Re:Richard Stallman is coming back to the board of the FSF
by skissane on Monday March 22, 2021 @07:00AM
(#26539141)
> People who claim to have "moderate OCD" are just people who like things being tidy
Some people are actually diagnosed with "moderate OCD" though. Some psychiatrists like to use descriptors like "mild" or "moderate" or "severe" when they make a diagnosis. The DSM-5 doesn't include those terms as specifiers, but that doesn't stop some clinicians from using them anyway. (Clinicians vary widely in how strictly they adhere to the DSM-5.)
Also, while the DSM-5 doesn't include the concept of "mild"/"moderate"/"severe" OCD, some rating scales used clinically in diagnosing OCD do include such a distinction. Y-BOCS (Yale-Brown Obsessive Compulsive Scale) scores are divided into four ranges – subclinical, mild, moderate, severe, extreme. A person with an OCD diagnosis who scores in the moderate range of the Y-BOCS will quite possibly be told they have "moderate OCD".
The DSM-5 does include three specifiers of level of insight for OCD: "good or fair insight" ("The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true"), "poor insight" ("The individual thinks obsessive-compulsive disorder beliefs are probably true"), "absent insight/delusional beliefs" ("The individual is completely convinced that obsessive-compulsive disorder beliefs are true"). It is an oversimplification to equate that to "mild"/"moderate"/"severe", but some people will do it anyway.
Clinicians need to convey to patients (and their family members and others) the severity of the individual's condition in terms which lay people will readily understand. Terms such as "mild","moderate","severe", despite their limitations, meet that need.
> People really need to stop saying they have OCD unless they've been diagnosed by a professional.
Self-diagnosis is always a dangerous thing, but I think it includes a big spectrum of behaviours, from "I saw a TV show once about X and now I think I've got it" through to "I've read the DSM-5 and dozens of books and papers on X and I think I've got it". In both cases, the person could well be wrong, but arguably they have a significantly greater chance of being right in the second case than in the first. (And a lot of the time when people who engage in self-diagnosis get it wrong, they actually do end up diagnosed with something, just not the thing they expected.)
Speaking somewhat personally – I've listened to school teachers and psychologists tell me all these things our son does which are "symptoms of autism" and I'm sitting there the whole time thinking to myself "what's 'autistic' about that, I did that too as a child, I even still do that as an adult?" That's not saying that I do or don't have ASD – I've never sought a formal assessment of it for myself, maybe one day I shall, maybe I never will – but my suspicions that I might have ASD probably have somewhat more weight to them than "oh I saw a TV show about it once and now I think I have it".
Some people are actually diagnosed with "moderate OCD" though. Some psychiatrists like to use descriptors like "mild" or "moderate" or "severe" when they make a diagnosis. The DSM-5 doesn't include those terms as specifiers, but that doesn't stop some clinicians from using them anyway. (Clinicians vary widely in how strictly they adhere to the DSM-5.)
Also, while the DSM-5 doesn't include the concept of "mild"/"moderate"/"severe" OCD, some rating scales used clinically in diagnosing OCD do include such a distinction. Y-BOCS (Yale-Brown Obsessive Compulsive Scale) scores are divided into four ranges – subclinical, mild, moderate, severe, extreme. A person with an OCD diagnosis who scores in the moderate range of the Y-BOCS will quite possibly be told they have "moderate OCD".
The DSM-5 does include three specifiers of level of insight for OCD: "good or fair insight" ("The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true"), "poor insight" ("The individual thinks obsessive-compulsive disorder beliefs are probably true"), "absent insight/delusional beliefs" ("The individual is completely convinced that obsessive-compulsive disorder beliefs are true"). It is an oversimplification to equate that to "mild"/"moderate"/"severe", but some people will do it anyway.
Clinicians need to convey to patients (and their family members and others) the severity of the individual's condition in terms which lay people will readily understand. Terms such as "mild","moderate","severe", despite their limitations, meet that need.
> People really need to stop saying they have OCD unless they've been diagnosed by a professional.
Self-diagnosis is always a dangerous thing, but I think it includes a big spectrum of behaviours, from "I saw a TV show once about X and now I think I've got it" through to "I've read the DSM-5 and dozens of books and papers on X and I think I've got it". In both cases, the person could well be wrong, but arguably they have a significantly greater chance of being right in the second case than in the first. (And a lot of the time when people who engage in self-diagnosis get it wrong, they actually do end up diagnosed with something, just not the thing they expected.)
Speaking somewhat personally – I've listened to school teachers and psychologists tell me all these things our son does which are "symptoms of autism" and I'm sitting there the whole time thinking to myself "what's 'autistic' about that, I did that too as a child, I even still do that as an adult?" That's not saying that I do or don't have ASD – I've never sought a formal assessment of it for myself, maybe one day I shall, maybe I never will – but my suspicions that I might have ASD probably have somewhat more weight to them than "oh I saw a TV show about it once and now I think I have it".