Sex addiction, obesity, Internet addiction not included in proposed changes to APA diagnostic manual

Binge eating and gambling are in, but sex addition, obesity and Internet addiction are out.

And there are many other proposed changes to the American Psychiatric Association’s diagnostic manual, which is widely used around the world by doctors and insurers to treat mental illness.

Among the changes, the APA is calling for the four separate autism diagnoses to now be unified in a single category, “autism spectrum disorders."

The APA will solicit feedback via the Internet from psychiatrists and the general public, according to The Associated Press. The draft document of the manual will be displayed so doctors and the public can comment until April 20 at www.dsm5.org.

The final guide, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, won’t be published until 2013. The last revision was in 1994, says The Los Angeles Times.

“This has been a massive effort on the part of a very dedicated team,” Dr. David Kufper, chairman of the DSM-5 task force, said at a news conference Tuesday. “Their priorities were to make sure the manual is based on scientific evidence is useful to clinicians and maintains continuity with the previous edition wherever possible.”

It’s expected that DSM-5 will have fewer diagnoses than in the previous editions of the manual. The reason some disorders will be folded into single categories is because studies show that they have similar symptoms and treatments.

The new draft’s “autism spectrum disorders” will refer to several conditions, from slight social impairment to severe symptoms such as poor communication and repetitive behavior, according to The Associated Press.

Some of the proposed changes are expected to set off a debate, The Associated Press says.

“From a scientific standpoint, the changes in the DSM make sense,” says Geraldine Dawson, chief science officer at Autism Speaks, a research and advocacy organization, and a research professor at the University of North Carolina at Chapel Hill. “But people living with autism spectrum disorders may have a different viewpoint. For some, the change will be very disruptive and distressing. They participate in support groups that identify with a particular label. We need to be compassionate and sensitive about this.”

Another proposed change would place personality disorders into a single category. Valerie Porr, founder and president of The Treatment and Research Advancements Association for Personality Disorders, says this would be a disaster.

“Borderline personality disorder has been the stepchild of psychiatry for a long time,” she says. “It’s very different from, say, bipolar disorder, and it’s the least funded and least studied of any mental illness. By lumping all the disorders together, how do you keep the research going?”

Adding gambling disorder and binge-eating disorder to DSM-5 are long-endorsed proposals, says The Los Angeles Times. “About 15 million people have binge-eating disorder,” National Eating Disorders Association chief executive Lynn Grefe said. “Hopefully, (this) would help them get the help that they need.”