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Hmm - I don't hate the proposed Borderline changes as much as I thought I would.

Thanks for posting that, Helen

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Finally, they are putting something out there about the proposed changes. But y'all gotta remember that these are PROPOSED. There is still a lot of time for various interest groups and Big Pharma to exercise their influences. I can see possible problems with Aspie kidz and special educational service qualification. I imagine the Mood Disorders group duking it out for whose proposals will prevail. Thus far, the Personality Disorders group looks to be the most reasonable, though I still wish they'd scrap the Borderline name in favor of something more accurately descriptive. And I think maybe, just maybe, someone took a gander (oops, tranny goose?) at Mudpuppy's manifesto from a few months back.

May you live in interesting times....

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Dr. Dan has a nice bit in the Carlat Psychiatry Blog. I hope he posts more on this as he only put a couple of toes in the water.

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Urg don't like his comments about Autism.

The previous criteria were virtually identical.

we are talking like maybe on or two phrases about age of onset and "clinically significany".

Plus many people doing the dx were ignoring the other two things that could have been delayed and focusing on the language delay.

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I'm a little ticked that CPTSD doesn't seem to be getting added, especially with the tightening of the criteria for PTSD, with no mention of looser criteria for children that I could see

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I'm a bit disappointed that van der kolk's developmental trauma disorder didn't make it through, but it seems some aspects may be added in preschool PTSD or developmental aspects of PTSD.

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I am soooo happy to see this DSM-V as a (pseudo?) open forum. Big step forward. I am most excited about the realization of the bipolar Dx in kiddos bubble we've seen lately - that's where Big P has taken advantage by pushing through legislation to allow Rx meds for little ones that have not been adequately tested. I HATE Big P with a passion.

BTW did anyone not know that NAMI has been part of that scandal? Yep - lobbying and laundering money for Big P, and other scandalous activity.

http://www.bloomberg.com/apps/news?pid=20601124&sid=a4V6UEpXf_mY&refer=home

And there's actual Congressional interest in this! Color me shocked. By a Republican, too.

Back to DSM: I recently (last fall) took a graduate class in psychodynamic psychology and took away this:

1) these psych diagnoses are meaningless without a treatment plan - but they do govern how insurance will cover treatment

2) Personality disorders (the focus of the class I took) are tricky - and multi-axial. There is the axis for severity (neurosis, borderline, psychosis) - and those refer to severity and impingement on daily life functioning. So I feel BPD is not a distinct personality disorder, it is basically the middle ground in terms of disorder severity, whether you're talking OCD or narcissistic or schizoid.

3) Labels are just labels. For personality disorders, meaningless. It's within the context of Tx that gains are made. And there's no silver bullet.

Take the opportunity to give APA feedback. They always say - "write your congressman a letter"...well, you have no right to complain if you don't voice your concerns. It's free to set up a login and send in your thoughts.

Oh, and it's hard to discern where the personality disorder starts, the psychiatric disorder ends, and what role the bad attitude takes!

Me - guilty of borderline-severity poly-symptomatic personality disorder. What does that mean? I'm not concerned...

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that's where Big P has taken advantage by pushing through legislation to allow Rx meds for little ones that have not been adequately tested. I HATE Big P with a passion.

BTW did anyone not know that NAMI has been part of that scandal? Yep - lobbying and laundering money for Big P, and other scandalous activity.

http://www.bloomberg.com/apps/news?pid=20601124&sid=a4V6UEpXf_mY&refer=home

And there's actual Congressional interest in this! Color me shocked. By a Republican, too.

I think you should note that this is all alleged, nothing proven.

I hate big pharma as much as any lefty, but I'm also forced to be thankful to them for the differences they have made in my quality of life. It's an odd position to be in for sure.

I like NAMI a lot. I despise Chuck Grassley and Blooberg has a right wing editorial stance. I take anything coming from either with a grain of salt.

FWIW there are a lot of cases where there are no drugs approved for use in children for some indications. There's nothing aproved for pediatric OCD, for example, so physicians are forced to rx off label. The reason nothing is approved is that in the current climate it's next to impossible to get trials on children approved for ethical reasons. So what do you do? Which is worse? Testing medications on children to try and get them approved or using medications on children which have not been tested on children because political pressures make it impossiable to get the tests approved?

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I think you should note that this is all alleged, nothing proven.

I hate big pharma as much as any lefty, but I'm also forced to be thankful to them for the differences they have made in my quality of life. It's an odd position to be in for sure.

I like NAMI a lot. I despise Chuck Grassley and Blooberg has a right wing editorial stance. I take anything coming from either with a grain of salt.

I hear you, you always have to consider the source, but I've researched these allegations via disparate sources thoroughly enough to be satisfied that at least something is amiss. It is a sore spot with me for a couple reasons:

1) I've supported NAMI financially for 11 years

2) I've supported NAMI with my time whenever I've been able

3) This is the biggest lobby for mental illness, and of late I've been receiving newsletters from them with a message of "recovery". They are saying that people can "recover" from mental illness.

Recover? I have Bipolar I. I know there's no cure. It's a chronic disease. It can be successfully managed, but you don't "recover". I feel that messaging is irresponsible and instills false hope in those they aim to serve and represent.

Remission may be a better word. But "recover" is something else entirely.

Your thoughts?

Oh - and I am also p.o.'d at the deal Obama's administration cut with Big P to get their endorsement of the original healthcare bill....sold us short, big time. But I will refrain from ranting. Peace.

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Well, this kind of explains why my p-doc changed my diagnosis to BP NOS. He is an academic physician, and probably has been reading up on this. I am doing well at the moment, but I have had a lot of new developments in my illness in the last 3.5 years. I got moved from BP II.

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