NIH Official Raises Concerns About New Psychiatry Manual

The director of the National Institute of Mental Health says the American Psychiatric Association's DSM-5 lacks validity, and his organization plans to launch a possible replacement diagnostic tool.

Medscape: NIMH, APA Clash Over Upcoming DSM-5
Two of the biggest organizations in the field of psychiatry are clashing over the soon-to-be-released Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which will be released by the American Psychiatric Association (APA) on May 18. ... In a blog post published on the National Institute of Mental Health (NIMH) Web site, the organization's director, Thomas Insel, MD, states that the upcoming manual is reliable but lacks validity and that "patients with mental disorders deserve better." ... Dr. Insel also reported that the NIMH is launching the new Research Domain Criteria (RDoC) project as a possible replacement diagnostic tool sometime in the future and as "a first step towards precision medicine." It will incorporate genetics, imaging, and other data into a new classification system. In addition, the organization noted that it "will be re-orienting its research away from DSM categories"  (Brauser, 5/7).

In other news about medical quality issues -

Reuters: Many Medical Guidelines Don't Consider Costs
Professional medical societies don't often consider costs when they're developing their treatment guidelines for specific conditions, according to a new study. Researchers found that just over half of the top medical societies with at least 10,000 members considered costs when developing best practices. The other half either implicitly considered costs or didn't address them at all (Seaman, 5/7).

Modern Healthcare: HHS To Providers: Check Lists Of Excluded Medicare Personnel
HHS maintains a list of 51,588 people who are categorically excluded from providing even indirect care to Medicare patients, and new guidelines that will be published today recommend healthcare providers check their personnel rosters against the list once a month. That obligation extends to temporary nurses and doctors who work under contract from staffing firms. And it might not hurt to print out screen shots proving that the list was checked, the new guidance says (Carlson, 5/8).

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