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Open Access Commentary

Patient advocacy and DSM-5

Dan J Stein1* and Katharine A Phillips2

Author Affiliations

1 Department of Psychiatry, University of Cape Town and Groote Schuur Hospital J2, Anzio Rd, Observatory 7925, Cape Town, South Africa

2 Rhode Island Hospital and the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Coro Center West, Suite 2.030, 1 Hoppin Street, Providence, RI, 02903, USA

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BMC Medicine 2013, 11:133  doi:10.1186/1741-7015-11-133

Published: 17 May 2013

Abstract

The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a useful opportunity to revisit debates about the nature of psychiatric classification. An important debate concerns the involvement of mental health consumers in revisions of the classification. One perspective argues that psychiatric classification is a scientific process undertaken by scientific experts and that including consumers in the revision process is merely pandering to political correctness. A contrasting perspective is that psychiatric classification is a process driven by a range of different values and that the involvement of patients and patient advocates would enhance this process. Here we draw on our experiences with input from the public during the deliberations of the Obsessive Compulsive-Spectrum Disorders subworkgroup of DSM-5, to help make the argument that psychiatric classification does require reasoned debate on a range of different facts and values, and that it is appropriate for scientist experts to review their nosological recommendations in the light of rigorous consideration of patient experience and feedback.

Keywords:
Diagnostic and Statistical Manual of Mental Disorders; Psychiatric classification; Nosology; Diagnosis; Patient advocacy; Consumer advocacy; Obsessive-compulsive and related disorders