DSM5 - Ticket Back To Reevesville

Discussion in 'Fibromyalgia Main Forum' started by Khalyal, Feb 12, 2010.

  1. Khalyal

    Khalyal New Member


    DSM is the Diagnostical and Statistical Manual of Mental Disorders.
    It’s the bible used by US psychiatrists and other mental health professionals and contains a listing and description of every psychiatric disorder recognized in the United States.

    Right now, the first draft has been issued for DSM-5, the newest version which is due to come out in 2013. (However, the first Field Trials will occur as early as May of this year.) You, autistic children, people with learning disabilities, people with breathing-related disorders, are all on the verge of being officially psychologized.

    Complex Somatic Symptom Disorder
    How does that sound? CSSD. If you thought the name “Chronic Fatigue Syndrome” was a stigma, this one is a doozy.

    Here are the criteria:


    To meet criteria for CSSD, criteria A, B, and C are necessary.

    A. Somatic symptoms:

    Multiple somatic symptoms that are distressing, or one severe symptom

    B. Misattributions, excessive concern or preoccupation with symptoms and illness: At least two of the following are required to meet this criterion:

    (1) High level of health-related anxiety.
    (2) Normal bodily symptoms are viewed as threatening and harmful
    (3) A tendency to assume the worst about their health (catastrophizing).
    (4) Belief in the medical seriousness of their symptoms despite evidence to the contrary.
    (5) Health concerns assume a central role in their lives

    C. Chronicity: Although any one symptom may not be continuously present, the state of being symptomatic is chronic and persistent (at least 6 months).
    The following optional specifiers may be applied to a diagnosis of CSSD where one of the following dominates the clinical presentation:

    XXX.1 Multiplicity of somatic complaints (previously, somatization disorder)

    XXX.2 High health anxiety (previously, hypochondriasis) {If patients present solely with health-related anxiety in the absence of somatic symptoms, they may be more appropriately diagnosed as having an anxiety disorder.} *

    XXX.3 Pain disorder. This classification is reserved for individuals presenting predominantly with pain complaints who also have many of the features described under criterion B. Patients with other presentations of pain may better fit other psychiatric diagnoses such as major depression or adjustment disorder


    Pain disorder means that the more you complain about pain, the more sure they will be that you have a mental disorder. Oh, and does that 6 month time period sound familiar? It did to me.

    From the CDC’s CFS web section:


    A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms include:

    cognitive dysfunction, including impaired memory or concentration

    postexertional malaise lasting more than 24 hours (exhaustion and increased symptoms) following physical or mental exercise

    unrefreshing sleep

    joint pain (without redness or swelling)

    persistent muscle pain

    headaches of a new type or severity

    tender cervical or axillary lymph nodes

    sore throat.


    Much of the above can also be classified as “Pain Disorder”, which, by the way, is not a codable disorder in the DSM5.

    Who is making these determinations?
    There is a work group in charge of Somatic Symptoms Disorders, chaired by Dr. Joel Dimsdale, MD. Here is an introduction to some of the members:

    Cast of Characters
    Joel Dimsdale, MD

    Quoted as saying that the “concept of somatization that is used for characterizing symptoms in the absence of any detectable disease is of little operational value if not misleading. For instance, the enduring fatigue experienced by the vast majority of breast cancer survivors could be easily labeled as a somatization disorder according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders.”



    Arthur J. Barsky III

    Published a paper in the Annals of Internal Medicine, Functional Somatic Syndrome, 1999.


    In the paper, he includes multiple chemical sensitivity, sick building syndrome, repetition stress injury, side effects of silicone breast implants, the Gulf War Syndrome, chronic whiplash, the Chronic Fatigue Syndrome, irritable bowel syndrome and fibromyalgia….as examples of Functional Somatic Syndrome – a condition where the symptoms are characterized more by the symptoms, suffering, and disability more than any demonstrable tissue abnormalities.

    He goes on to say that the suffering of these patients can be highly exacerbated by a self-perpetuating and self-validating cycle. He adds that litigation, compensation, and physician validation all feed into this cycle.


    Francis Creed, MD


    Recent member of the MRC, the UK’s Medical Research Council. Co-Editor of the Journal of Psychosomatic Research. Recent member of the international CISSD project, of which Michael Sharpe was chair. Michael Sharpe is part of the Wessely school of thought on CFS/ME in the UK.


    Michael Sharpe, MD

    Chair in Psychological Medicine at University of Edinburgh, UK. Leads the University’s Psychological Medicine Research Group. Specializes in non-pharmacological interventions and clinical trials to test them (GET and CBT).

    Worked as an Expert Witness for Unum Provident and Windsor Life among others.

