When Dr. Frances refers to the DSM5 as “a guide, not a bible,” and urges skepticism about some of its diagnoses, he is advocating an approach that patients and families should probably bring to any medical decision.
Not all of the truly important medical developments come out of the laboratory, and in fact, many of the most noticeable shifts felt by doctors and patients alike spring from committee. For those of us with elderly loved ones, the committee with which you should become most familiar is the American Psychiatric Association and their upcoming best-seller, the DSM5. The book may usher in new ways of approaching elders and depression, and that may not be a good thing according to some.
The concern over the DSM5 has come to a slow boil. The conversation about DSM5 has begun seeping out from the academic literature and into the public square with articles like a recent piece in The New York Times titled “Time to Recognize Mild Cognitive Disorder?”
The DSM5 will be the sequel to the Diagnostic and Statistical Manual of Mental Disorder IV (DSM-IV), the utterly necessary reference book and dust-gatherer of psychologists, doctors, insurance companies, bureaucrats, and lawyers alike. DSM-IV chronicles known and diagnosable psychological disorders.
For seniors, the new disorder making the rounds is “mild cognitive disorder.” This diagnosis is an attempt to bring to psychiatry the same awareness to levels of cognitive senility that medical doctors know all too well and yet still understand too little. If the DSM5 is published as is, and becomes the go-to reference, then we’re likely to see many more elderly diagnosed into categories that have only just now been created.
For families taking care of elderly loved ones, and those getting on in years themselves, it’s useful to understand the basis for any diagnosis made by their doctors. Regardless, the takeaway would be to get your legal ducks-in-a-row before a future diagnosis diminishes the legal capacity to make proper estate planning decisions.
Reference: The New York Times – The New Old Age Blog (January 25, 2013) “Time to Recognize Mild Cognitive Disorder?”