View Full Version : Possible Classification Change of TS for DSM-V


Don S.
05-15-10, 06:52 PM
I received an email inquiry at my website asking if I consider a possible revision in the classification of TS in DSM-V to be a vindication of my views denying that TS is an organic illness as opposed to a psychiatric one. The following is my response.

Thank you for your inquiry. If this change were to come to fruition, it would not only be long overdue but, in my estimation, attests to the fact that TS should never have been reclassified as a “neurological disorder” in the first place as explained in my essays on the subject.
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For those unfamiliar with DSM, it stands for Diagnostic and Statistical Manual and has been published by the American Psychiatric Association since 1952. It is widely held to be authoritative by a range of players regarding psychiatric illnesses, including physicians and insurance companies. The manual has been updated several times and currently possible revisions are being considered for the fifth manual or DSM-V.

In DSM-IV, the current edition, TS is classified under the heading “Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence.” Although that certainly describes TS accurately, it is rather a mealy-mouthed classification that is currently being considered for elimination; a change that I would wholeheartedly endorse. (TS is named for a French physician. Why not classify it under “Diseases Named for French Physicians”? Its present classification is little more edifying.) <O:p< font>

Unfortunately, the DSM work group considering how to classify TS is recommending that it remain under its present classification. However, if the classification is discontinued, they are recommending it be assigned to “Anxiety and Obsessive-Compulsive Disorders” exactly as I advocate and hold to be obvious. The Tourette Syndrome Association and other advocates for those with Tourette’s Syndrome have, of course, launched a lobbying counterattack to prevent the change.

As I have stated elsewhere, I do not see what real benefit it is to those who suffer with TS to maintain what I perceive to be the transparent fiction that Tourette’s is organic. Admittedly, the status quo does have certain economic benefits in regard to treatment options. However, I strongly hold that TS sufferers would be better off if TSA and other advocates for TS patients would accept TS as a psychiatric condition and shift their focuses to lobbying for funding of various behavioral therapies that hold actual, demonstrated promise for vastly improving the conditions and lives of TS sufferers, as well as for better understanding of those who suffer from various mental illnesses. As the matter stands now, TS sufferers are all too often left passively waiting for the magic bullet of a cure, such as a medication or an operation, while researchers are off on a forty year old quixotic search for the elusive (and in my opinion, nonexistent!) underlying physical cause of the affliction.

The absurdity of the situation is evidenced by the fact that TS is classified at all by DSM, an organ of the American Psychiatric Association. Why is an association of psychiatrists categorizing that which is allegedly an organic illness?
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I chose not to comment on the possible change in Tourette’s classification at the DSM website. Although I have numerous hits on my several TS related articles, I have no idea who exactly are reading them. However, I do not flatter myself into thinking that any of my views were even incrementally involved in the consideration of such a proposed change. I am not at all confident that the prospective change in classification will occur in DSM-V. Such a change would necessitate the folks at the American Psychiatric Association to actually act like scientists as opposed to politicians.<O:p< font>
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