additionally, a systematic way to take population-level variations in diagnoses into account was lacking.

The authors propose the creation of an independent research review body to address the shortcomings. The review body would monitor variations in diagnostic patterns, inform future DSM revisions, identify needed changes in mental 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," the authors write.