PowerJet SaM146 not designed for rapid climb due to fuel saving technology

Thursday, May 10, 2012

MOSCOW – Russian investigators opened a criminal probe on Thursday into possible misconduct during preparations for the exhibition flight of a new Superjet 100 jet which came down in Indonesia.
The Investigative Committee said it would probe “the procedure for preparing the flight crew and also the technical condition of the craft itself before its departure from Russia.”
The twin-engine plane vanished from the radar screens on Wednesday about 50 minutes into its exhibition flight. Rescuers at the scene said on Thursday they had found bodies but no survivors.
Initial reports on the number of people on board varied between 46 and 50.
Russia’s Investigative Committee said it believed the plane was carrying 48 crew and passengers of five different nationalities including eight Russians.
The Russian investigators said they would question the technical personnel who prepared the crew for the flight “and representatives of the Sukhoi Civil Aircraft company involved in making the plane and preparing it for operations.”
The Russian committee said it was also studying the option of sending a team to Indonesia “that could be present for the investigation being conducted by the Indonesian law enforcement authorities.”
The PowerJet SaM146 is a turbofan engine produced by the PowerJet joint venture (not to be confused with Power Jets) between Snecma of France and NPO Saturn of Russia.[2] Snecma is in charge of the core engine, control system (FADEC), transmissions (accessory gearbox, transfer gearbox), overall engine integration and flight testing.[citation needed] NPO Saturn is responsible for the components in the low pressure section and engine installation on the Sukhoi Superjet 100 regional aircraft and ground testing.[citation needed]

The SaM146 design is based on the CFM56[3]. In keeping with the design and development of jet engines from manufacturers like Pratt & Whitney Canada, General Electric and Rolls Royce, the engine has been conceived to meet customer requirements regarding fuel burn, cost of operation and dispatch reliability.
The core was developed by Snecma, drawing on its M88 ‘hot section’ military engine experience and the DEM21 core demonstrator project – with its six-stage compressor and single-stage, high-pressure turbine with active blade-tip clearance control – and various other modern design features (such as single-piece bladed disks).
The SaM146 provides 62 to 77.8KN of thrust (6,200 to 7,700 kg). In April 2003, Sukhoi Civil Aircraft Company selected the SaM146 for its Superjet 100 regional aircraft, to be produced in 75 and 95-seat versions.
The SaM146 utilizes a single-stage turbine and as a new design has been developed to meet current and projected environmental standards, including regulations of the ICAO Committee of Aviation Environmental Protection Sixth Session (CAEP VI), set to become effective in 2008.[citation needed]
Blisk technology is used to improve fuel economy and lower maintenance.[4]
On 23 June 2010, it was announced that EASA certified PowerJet for its SaM146 engine.[5] It gained Russian certification in August 2010.[6]
As is usual with modern jet engines, PowerJet intends to offer the usual range of support services for operators.
Investigators are now examining taped conversations between the pilots and air-traffic control, particularly the pilot’s request to descend from 10,000ft to 6,000ft seconds before the plane disappeared from radar screens.
“The airplane crashed at the edge of Salak mountain,” said Indonesian president Susilo Bambang Yudhoyono. “An investigation must be done immediately and thoroughly.” Aerial pictures from the crash scene revealed tiny sections of wreckage from the wings and fuselage scattered down an exposed stretch of cliff surrounded by the dense forest.
Indonesia’s search and rescue agency chief, Daryatmo, said: “From the pictures we’re seeing it looks like it was a total loss.” Sukhoi has already won 170 orders worldwide for its Superjet-100 and was aiming to sell 42 in Indonesia alone, competing against similar-sized offerings in the passenger jet market from Brazil’s Embraer and Canada’s Bombardier.
If the cause of the crash turns out ultimately to be a pilot or air-traffic control error, the effects on sales might not prove too disastrous. But a technical fault in the jet that has already suffered delays could be catastrophic for orders.


Who selected the route of the ill fated aircraft, it is not designed to climb mountains with rapid acceleration due to it’s fuel saving technology. I supposed the pilot is experienced in flying larger jets but have no experience flying the Superjet 100. Other than that, there should not be any problems. – Contributed by Oogle. 


