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Biz opportunities in diagnostic manual

Gregory Warner Feb 10, 2010
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Kai Ryssdal: For the first time in about 15 years, mental health professionals have a new guidebook. It’s called the The Diagnostic Statistical Manual of Mental Disorders. Catchy, I know. It lists the official diagnoses that can be applied to our various problems.

A draft of the fifth edition of the DSM hit the Internet today. Not a huge deal for lay-people but for drug companies, and insurer companies, and researchers, the DSM isn’t just a guide to disorders, it’s a manual for how to make money. Gregory Warner reports from the Marketplace Health desk at WHYY in Philadelphia.


GREGORY WARNER: To get a new drug approved by the FDA, pharmaceutical companies have to show there’s a legitimate problem that it’s meant to treat. If it’s a mental disorder, that diagnosis — with rare exception — must be listed in the DSM.

Michael First is a professor of clinical psychiatry at Columbia. He helped edit the previous version of the manual. That manual introduced a new diagnosis — social anxiety disorder — which applied to millions of potential new sufferers. As a result…

MICHAEL FIRST: Soon as it’s in the DSM, it greatly facilitates their ability to argue to the FDA that this is a legitimate use of my new medication.

The FDA agreed. GlaxoSmithKline built their ad campaign for Paxil, an SSRI and anti-depressant, around the new diagnosis.

FIRST: Some of the pharmaceutical companies started believing that SSRIs, which were already in their pipeline, might be helpful for social anxiety disorder.

The proposed DSM-5 released this morning on the Internet includes its own new names, expanded diagnoses for binge eating, a diagnosis for hypersexuality. Insurance companies use the DSM as a guide to what treatments they’ll pay for.

Ed Cook is a professor of psychiatry at the University of Illinois at Chicago, and one of the authors of the DSM-5.

ED COOK: If I put in a claim for a treatment or even a diagnostic visit without some kind of code, the insurance company is going to go what are you doing here?

When something is listed in the DSM it also invites new funding for research and clinical trials. The draft of the DSM-5 is open for public comment until April, giving people who get those diagnoses a chance to weigh in.

People like Philip Dawdy who blogs under the name “Furious Seasons.”

PHILIP DAWDY: It’s a victory for the consumer or the patient movement to even have us considered.

He’s waiting to see whether any of his suggestions get heard.

In Philadelphia, I’m Gregory Warner for Marketplace.

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