The DSM, that is to say the diagnostic and statistical manual of mental disorders is a work of psychology developed by the Association of American Psychiatrists (APA) and intended for mental health professionals. It helps to classify and categorize mental disorders

Written by a collective of psychiatrists, the diagnostic and statistical manual of mental disorders offers a description and classification of mental illnesses. The first version of this catalog, published in 1952, listed 108 categories of mental pathologies. The manual has since evolved based in particular on statistics collected in psychiatric hospitals.

The latest version, the fifth edition of 2013, called DSM-5 and translated into French in 2015, has nearly 300 pathologies. While this is a tool widely used by health professionals, it is still the subject of many criticisms.

Its content is similar to that of the ICD, the International Classification of Diseases, established by the World Health Organization (WHO), another guide used in several countries for defining mental disorders.

It is a guide to daily practice for mental health professionals. Its goal is in particular to standardize diagnoses by adopting a common language to “define, communicate and share” between actors in the sector and this, all over the world, explains the monthly magazine for psychiatric care teams Mental Health.

This categorization, which is particularly difficult to establish in the case of mental disorders, also makes it possible to define the care and compensation of patients where applicable.

Each mental disorder is described in the book in a systematic and detailed manner as follows:

• characteristics for making a diagnosis;
• prevalence, ie the number of cases of illnesses recorded for a given population;
• the course of the disease;
• risk and prognostic factors;
• diagnostic issues related to the patient’s culture or gender.

When it was released in 2013, the fifth version of the Diagnostic and Statistical Manual of Mental Disorders was very poorly received by mental health specialists. Accused of fabricating mental illnesses without a scientific basis and of pushing the population to the consumption of psychotropic drugs. Among the most controversial elements is mourning.

Indeed, according to the DSM, if a bereaved person shows signs of depression for more than two weeks, they can be diagnosed as suffering from “major depressive episode ”. A time frame that was set at two months in the previous version of the manual.

But the controversy is nothing new. From the first publications of the diagnostic and statistical manual of mental disorders, the criticisms were virulent. Many are particularly concerned about the labeling of patients which may result in a limited evaluation of patients.

In 1996 in the columns of Liberation, Professor Edouard Zarifian – now deceased – renowned for his popular scientific works on psychotropic drugs was worried about this desire to categorize patients. “The symptom is apparently unequivocal for one who considers it only in an accounting way; and it is to this accounting dimension that the use of the DSM leads. The situation becomes caricatured: we reduce the suffering of a unique being to a symptom, described in a catalog and we ignore its social or personal context. ”

Asked by Le Monde, Richard Delorme, child psychiatrist at Robert-Debré hospital in Paris, reminds that this manual must above all be considered as an imperfect but necessary clinical tool, which should be adapted to medical practices and to patients. “The DSM is an atheoretical model, not an ideological one. For me, it is the front door of a house, it helps to prioritize intellectual reasoning, but it is not an end ”, he concludes.

On the website of the American Psychological Association – APA PsycNet – psychology professor Jonathan D. Raskin and clinical psychologist Gabrielle Phillips emit several alternatives to DSM to define mental disorders including:

• the International Classification of Diseases (ICD) developed by the World Health Organization;
• the Psychodynamic Diagnostic Manual written by several members of psychoanalytic, psychiatric and psychological associations;
• the hierarchical taxonomy of psychopathology proposed by some fifty researchers in psychology and psychiatry.