To the OP
DSM 5 has not yet been released....(due to be released in 2013) The video is speculative and rather presumptuous.
Many of the inclusions are supported by science and field studies. Psychiatric evaluation process requires observational methods of analysis, which are historically a very useful mode of scientific enquiry. The information often presented to psychiatrists includes biological studies which have ruled out general biological causes, there is also consideration of those in proximity to the patient (if present and accessible) as to their observations of behaviours. Psychiatrists are very well educated, and if they have sufficient experience, they have a greater number of clinical observations to draw knowledge from. A complete picture is expected and a ruling out of possibilities is the practice. They are also trained in appropriate use of the DSM and other diagnostic tools, the book provides guidance, but the practice is about exploration and ruling out than it is about slapping someone with a book.
There are some mental disorders that can more observable than others, such as the repetition of acute OCD, the changes in personalities in personality disorders, and the belief systems of delusional, and self harm. Then there are others such as depression and dissociation that require a carefully trained eye. It can become automatic that when a patent walks into a room you start ruling out diagnosis based on obvious behavioural observations.
I see quite a bit of editing in the OP video, where they capture 'voice grabs' of psychiatrists prescribing and do not show what the undercover interviewer had said prior to this point. I may be not listening actively enough, but I did hear one psychiatrist comment that the interviewer said he was depressed and was taking him on face value. I would be much more concerned if the interviewer was diagnosed with a more obviously incorrect diagnosis at the behavioural observational stage, then speculating that it could be depression based on what the interviewer might have said.
We can also consider that the insurance questions of the psychiatrists may have been in response to payment for consultation and not just medication. If you have insurance, you don't need a diagnosis for justifying payment because it can be justified by an exploration of the problem - at least for a set number of investigations depending on policy you pay for or your work pays for.
Then there is whether the interviewer asked what the treatment was for depression and the psychiatrist answered the question, and if a prescription was handed over was at all, let alone the dosage provided. Some may offer such a small dose of medication that it is the inequivalent of a mild sleeping tablet to see the extent or severity of the problem. Ultimately, patients need to be as honest and truthful with psychiatrists, as much as psychiatrists need to be careful about prescribing.
If there is a skin picking reference in the DSM it may be a component of a broader illness like Body Dimorphic Disorder (BDD) within the self-harm spectrum. It is very difficult for anyone to use the DSM correctly without access to the DSM, proximity to the patient and enough time to make observations and obtain clarity of communication and feedback.
Many things considered ''culturally''acceptable have been revised with knowledge, like homosexuality, and like religious belief systems which could easily fit a delusional disorder if they are not culturally acceptable.
The fact that this process happens shows that there is some ''humanism'' in contributions and revisions of the DSM and a recognition of 'normal' and culturally acceptable behaviours, and a willingness to revise as more information comes to light, whether that be through field studies, or an acceptance of a ''cultural'' or ''societal view'' of behaviours or belief systems.
Those in the video that claim the DSM is a trading floor, may have made their own assumptions and have their own agendas. For example, one psychiatrist may not have been successful in achieving the changes he/she desired at the conference or did not feel listened to and reacted in a hostile way against the process because of personal bias, ambiguity, assumptions and hurt egos.
The other thing to consider as one person pointed out before was what is the agenda of the videos creator. We can talk a lot about compensation and insurance in a negative way as well as the pharmaceutics capitalism efforts. However, we can't ignore the compensation and capitalism of the Scientology who created the video. The growth strategy of belief followings is about donations and you get donations by putting bums on seats. I personally have observed multiple faiths who are targeting depression as a larger problem than it is, as they believe faith communities are only answer to curing depression. Or is it possible that those who feel a little sad, are unaware of the severity of a depression diagnosis, which faith groups can market to, to increase bums on seats and donations.
All the above is possible. The diagnosis is dependant on truthfulness an honesty of both parties. Assumptions are dangerous, yet we all make these assumptions nonetheless based on our own bias and perceptions.
