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Panel suggests DSM-5 psychiatry manual drops two disorders, keeps new autism definition


(CBS News) - A panel of doctors reviewing the much-debated Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) have recommended to drop two controversial diagnoses.

The panel announced that attenuated psychosis syndrome -- which identifies people at risk of developing psychosis -- and mixed anxiety depressive disorder -- a diagnosis which combines both anxiety and depression -- should not be included in the manual's upcoming version, the New York Times reported.

Proposed changes to autism definition may mean new diagnoses for people with Asperger's

However, a controversial definition for autism, which will delete diagnoses for Asperger's syndrome and pervasive developmental disorder and combine severe cases into the broader definition of autism, will remain.

According to the New York Times, there were worries from other health professionals and parents that the new autism definition would drastically reduce the number of people diagnosed. However, the panel said they were unfounded, citing a new study that showed those conclusions were not true.

However, this can also mean that many people who receive benefits from state and national run programs to help treat mental disorders like autism would no longer qualify under stricter definitions.

The reason why the attenuated psychosis syndrome was removed was because the panel was afraid that people would automatically be given medication before seeking therapy. Also known as psychosis risk syndrome, those who qualified under the diagnosis were typically young adults that may have heard whispers in their heads, viewed objects as threatening or suffered other subtly psychotic symptoms, Nature reported.

Proponents of the diagnosis believe this addition could help people get treatment and prevent a serious condition, according to Nature. But the fear of the over-prescription of anti-psychotic drugs as opposed to using other treatments -- like therapy or omega-3 fatty acids that have been proven to help -- led the panel to their conclusion.

As for mixed anxiety depressive disorder, many on the panel felt that people would unnecessarily be slapped with a psychiatric label when they may have been suffering from mixed states of depression and anxiety. The proposed definition had a lower threshold because both terms were included than each diagnosis alone.

The panel, currently meeting in Philadelphia, was appointed by the American Psychiatric Association to analyze what many mental health professionals consider to be the bible of the profession. They have posted their conclusions online and will allow public comments until June 15. The fifth edition is scheduled to go to print at the end of the year and be released May 2013.

Previously on May 8, the panel announced that field trials determined though a Kappa score -- a statistical measure of criteria reliability -- that the criteria for major depressive disorder (MDD) in adults and in children and general anxiety disorder (GAD) often led to incorrect diagnoses, according to Medscape.

Dr. Darrel Regier, vice-chair of the DSM-5 task force, said that patients at one center had major depression along with PTSD, antisocial personality disorder, and mild traumatic brain injury, which may have lead to the confusion.

"When other diagnoses were present, there tended to be a downplay of the reporting of depression in favor of the disorder considered more serious," he said to Medscape.

Despite these changes, this version of the DSM is still riddled with controversy with many psychiatrists believing the edition should be delayed for a year or more for further improvements, Reuters reported. More than 13,000 health professionals have signed an open letter petition to stop the DSM-5 from being published and are encouraging rethinking the process.

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