Health Highlights: May 15, 2013

Top Mental Health Official Softens Stance on New Edition of Psychiatric ManualU.S. Files Appeal to Delay Non-Prescription 'Morning After' Pill

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Mental Health Official Softens Stance on New Psychiatric Manual

Debate over the validity of the latest version of what is considered the diagnostic "bible" of psychiatry eased Tuesday after a top government health official who had criticized the manual softened his position in a public statement.

Set to be released Saturday, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA). This latest edition has raised some concerns because of changes in the diagnoses of some disorders, most notably in the area of autism spectrum disorders.

But the issue that Thomas Insel, director of the U.S. National Institute of Mental Health (NIMH), recently took with the manual was more fundamental.

Insel wrote in a blog post that the manual is "at best, a dictionary, creating a set of labels and defining each," and that its "weakness is its lack of validity."

In his post, Insel added that his agency would instead steer its research toward a new set of diagnostic parameters known as Research Domain Criteria (RDoC), because "DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."

However, in a joint release issued Monday, Insel and APA president-elect Jeffrey Lieberman noted that the DSM-5 "represents the best information currently available for clinical diagnosis of mental disorders."

The new statement further clarified that while the manual is used by practitioners, it "is no longer sufficient for researchers," and so RDoC will be the new focus for NIMH.

"Looking forward, laying the groundwork for a future diagnostic system that more directly reflects modern brain science will require openness to rethinking traditional categories," the statement explained. "This is the focus of the NIMH's Research Domain Criteria [RDoC] project. RDoC is an attempt to create a new kind of taxonomy for mental disorders by bringing the power of modern research approaches in genetics, neuroscience and behavioral science to the problem of mental illness."

The latest statement also pointed out that the DSM and RDoC "represent complementary, not competing, frameworks. . . . As research findings begin to emerge from the RDoC effort, these findings may be incorporated into future DSM revisions and clinical practice guidelines."

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U.S. Files Appeal to Delay Non-Prescription 'Morning After' Pill

The Obama administration on Monday filed an eleventh-hour appeal to delay the over-the-counter sale of "Plan B" emergency contraception to girls of any age.

Last month, U.S. District Judge Edward Korman ruled that the so-called "morning after" pill be made available without a prescription, with a deadline for any appeal set for Monday. On Friday Korman denied a U.S. government request to put a hold on his order while the Obama administration readied an appeal.

The appeal was filed Monday just before the noon deadline, the Associated Press reported. In the document, the government contends that Korman overstepped his authority.

But Korman said politics are driving moves by U.S. Health and Human Services Secretary Kathleen Sebelius to block over-the-counter access to Plan B. Earlier this month, the U.S. Food and Drug Administration lowered the age limit for access to the emergency contraceptive from 17 to 15 years of age, but Korman believes that doesn't go far enough.

In the meantime, the Center for Reproductive Rights, which instigated the lawsuit behind Korman's decision, said it would answer the Obama administration's filing within 10 days, the AP reported. In papers filed before the court, the center said that delays in access to Plan B could be "life-altering" for some women, the AP said.

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