The diagnosis of mental disorders: Diagnosing people with the wrong scale

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Being diagnosed with mental disorder can have far reaching consequences on sufferers.  Employers are not willing to employ people with mental health history.  The court can order for a forced medical treatment on any person clinically diagnosed with mental disorder.  In addition many universities may not be willing to admit people with known mental health problems.  In short the world seems to be turned up side down for people diagnosed with mental disorders.  These raise two important questions.  What instrument is used for diagnosing mental disorders?  How precise is such instrument?

A well-known measure for mental disorders is the Diagnostic and Statistical Manual for mental disorders (DSM) published by the American Psychiatric Association.  The current version is DSM- version 5 (DSM - V).  DSM is graded to help provide standardization to diagnosis of mental disorder.  Patients are diagnosed not by arbitrary decisions of clinicians but through established measures.  Thus, it becomes easy to make a comparison of people around the world with mental disorders using the DSM.

The major shortcoming of the DSM however is the arbitrary threshold or cut-off point for determining people with mental disorders. Every version of DSM consists of a number of symptoms such as the tendency to feel agitated or withdrawn which constitute mental disorders.  A person must exhibit a minimum number of these symptoms  to be diagnosed with a mental disorder.  This number can be 10 out of 20 symptoms.  That is people who exhibit between 10 and 20 symptoms of the mental disorder are considered abnormal while those who show less than that or between 0 and 9 symptoms are considered normal. While individuals who show ten symptoms are considered abnormal like people who show all the twenty symptoms, people who display 9 symptoms are considered normal like people who do not display any symptoms of mental disorders even though these individuals who showed the 9 signs have shown one symptom less than those who showed ten symptoms.

This problem of diagnosing mental disorders using the DSM should be changed for the scale to be valid.  The measure should not be used in a black and white fashion, all or nothing situation.  Instead the DSM should be used to diagnose people with varying degrees of mental disorders. These people can be labelled as having category one mental disorder, category two mental disorder and so on.  This classification can help to distinguish between individuals with serious mental disorders and those with minor mental problems so they can be treated differently.

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