"For more than 70 years, physicians seeking to diagnose mental-health conditions have turned to the 'bible for psychiatry' - The Diagnostic and Statistical Manual of Mental Disorders (). Last updated in 2022, and published by the American Psychiatric Association (APA), the DSM sets out diagnostic criteria for a panoply of mental-health conditions, from autism spectrum disorder to substance-use and personality disorders."
"In the Netherlands, roughly 25% of the population has been diagnosed with a mental-health disorder ( M. ten Have et al. World Psychiatry 22, 275-285; 2023). But diagnoses don't tell us what drives the feelings behind these conditions, or how to abate those that are problematic. Indicators of deteriorating mental health - such as persistent sadness and suicidal ideation - align with social inequality, educational pressure and other stressors."
The DSM has provided diagnostic criteria for mental-health conditions for over 70 years and was last updated in 2022 by the APA. The APA plans to include biological, environmental and cultural causes and to consult people with lived experience. Critics consider these changes insufficient, arguing that focusing on diagnoses risks neglecting improved lives. Experts should prioritize care and social drivers of distress rather than emphasizing labels. High diagnosis prevalence (about 25% in the Netherlands) does not reveal underlying causes. Indicators of poor mental health align with social inequality, educational pressure and other stressors. Mental distress often transcends symptom lists, with similar feelings such as entrapment or hopelessness appearing across diagnoses, and individuals with the same diagnosis having different vulnerabilities and care needs.
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