The American Psychiatric Association has recently approved the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSMV. The New York Times reports that after an extensive debate, the Association compiled a manual that provides new criteria for addressing some of the most common and controversial mental disorders. In certain instances, new definitions may alter, limit, or enhance insurance coverage for mental disorders previously considered behavioral or biological.
Notably, the authors of the DMSV have devised a more inclusive definition of depression. The Fourth edition of the DSM contained a "bereavement exclusion," which held that grieving a person's passing did not qualify as a mental disorder. The DSMV eliminates that exclusion; thus, individuals who exhibit the symptoms of depression due to the grieving process will qualify for the diagnosis. This is controversial because it places a potentially stigmatic label on the bereaved. From a disability perspective, however, those rendered unable to work following the traumatic experience of loss will now have a diagnostic basis for claiming benefits.
The committee working on Autism also re-structured the way the disorder is characterized, which is a development we discussed in February 2012. While Autism and related syndromes have previously been broken down into categories including Asperger's and pervasive developmental disorder not otherwise specified, all of the categories will now come under the unified heading of "autism spectrum disorder." However, criteria for this new category are predicted to exclude some of those who previously would have qualified for a diagnosis. This raises concerns regarding disability resource availability--including private insurance and social security benefits--for those who no longer fall under the definition of autism.
Another controversial decision was to create a new category for "disruptive mood dysregulation disorder," or D.M.D.D., which will now include many children who had been previously diagnosed as bipolar. D.M.D.D. will be used to diagnose children who display "extreme hostility and outbursts beyond normal tantrums." The committee working on D.M.D.D. created this new category to avoid placing the lifetime label of "bipolar" on children where researchers have found that most children diagnosed as bipolar are not truly suffering from the disorder. It remains to be seen how the creation of this new diagnosis and the removal of the bipolar label will affect pediatric patients' rights to insurance benefits, including disability and social security benefits later in life if symptoms do not improve.
The affect of any paradigm shifts within the DSMV on patients' ability to obtain resources necessary to deal with their disorders had yet to be determined. We at Bonny G. Rafel can provide consultation if you are concerned with how changes in the DSM's diagnostic criteria may impact your entitlement to disability benefits.
- By Sara E. Kaplan, Esq.