13/10/2026
Richard Sears covers a new editorial that argues that adding more psychiatric categories and biological markers will not solve the DSM’s deeper problems, calling instead for an approach centered on personal experience, relationships, and social context.
The American Psychiatric Association is hard at work planning their next edition of psychiatry’s “Bible,” the DSM. According to one APA committee involved, the purpose of the DSM is not to provide diagnosis (or treatment) guidance for known medical problems, but to “meaningfully change the way clinicians think.” They have proposed using “candidate” biomarkers to define “mental illness”—”candidate” here meaning theoretical biological associations which have not actually been found.
The committee notes that “including only validated biomarkers, as per FDA criteria, would be too limiting, since these exist only for Alzheimer’s disease and opioid use disorder at this time.” The committee also notes that even these biomarkers are controversial, as they are FDA-approved but not technically validated.
Other researchers, though, are pushing back against this. A new editorial published in Psychological Medicine argues that the DSM is in need of a serious overhaul. This redesign should go well beyond currently proposed revisions that emphasize increasingly precise psychiatric categories which fail to capture the complexity of individual mental health struggles.
Authors Lars Veldmeijer and Jim Van Os from Utrecht University and Laura Batstrain from the University of Groningen in the Netherlands argue that, “current revision considerations risk increasing complexity without resolving fundamental limitations in psychiatric classification. Specifically, our analysis highlights several areas that warrant further consideration … In response, we propose redesigning the DSM as a hybrid dialogical system that retains coarse-grained classificatory categories for pragmatic purposes while shifting diagnostic practice toward contextual interpretation, collaborative meaning-making, relational understanding, and individualized care formulation.”
Problems with the DSM ‐
- Past research has found that the DSM-5 lacks reliability, meaning that two clinicians often arrive at a different diagnosis when considering identical symptoms.
- Experts say that its diagnoses do not reflect the reality of mental health struggles.
- Research has also concluded that DSM-5 diagnoses are “scientifically meaningless” and arbitrary. One clinician described the DSM-5 as “more like a religion, and less and less scientific.”
- Researchers have criticized the DSM-5 for its ties to the pharmaceutical industry, with 69% of DSM-5 task force members accepting some form of industry payment.
The authors of the editorial identify five “blind spots” in the DSM and proposed revisions that make it unreliable as a diagnostic system.
To read them, click here: @[https://www.madinamerica.com/2026/10/is-it-time-to-rethink-psychiatrys-diagnostic-bible/]
[psychiatry, madness, diagnosis, research, psychology, medicine, news, mental health, mad in america]
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