New labels for old 'problems'

This may come as unwelcome news to the millions of men who, surveys suggest, think about sex at least once every 20 minutes: you may be suffering from "hypersexual disorder".

It is also likely to irritate the millions of women who feel grumpy at a certain time of the month: you may be labelled with "pre-menstrual dysphoric disorder".

The latest edition of the psychiatrists' bible - the fifth Diagnostic and Statistical Manual of Mental Disorders, or "DSM 5" - is already drawing flak for pathologising behaviour which many doctors regard as part of ordinary life.

The first complete revision of the manual since 1994, DSM 5 was unveiled by the American Psychiatric Association last week.

Critics fear it could increase the numbers diagnosed with mental illness and treated with powerful psychotropic drugs, as well as subtly shifting perceptions of what it is to be normal.

Other new diagnostic labels include "binge-eating disorder", "gambling addiction", and "internet addiction".

Some of the most controversial involve the extension of adult diagnoses to children, such as "psychosis-risk syndrome", for those with mild symptoms of suspicion or delusions. There will always be adolescents whose ideas are a little odd.

Peter Tyrer, professor of psychiatry at Imperial College London and chairman of the working group leading revision of the International Classification of Diseases on personality disorder, said:

"The joke about the DSM is that it doubles in size each time it is revised so everyone is pathologised in time.

"I call hypersexual disorder the Bill Clinton Syndrome. If you are really going to pathologise men who can't stop thinking about sex, that is going to be an awful lot of people.

"Similarly with pre-menstrual dysphoric disorder - it is likely to affect 50 per cent of women of child-bearing age."

The revised DSM 5 has involved more than a decade of work by hundreds of experts. Professor Tyrer said:

"They promised to include only disorders with a proper basis in biology. They have abandoned that entirely now. The scope has widened further than ever despite the concern that we are medicalising far too many conditions."

Critics say the manual's expansionist tendencies are driven in part by the pharmaceutical industry, always on the lookout for new indications for its costly drugs.

Tim Kendall, the deputy director of research at the Royal College of Psychiatrists, said: "We know that shortly after a new category of disorder is developed, companies come in with a drug to treat it.

"You can characterise almost any behaviour as a psychiatric problem. But it should only receive a diagnosis if it impairs your ability to lead the life you want to live."

- INDEPENDENT