Understanding more disorders

Re “Psychiatry manual’s secrecy criticized,” Dec. 29

Your story notes: “As the field has changed, the number of disorders in the DSM has tripled to 300, an increase paralleled by the rise in sales of drugs that pharmaceutical companies and psychiatrists tout as remedies for emotional suffering. Some critics suspect a quest for profits may have encouraged the field to create mental illnesses out of personality quirks.”

Readers might infer that this expansion was the result of adding disorders to the Diagnostic and Statistical Manual of Mental Disorders that lack a known cause or are related to those disorders for which there is a new medication. Not true. Fifty-three percent of the diagnoses in the 2000 edition are related to a cause. The major expansion, since the first edition, has been substance-related diagnoses, from eight in 1952 to 124 in 2000. The total number of diagnoses not related to a cause has not been markedly expanded.

The vast expansion of medical knowledge has led to an explosion of medical diagnoses, including psychiatric. That expansion does not imply that values are coming into play but rather that our understanding of the human body and mind has grown.

Roger Peele MD

Rockville, Md.

The writer is a member of the task force of DSM-V.