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That's what DSM-5 needs: One more diagnosisNassir Ghaemi, MD, Psychiatry/Mental Health, 09:29PM Sep 19, 2012

Maybe I jst !"n#t n!erstan!, bt spp"se y" a$ree %ith all the %"rl! that hates the

!ia$n"sis "& bip"lar !is"r!er in chil!ren' ()actly h"% !"es it ma*e sense &"r DSM+ t"speci&icially try t" !isc"ra$e the !ia$n"sis "& bip"lar !is"r!er in chil!ren by a!!in$

an"ther !ia$n"sis + -emper Dysre$lati"n Dis"r!er .-DD, s"methin$ in bet%een

"pp"siti"nal !e&iant !is"r!er .DD an! attenti"n !e&icit hyperactiity !is"r!er .DHD+ s" that i& a chil! is a$$ressie an! hyperactie y" can $ie him "ne, "r all "& these

"ther !ia$n"ses + an! n"t bip"lar !is"r!er3

Pe"ple c"mplain ab"t DSM: they say it has ab"t 400 !ia$n"ses + that#s t"" mch'

Pe"ple c"mplain ab"t the pharmacetical in!stry: they say they create !ia$n"ses &"r

their !r$s' S" h"% is it a s"lti"n t" ma*e p "ne m"re !ia$n"sis, thin*in$ %e can

"tsmart the pharmacetical in!stry s" that %e !"n#t se their !r$s anym"re &"r bip"lar

!is"r!er3 I hae a hnch the pharmacetical in!stry %ill jst trn t" !"in$ clinical trialsin -DD, an! they#ll $et 5D in!icati"ns, an! %e#ll be ri$ht bac* %here %e %ere'

-here are s"me !ata t" spp"rt -DD, s"me %ill say' 6t all th"se !ata c"me &r"m "ne

researcher#s $r"p, %h" happene! t" be "n the DSM+ c"mmittee an! str"n$ly pshe! &"rthe ne% !ia$n"sis' Isn#t that a c"n&lict "& interest, especially &"r a t"tally ne% !is"r!er3

-hese th"$hts came t" min! %hen I rea! a NIMH+sp"ns"re! c"n&erence at the Hastin$s7enter in Ne% 8"r* "n chil!h""! bip"lar !is"r!er' M"st "& th"se in"le! %ith chil!

psychiatry in relati"n t" this c"n!iti"n a$ree! %ith the i!ea "& -DD' I %asn#t c"nince!,%hich I#ll e)plain in &tre bl"$ p"sts' n! I %"n#t be srprise! i& many %h" %illc"mment here %ill a$ree %ith the -DDites'

-rth is n"t a matter "& maj"rity "te, h"%eer, an! I hae a hnch that in the &tre %e

%ill l""* bac* "n this -DD mania %ith inc"mprehensi"n'

-hat#s the %h"le pr"blem %ith DSM, as I#e sai! be&"re'

hy !"n#t %e jst all"% the !ia$n"sis "& bip"lar !is"r!er in chil!ren .there are $""! !atathat it happens, een $"in$ bac* t" 14 5rance in (s;ir"l#s te)tb""*, an! then e!cate

clinicians ab"t h"% t" !ia$n"se it, a"i!in$ "er!ia$n"sis, an! h"% t" treat it, a"i!in$

"erse "& !r$s %ith the m"st ris*s, sch as anti!epressants an! antipsych"tics3

Instea! "& bein$ scienti&ically h"nest in "r n"s"l"$y an! ta*in$ p"n "rseles thepr"&essi"nal resp"nsibility "& a!e;ate e!cati"n, %e se the ne)t reisi"n "& DSM t"

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ma*e p an entirely ne% !ia$n"sis s" that %e can, m"re "r less, &"rce clinicians t" !"

%hat %e %ant' D"n#t !ia$n"se that c"n!iti"n .an! se !r$