New DSM-IV Final Revision simplified to "Crazy/Not Crazy"

            The American Psychiatric Association announced Friday that it has updated its current recommendations for diagnosis of mental disorders in the new DSM-IV-FR (Diagnostic and Statistical Manual of Mental Disorders Final Revision).  The manual has undergone numerous revisions through the years to reflect the trends and new insight into psychiatric problems. 

This revision is by far the most drastic in the history of the DSM.  The previously 950-page compendium has been edited to a simple 3"x 5" note card.  The most notable change is the loss of several clinical diagnoses such as schizophrenia and bipolar syndrome in favor of a more dichotomous question of "Crazy/Not Crazy".

            "This is a major step forward for our field.  We have been spending centuries trying to understand the human mind, trying to comprehend the intricacies of psychiatric disorders.  What we should have been doing this whole time is just figuring out if someone is crazy or not crazy," said Dr. Bernard Beitman of the MU Department of Psychiatry.

            "The newest revision has turned the psychiatry world upside down.  It is a more patient oriented approach.  People don't want to know if they are schizotypal or obsessive compulsive; they want to know if they are crazy or not crazy," chimed Dr. James Slaughter.  "At first I thought that the new DSM was avoiding many key issues, then I realized that words like 'avoidance' are exactly the sort of thing that the Final Revision has tried to eliminate.  It made me wonder 'Maybe I'm crazy?'"

This sentiment has been echoed throughout the field.  Dr. Susan Matthews from the University of Washington has published a book entitled Dr. Slaughter is Crazy.  She further agreed with many of the changes in the new DSM.  In an excerpt from Chapter 4:  Id, Ego, SuperegoÖ My Ass, she writes "And suddenly it was all pretty clear. The answer was fewer clients.  Caring for them, caring for ourselves, and the games too.  Starting our lives, really."  Although this and other lines were stolen directly from Jerry Maguire, the fact remains that the return to patient-oriented medicine is essential. 

The truncation of the diagnostic manual has made it significantly lighter and easier to carry.  The laminated card comes in many designer colors and comes with a black dry erase marker to circle the diagnosis.  In omitting the vast majority of diagnoses, the DSM-IV-FR has the following criteria in its differentiation of psychiatric states:

1.0  Crazy ñ An individual is considered crazy if any of the following are true:

                                    A.  Person has thoughts or perceptions inconsistent with reality.

B.  Person behaves in manners that are wholly inappropriate for situations, circumstances, and personal values.

C.  Person makes you think "Holy crap, this guy is crazy."

D.  Person gives you the creeps.

1.1 Not Crazy ñ An individual is considered not crazy if they do not fit into the diagnostic criteria for diagnosis 1.0.

This major renovation in the field of psychiatry may lead to changes in other fields of medicine.  Dr. Beitman noted "We are establishing ourselves as the forerunners in the advancement in medicine.  Don't be surprised if you see the Infectious Disease people classifying diseases as 'Bugs' or 'Not Bugs' in the not too distant future."