Cognition & Reality

Thursday, 22 July 2010

The Danger of Diagnosis

Filed under: Diagnosis,DSM,Uncategorized — drtone @ 12:21 pm
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A psychologist who must send a report to an insurance company in order to obtain reimbursement for treating a patient is in a difficult situation, however routine such reports may be. He or she must supply a “diagnostic code” based on the Diagnostic and Statistical Manual, published by the American Psychiatric Association, soon to appear in a fully-revised fifth edition. Although it is not a legal document or itself the result of legislative action, the DSM has attained a quasi-legal status. Technically, for a psychologist to supply an erroneous DSM diagnostic code on an insurance form is a violation of standards that are established by law in California and other states.

DSM diagnosis, reflecting psychiatry as a branch of medicine, presupposes that there is an underlying factor similar from one patient to another that produces a set of observable symptoms, as might be the case for an infection. Never mind that such is manifestly not the case, even where a symptom picture is similar from one patient to another. A psychiatric diagnosis is, therefore, a descriptive box that fits no one. It does little, if anything, to support treatment.

Being forced to produce a diagnosis, however, cannot help but color a psychologist’s perception of a patient, no matter how much or how little faith the psychologist has in the diagnostic procedure. The psychologist treats the patient while being paid to treat his or her disorder,  a fine kettle of fish, good for no one…except the insurance company.

Note: A few days after I posted this, I found this post by Peter Breggin, which covers the same topic in a manner consistent with my point of view, but from a different angle.

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