DSM and Misdiagnosis

Often clinical patients are formally diagnosed for the purpose of developing a treatment plan and for monetary reimbursement from insurance companies.

The DMS, a Diagnostic and Statistical Manual of Mental Disordered rendered by the American Psychiatric Association, is a symptom-based manual that classifies and described over 400 psychological conditions. Psychiatric and psychological practitioners utilize the DMS in order to diagnose patients whose symptoms may pertain to criteria of a disorder listed in the manual. While the DMS can often lead to specific and reliable classification, misdiagnosis is still commonplace.

Kirk and Kutchins, in an article called Deliberate Misdiagnosis in Mental Health Practice, discussed the deficiencies in the structure of the diagnosis system used in the DSM-III. These authors said a reason contributing to misdiagnosis is “the unreliability of the of diagnostic classification system.” The rigid classification system leaves little room for “uncertainty and ambiguity of individual cases”, according to Kirk and Kutchins. There are many other reasons why a patient might be misdiagnosed, but misdiagnosis can hinder the progress of the patient.

My mom is a therapist who works primarily with patients from failed treatment who were previously misdiagnosed with borderline personality disorder. Because of the complicated the symptoms that accompany unresolved trauma, it is very difficult for clinicians to classify. She said that most of her patients have dissociate disorders associated with trauma, but previous practitioners have diagnosed them with depressive disorders or borderline personality disorders, which blame the victim instead of looking at the trauma and the real root of the problem. She then said that treatments for each disorder are different, and misdiagnosing patients will miss a huge piece of the problem and the patient will not get well.

So, in conclusion, I would like to say that while the DSM has many advantages, it forces many practitioners to classify their patients into rigid disorders, which then leads the practitioner to adopt a treatment plan that may not work if the patient was misdiagnosed.

Kirk, Stuart A., and Herb Kutchins. Deliberate Misdiagnosis in Mental Health Practice. 2nd ed. Vol. 62. N.p.: The University of Chicago Press, 1988. 225-28. JSTOR. JSTOR. Web. 8 Apr. 2014. <http://www.jstor.org/stable/30011964>

1 thought on “DSM and Misdiagnosis

  1. Kelsey Ann Grolig

    The DSM system is very controversial with regards to its specificity with diagnosis and accuracy. Many of the DSM codes encompass similar disorders that can be confused if the patient reports vague symptoms that relate to various different disorders. This can be detrimental to a patient’s health if they are not receiving the correct treatment. On the contrary, DSM codes are a unified way to recognize disorders and classify symptoms across the board among doctors worldwide. This system leads to less confusion when a patient visits many doctors or moves to a different state or country. Overall, I agree that DSM is a good system, but there are many improvements that can be made to make for a better categorization system.

Leave a Reply