    “Despite denials from Dr Sharpe that he has ever harmed “CFS” patients, there is mounting evidence that such is not the case; documented and detailed evidence of the consequences of inappropriate psychiatric intervention has been put before the Chief Medical Officer and is also variously recorded in Hansard ( for example Hansard (Lords) 19 December 1998:1013; Hansard 21 December 1999 147WH-166WH).

    Patients with ME/CFS have even been threatened with being sectioned under the Mental Health Act unless they agree to psychiatric interventions.”


    Six Degrees to Kevin Bacon
    “Six degrees of separation” refers to the concept that everyone is connected to everyone else by a maximum of six steps; for instance, you know so-and-so who is related to so-and-so, who cleans house for so-and-so, who gets her hair done at Curl UP N’ Dye, who does Kyra Sedgwick’s hair, (Not really.) who is married to Kevin Bacon. That gives you six degrees of separation from Kevin Bacon.

    But there aren’t even six. Michael Sharpe, listed above, is part of that UK evil trinity who work so hard to psychologize CFS/ME…Wessely, White, and Sharpe.

    Our friend Bill Reeves is in awe of Peter White.

    Voila. Two steps. Maybe just one.

    Back to Reeves?
    Effective February 14, 2010, Dr. Reeves will begin his assignment as Senior Advisor for Mental Health Surveillance in the Public Health Surveillance Program Office within the CDC’s Office of Surveillance, Epidemiology, and Laboratory Services.

    What does that mean to us? Doesn’t the invention of CSSD throw us right back into his loving arms?

    What do they do over there at the Public Health Surveillance Program Office anyway?


    “Maintaining focus on the overall health of our population will be critical in the next decades, as will leaving behind the commonly accepted divide between mental and physical illnesses, “despite the fact that both exist within individuals in an exquisitely integrated fashion” (20). An optimal surveillance system will examine interactions among biological, social, psychological, and environmental factors to support health promotion, intervention programs, and both mental illness and chronic disease prevention.”
    Reeves has just become a hydra.
    Chop a head off and another appears. His move out of the CFS department may look good to us on the surface, but he has just resurfaced in a position that has the potential to do us a lot more damage, and not JUST the CFS cohort. ALL of us.

    This is it.. This is the call to arms. If you ever in your life stand up for anything, now is the time.
    What can you do?

    Sign Tom Kindlon’s petition.


    Read Mary Schweitzer’s excellent blog on how the CDC has deceived us:


    Support the heck out of the science that is going on over at WPI, because it’s science alone that will save us all from this atrocity:


    Get involved in potential congressional inquiry:


    Make comments at the DSM5 website:


    Stand up and scream your loudest. Develop a zero tolerance for bullshit.

    “Don’t let your suffering be your cloak. Instead, let it be your shining spear of righteousness, your sword of justice. Use it without prejudice. Set your eye on the truth and do not waver.”
    (Suzy Chapman has an excellent website up where she is keeping tabs on DSM5 developments. Keep up to date on this issue at:


    [This Message was Edited on 02/13/2010]
  2. Khalyal

    Khalyal New Member

  3. AuntTammie

    AuntTammie New Member

    they should have to read the article "Magical Medicine: How to Make a Disease Disappear

    (It is written re the UK but it contains a wealth of info about the real physical issues in ME/CFS as well as the poor treatment that has arisen form the psych camp, and so much more)
  4. Khalyal

    Khalyal New Member

    That was awesome, girl!

  5. simonedb

    simonedb Member

    khalayal and cate--thanks for keeping us informed and smiling!

    This is really disturbing to me, when is it going to be cemented?
  6. simonedb

    simonedb Member

    Also, do you guys have any suggestions of what would be effective comments to make at dsm page?
  7. AuntTammie

    AuntTammie New Member

    the paper I referred to above has more than 100 pages of info about physical issues that have been proven to be part of ME/CFS.....referring to that could be good, also the Candian criteria is another good source to point them to

    also I would point out that there is a difference between criterian B (being preoccupied with physical symptoms) and being so sick that the physical illness forces you to rearrange your life to accommodate it
  8. DeborahLynn

    DeborahLynn Member

    I had a good laugh (even though I am so weak today I could hardly laugh at all). Thanks, Aunt Tammie, for your info, too.

    Now I have to go recover from laughing! :)

  9. DeborahLynn

    DeborahLynn Member

    I try to read up on all I can (with the limited energy I have) on CFIDS/FMS... how did you find this paper? I look on ProHealth, Phoenix Rising CFS, CFIDS Assoc., Whittemore Peterson Institute and other places; do you know of some other places to look?

    Thanks! (BTW, I have a sister-in-law named Tammy; Aunt Tammy is a dear name to our household!)