Psychiatric Times has a revealing article this month that is before its time: Dump the DSM. The DSM, short for the Diagnostic and Statistical Manual of Mental Disorders, is the leading resource used by mental health professionals to define mental illnesses.

In its 50-year history, the DSM has been significantly updated four times--in 1968, in 1980, in 1987, and in 1994.  The diagnoses of mental disorders contained within the DSM are made using specific criteria and are considered as reliable as those for physical medical problems.  The reality is they are not.

The problem with the DSM’s descriptions of mental illnesses is that they are top down.  By this I mean that mental disorders are defined primarily via evaluation of externally observed symptoms through the perception of the practicing psychiatrist against a checklist contained in the DSM.

As information from biochips and brain imaging technology becomes available it will be possible to diagnose mental disorders from the bottom up.  That is, from the precise neural chemical imbalances that actually exist, rather than through externally observed behaviors.  Moreover, neuroceuticals will make it possible to treat those imbalances accurately.

The DSM was a good first step, but soon it will be time to dump the DSM.