Hoarding disorder gets spotlight in DSM-5

[Hum]

Regular viewers of reality shows about hoarding are used to being stunned by someone's clutter. But behind the sensationalistic stories of rooms buried in trash, kitchens filled with rotting food, and yards overrun by goats are people suffering from a serious mental illness ?hoarding?that for many years was misdiagnosed.

The upcoming fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) aims to change that. The highly influential DSM-5 will classify hoarding as a distinct disorder within the chapter about obsessive-compulsive and related disorders. Before the DSM-5, hoarding could be misdiagnosed as a form of obsessive-compulsive disorder.

The classification change isn?t just symbolic. The American Psychiatric Association believes it will have a real effect in terms of the diagnosis and treatment of people who have a persistent difficulty ridding themselves of possessions, regardless of their value.

"The history of [misdiagnosing]," said Dr. Jeff Szymanski of the International OCD Foundation in a phone interview with Yahoo News, "is that hoarding possessions, keeping lots of possessions was considered a compulsive behavior early on, so it was put under the rubric of obsessive compulsive disorder. So if you were asking questions about OCD, you would say, 'Do you compulsively hoard lots of objects?' But that was really the only question you ended up asking. It's a key question, but it's really the only question you're asking.

"As people were being treated for OCD and they were working with this subgroup that had hoarding as their OCD symptom, they [mental health providers] started to recognize that, 'Wait a minute, these actually don't seem like they're the same group.'"

Over the past 20 years, researchers working on this have found that OCD and hoarding are quite different. ?There are brain imaging scans that compare people with OCD to people that have hoarding disorder,? said Dr. Szymanski. "And even in brain scans, they're showing some differences."

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[DocM]

DSM-5 is turning into a mess, so much so the National Institute of Mental Health is deemphasizing it in favor of genetic, biochemical etc. based classifications.

http://www.technologyreview.com/view/514571/nimh-will-drop-widely-used-psychiatry-manual/

NIMH Will Drop Widely Used Psychiatry Manual

NIMH director says the DSM lacks biological validity in its diagnoses: ?Patients with mental disorders deserve better.?

Just weeks before the American Psychiatric Association is expected to publish its new edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the director of National Institute of Mental Health?s director announced via blog post that his institution will be ?re-orienting its research away from DSM categories.?

The DSM is a manual for diagnosing and classifying mental disorders and is widely used by doctors and researchers. As Thomas Insel writes in his post, the goal of the manual is to ?provide a common language for describing psychopathology.? The problem, however, is a ?lack of validity.? He writes:

Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.

The alternative, Insel writes, is a new NIMH project called Research Domain Criteria (RDoC), which will incorporate genetics, imaging, cognitive science, and other information into diagnoses. Mental health researchers are taking on more molecular- and cellular-focused tools , such as those based on DNA analysis or brain scans, in the hopes of improving diagnoses and treatment.

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[Phouchg]

How does one call a disorder when I delete stuff only when something new doesn't have enough space anymore?

[Hum]

I personally know someone with a compulsive shopping, hoarding condition.

It's sad to watch her bankrupt herself. :/

[Osiris]

Yeah the DSM5 has made negative headlines everywhere, most places seem to be sticking with DSM4. I like parts of the NiMH program but I don't believe mental illness' can be fully diagnosed from a biological level. Like we discover so often, taking the best from both worlds and forging a new synthesis would the best approach but most likely it will just devolve into an intellectual rivalry over which doctrine is the best etc.

[DocM]

^^ I agree, unfortunately.