The Risk That DSM-5 Will Promote Even More Inappropriate Antipsychotic Exposure In Children and Teenagers

DSM-5 is considering adding a diagnostic category for young people who may be at higher risk of developing schizophrenia. Changing what otherwise would be risk factors for a future disease onset into a disease into its own right would open up floodgates for inappropriate and potentially harmful exposure to antipsychotic medication. The “at risk” population would not benefit from receiving a formal diagnosis because the proposed criteria stipulate that the individual already has to be help-seeking and desire psychiatric treatment, so already by definition these individuals are receiving psychiatric services. The implication that presence of risk factors implies future disease is not supported in epidemiologic studies in that there is insufficient specificity or sensitivity. Including the proposed risk category into DSM-5 therefore violates the basic medical principle of “first do no harm.”