Posted by fachad on September 2, 2002, at 12:19:13
In reply to Re: Meeting DSM Diagnostic Criteria, posted by trialerror on September 2, 2002, at 6:41:48
> Sort of a wink-wink approach?
>
> Maybe that IS the best way.
>
> Tho' it does stick in my craw a bit.Not really a "wink-wink", just a realization of the limitations of the DSM system. It's modeled to look like the pathogen / disease / therapeutic agent medical model - think about the classic example of strep throat.
Everyone with strep throat will test positive on a strep culture. And that strep bug is the REAL CAUSE of the disease. And because it is a known bug, a known class of antibiotics will kill that bug, eliminate the cause of the disease, and cure the patient.
The situation is NOWHERE near that with DSM diagnosis. The diagnostic criteria are not based on the etiology (true cause) of the disorder; they are based on external symptoms. And the grouping of symptoms is arbitrary.
Imagine if an MD gave the diagnosis of "Fever Disorder" to patients with strep, malaria, food poisoning, and hyperthyroidism! They all meet the "criteria" of a body temperature above such and such, for at least 36 hrs, and they all have chills, and cold sweat...
So much for the validity of "symptom group" based diagnosis. Now the other thing with the regular medical model, in our example strep, is that the diagnosis is tied to the specific cure. Strep is CAUSED by a strep bug, and will always be CURED by a strep killing antibiotic. The treatment is specific, because the diagnosis is made based on a known cause.
But with DSM diagnosis, you get people who are diagnosed with depression responding to ADs, APs, BZDs, mood stabilizers, and even stimulants! If I respond to a mood stabilizers, does that mean I "was really bipolar" all the time? No. If my depression responds to a stimulant, does it mean I must have at least a touch of ADD? No.
That turned into quite a little rant.
poster:fachad
thread:118329
URL: http://www.dr-bob.org/babble/20020829/msgs/118544.html