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Psychiatrists’ bible to get new conditions, names

Washington – Is your child often grumpy and prone to temper tantrums? They could soon be diagnosed with TDD, or temper dysregulation with dysphoria to give it its full name.

If they have Asperger’s syndrome, you might have to stop calling it that and switch to "mild autism spectrum disorder." And if getting a handle on math is their problem, they could have "dyscalculia".

Those are just some of the new names and mental disorders released Wednesday by the American Psychiatric Association (APA) that could be included in the next edition of mental health practitioners’ tome of reference, the Diagnostic and Statistical Manual, usually called the DSM.

If all the proposed changes make it into the new DSM, which is due to be released in three years, "mental retardation" will be replaced by the more politically correct "intellectual disability," and conditions such as binge eating will be recognised as bona-fide mental disorders.

Pathological gamblers will get their very own category — behavioural addictions.

But if you’re looking for a classification for kids of all ages who lock themselves in their rooms and spend hours on end on the internet, you’ll have to wait.

"Internet addiction" was considered for inclusion in the same behavioural addiction category as pathological gambling, but the work group decided there was insufficient research data to do so.

The APA has posted all the proposed changes to the DSM on the internet to allow the public to review them and comment.

The new criteria for diagnosing a condition and new conditions will then be reviewed and refined over the next two years, and field trials will be conducted on some of the criteria to see if they work in a real-life scenario.

In the case of TDD, the manual sets a high bar for such a diagnosis.

A child’s outbursts have to be severe and occur three or more times a week to qualify as such. They have to be "grossly out of proportion to the situation or provocation and interfere significantly with functioning.

"Criteria also include extreme verbal and physical displays of aggression when faced with a common minor demand or stress. In between these outbursts, the individual’s mood is persistently negative: irritable, angry and/or sad," the draft definitions posted by the APA say.

For TDD to be diagnosed, the symptoms must have begun before the age of 10 and the child has to be older than six.

"Many children with these symptoms have received a diagnosis of one of the disruptive behaviour disorders, such as oppositional defiant disorder, and in most cases that would be appropriate," said David Shaffer, who led the ADHD and disruptive behaviour disorders work group.

The manual distinguishes simple overeating from binge eating, which it defines as recurring episodes of eating "unusually large amounts of food" while feeling "a sense of loss of control and strong feelings of embarrassment and guilt."

Episodes of binge eating have to occur at least once a week for three months for a mental health professional to consider diagnosing the disorder.

AFP / Expatica