Several new diagnoses will appear in the soon to-be-released Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V). In fact, quite a bit of controversy surrounds the inclusion of several of these new “disorders” in what is considered to be the mental health world’s diagnostic “bible,” as many question their validity and appropriateness for inclusion.
Among the new DSM-V disorders is Excoriation (Skin Picking) Disorder, classified within the Obsessive Compulsive and Related Disorders. It is understandable that the initial public reaction to this release of information has been skeptical (at best). News outlets have begun to question the validity of the diagnosis. Readers have begun to leave comments such as, “Great, now we’re all mentally ill.”
Yes, everyone picks at his or her skin at some point; however, Excoriation Disorder far exceeds “normal” grooming behavior. Think of grooming behavior as occurring on a continuum, with normal, washing and exfoliating on one end of the continuum, extending to picking, scraping, or gouging that results in scarring or disfigurement on the other end.
Improving the Diagnosis of Bipolar Disorder in Children
Approximately 1.5% of the population, worldwide, bipolar disorder is not uncommon. However, bipolar disorder in children presents differently than it does in adults, an important difference which is not addressed in our current diagnostic manual (DSM-IV-TR). As a result, it is frequently misdiagnosed.
Let’s look at the facts:
Approximately 6 million individuals experience panic disorder each year. Panic disorder is characterized by recurrent, intense periods of anxiety/panic, which are often unprovoked, or, “out-of-the blue,” and are accompanied by anticipatory anxiety regarding the possibility of future attacks. Panic disorder can be quite debilitating, sometimes accompanied by agoraphobia, or avoidance of pubic places due to fear of being in a setting or situation from which escape or finding help may be difficult.
Before we get to what DOES NOT work, let’s discuss what DOES work. Evidence for effective treatment of panic disorder is very well documented. The data show with great robust that cognitive behavioral therapy (CBT) is effective and is superior to a number of other treatment strategies.
Cognitive behavioral therapy for panic disorder often includes: