TODAY | December 03, 2012
>>> back now at 8:13 with today's health and what could be some major changes to mental health care after years of review and debate. the american psychiatric association has approved widespread revisions to its manual which is used to diagnose and treat millions of people. add together controversy, some mental disorders are being added, others cut out. what does it all mean? we ask our "today" contributor dr. gail saults, good morning.
>> good morning.
>> this is "the dsm-5," people in your world know it like the bible but what is this and why does it matter?
>> the guide that contains all the symptoms of every mental health problem you could have grouped so they are in diagnoses and this will be the guide that determines what diagnosis you will get and, therefore, what treatment makes sense.
>> let's talk about some of the headlines come out of it. asperger 's, no longer part of this manual. what does that mean as a practical matter?
>> people with asperger 's are really distressed with this. asperger 's is always understood to be on the mildest end of autism, so its diagnosis is disappearing, but it will be subsumed and included as a mild form of autism in the autism spectrum disorders , so that's what the new disorder will become. it's not that asperger 's patients are going away or the diagnosis is going away. asperger 's patients are afraid they won't get reimbursement but many states and schools don't provide services for asperger 's but do for autism.
>> what about added binge eating ?
>> yes, really important. some people eat huge quantities of food in a short period of time and feel sick and guilty afterward. that's what binge eating was. wasn't in the diagnosis before. there was just anorexia or bulimia. however, many people just have binge eating and don't have those other eating disorders . by putting this in, we provide a category for people with just this and they have a different treatment from other people with other eating disorders , and they will get reimbursed for that treatment.
>> another condition was hoarding, an anxiety disorder before?
>> hoarding was often included as a symptom as obsessive compulsive disorder and sometimes it is. this is an updating of all the science obtained over the last 18 years, many people have hoarding and no symptoms of obsessive compulsive disorder . they will have their own category and own treatment and own potential reimbursement.
>> and a new diagnosis for children with severe recurrent temper tantrums. there's a new name for this and how do you deal with the issue of whether or not this is just normal childhood behavior or something that merits a psychological diagnosis?
>> the reason that doctors decided it was important to have this category is there's concern about overdiagnosis of bipolar disease in children. this is a category for ages 6 to 10 who have extreme temper tantrums like several times a week for at least three months, and they must be between the ages of 6 and 10. so if this is going on, but you don't have the other symptoms of bipolar disorder , then this is the diagnosis you would receive. it needs to be seen, not only in the parent, but in other people outside, so we're talking about pretty extreme behavior with anger and irritability in between. most people would be able to see this isn't typical childhood behavior and that's why it's there.
>> the full manual comes out this spring. doctor, thanks for the help.