DSM-5 Adds “Behavior” to List of Addictions


The APA convention last week included a debate about the addition of “Behavioral Addiction – Not Otherwise Specificed” to the new edition of the DSM. The new category could be used to diagnose as illnesses addictions to shopping, sex, the internet, or video games – a potential addition of 20 million newly categorized “addicts.” “The biggest problem in all of psychiatry is untreated illness, and that has huge societal costs,” said Dr. James H. Scully, chief executive of the APA. Others are concerned the change would result in a misdirection of resources. “These sorts of diagnoses could be a real embarrassment,” said Thomas F. Babor, editor of the journal Addiction.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. “The biggest problem in all of psychiatry is untreated illness, and that has huge societal costs,”

    To the APA Untreated = unmedicated. An unmedicated person is a dollar lost and a slave let loose.

    ‘Many of those who get addiction diagnoses under the new guidelines would have only a mild problem, he said, and scarce resources for drug treatment in schools, prisons and health care settings would be misdirected.’

    Pullleeeze! They are not ’embarrassed’, the time for embarrassment and having a conscience is long gone. there are no scarce resources for forced drugging. Schools , prisons are conquered – next are all the workplaces – there’s the gold – the workers completely under the thumb of the exploiters.

    ‘Dr. O’Brien, who led the addiction working group, has been a consultant for several pharmaceutical companies, including Pfizer, GlaxoSmithKline and Sanofi-Aventis, all of which make drugs marketed to combat addiction.

    He has also worked extensively as a paid consultant for Alkermes, a pharmaceutical company, studying a drug, Vivitrol, that combats alcohol and heroin addiction by preventing craving. He was the driving force behind adding “craving” to the new manual’s list of recognized symptoms of addiction.

    “I’m quite proud to have played a role, because I know that craving plays such an important role in addiction,” Dr. O’Brien said, adding that he had never made any money from the sale of drugs that treat craving.’

    Oh yes, he can honestly say he doesn’t sell the junk or force it down the throats of the population – Pharma and the police do that – he just ‘consults’ for them.

    ‘several researchers involved with the manual have said that the panel is not likely to change its proposal significantly’

    That’s the bottom line – the fix is in, if it’s stopped this time , it will get in next time.

    Does anyone see the medical model here? – It’s Spock – they want everyone to be Spock clones – obedient emotionless servants of authority and the rich elite. No more nasty emotions , no more self-actualized reading – no more pointless activities like sex and reading.
    Goodbye civilization , it was nice knowing ya!

    Get out! Get out of America while you can – there is still freedom in the third world, for a while.

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  2. i hear panama is nice this time of year.

    I was discouraged by the reader responses in the origonal article. The general concensus seems to assume that treatment actually works. IN my mind this is very unclear, especially in treating addictions.

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