New Psychiatric Manual Combines Alcohol Disorders

The newly released update to psychiatry’s diagnostic manual combines problem drinking and alcoholism into a single condition known as “alcohol use disorder,” which some experts say could lead binge drinkers to be mislabeled as alcoholics.

CNN reports the new diagnosis, found in the updated Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5, could follow college students into adulthood. The earlier version of the manual, DSM-4, had separate categories for alcohol abuse and the more serious alcohol dependence.

A recent study suggests the changes to alcohol disorders may not improve the diagnosis of alcoholism. The study found the changes are unlikely to result in a less accurate diagnosis, but they do not represent a clear improvement above the current diagnostic criteria.

In addition to being used by mental health professionals to diagnose patients, the DSM is used by insurance companies and schools in making decisions about coverage and special provisions for people with developmental or mental disorders, the article notes.

Critics of the DSM-5 say it will expand the list of what constitutes mental illness and will lead to a needless increase in diagnoses. A growing number of psychiatrists, psychologists and clinical social workers say depression and other normal responses to life events are too often labeled as mental illness, increasing the use of potentially dangerous medication.

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    David Miles

    May 23, 2013 at 5:45 PM

    I agree that most of the professionals who maybe highly educated, may lack, the practical experience of alcoholism, and addictions. Personally, I have struggled with both alcohol, and drugs, for the past 40 plus years. I am thankful, that I am in recovery, and blessed with grandchildren that I lived to see while they were growing up. But, I have seen the lack of quality counseling on my Indian reservation, due to many of the professional do no live among us Indians, and do not understand our thinking and what leads us back into that vicious cycle. We have higher rates of domestic violence, suicides nationally, and little economic opportunities to advance up the ladder. We are similar to inner city living, but it is on an Indian reservation. thank you.

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    May 23, 2013 at 10:35 AM

    In regard to the Mental Health piece, I recently heard Mental Health described as a continium. Not Mentally healthy or mentally ill but somewhere on the continium. Looks like we are all in that boat. 🙂

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    Alan Wartenberg MD

    May 22, 2013 at 1:15 PM

    I cannot understand anybody thinking that a binge drinker CANNOT be alcoholic. If someone who binges otherwise meets the other criteria, they clearly can be, and frequently are alcoholic. I am supportive of the new criteria precisely because of the misconception stated in your piece – that alcohol dependence is NECESSARILY more serious than alcohol abuse. It is not.

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    May 22, 2013 at 12:40 PM

    I believe the DSM 5 finally simplifies and makes common sense. The problem isn’t the diagnosis, it’s the insurance companies that don’t want to pay for anything that isn’t “treatment” and not prevention or wellness or education. Alcohol abuse and addiction is so closely related there really isn’t a “line in the sand” but behaviors, mental conditions, physical conditions, etc. which need to be addressed whether abusing or addicting. Many people are situationally depressed and can move forward given counseling and time without medication which a good therapist and their client decide. We have long relied on “diagnosis” and insurance rather than wellness and counseling for a long time now.

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