On Thursday, Russia’s acting Deputy Prime Minister Dmitry Rogozin said experts believe “human factor” was the most probable cause of the fatal crash of the aircraft.
“Experts say that all [the aircraft’s] equipment functioned smoothly. In other words, it could be some kind of a human error,” Rogozin told journalists.

Posted: 16 May 2012 0224 hrs
Indonesia team finds crashed Sukhoi’s black box
CIJERUK, Indonesia: A search team in Indonesia found Tuesday the black box of a Russian jet that could explain how a veteran pilot crashed the new plane into a dormant volcano last week, killing all 45 aboard.
“We found the black box at around 10 this morning (0300 GMT),” Ketut Parwa, head of the search operation, told reporters late Tuesday near the crash site at Mount Salak in western Java.
“It was found around 100 metres (328 feet) from where we located the tail.”

It's robbery and sadistic torture

New Straits Times
Friday, May 11, 2012

KUALA LUMPUR – While their father was claiming the body of their mother from Kuala Lumpur Hospital yesterday, the couple’s two children were at school sitting their first term examinations.
The children, a 12-year-old boy and a 10-year-old girl, had cried and grieved a day earlier after learning that their mother, real estate agent Chen Choi Mooi, 39, had been murdered before her body was dumped near Batu Dam, Gombak, near here.
Their father, Liew Yang Sei, 41, and family members had agreed that they did not want the children to dwell on their mother’s death and preferred them to sit their exams.
Liew and the rest of his family, were questioned by police while waiting for the post-mortem report at the mortuary yesterday.
Liew, also a real estate agent, later demanded answers for his wife’s murder.
“I want to know who did this to her, and why,” he said.”I cannot believe this could happen in broad daylight.”
Chen’s body was found near the dam on Wednesday night. She had strangulation marks on her neck, while her mouth, eyes and forehead were swollen.
Chen was last seen by her husband on Tuesday at 10am when he left their apartment in Jinjang Utara.
It was learnt that Chen had gone to meet a prospective tenant at 1pm.
She left after taking RM2,000 (S$818) from the couple who had wanted to rent a house, agreeing to meet them again at 3pm to hand them the house keys but did not keep the appointment.
Chen had apparently told the couple that she would be meeting the landlord of the house and another client before meeting them again later.
Her husband became worried when a neighbour dropped his children off from tuition as Chen, who was to pick them, did not show up.
He called his wife’s sisters but no one had seen her since that afternoon. He lodged a missing person’s report at 8pm.
At 10am on Wednesday, the family found Chen’s Proton Iswara in Batu 5, Jinjang. There was a pool of blood in the boot.
Later that night, Liew received a call from police, asking him to come to the KLH mortuary to identify a body.
Chen was still clad in the black T-shirt and black skirt which she had on when last seen on Tuesday.
Police had found a trail of blood, revealing that Chen had been dragged for more than five metres before her body was dumped.
The victim, the youngest of 10 siblings, was described as a religious person who was active in the temple and had many friends.
Gombak police chief Assistant Commissioner Abdul Rahim Abdullah said post-mortem results revealed that the victim died of strangulation. There were bruises on both her wrists, suggesting she was bound.
Her handbag, containing two handphones and an undisclosed amount of cash, was missing.
Rahim said they had yet to make any arrests. He declined to comment further.
Evidence from her mobile records will identify the “client”‘s mobile number, and his most common gps location which he cannot hide, this person has a history of sadistic violence and must be put away for good.  
– Contributed by Oogle.

The World will not fall back into a recession

04:45 AM May 08, 2012
ROME – Several candidates opposed to austerity measures were making a strong showing yesterday in early projections from Italy’s local elections – the first nationwide test for Premier Mario Monti since he was named to save Italy from its debt crisis.
In Germany, a state election on Sunday could be an omen of worse to come for Chancellor Angela Merkel’s coalition.
Analysts in Italy were watching for signs of voter anger over austerity measures and towards mainstream parties that have supported them since Mr Monti took over from Mr Silvio Berlusconi in November.
Candidates for Mayor in Parma and in Genoa, who galvanised discontent with mainstream politics, appeared to gain enough votes to force a run-off, projections showed. The Mayor of Verona, whose Northern League party has strongly opposed a new housing tax, appeared headed to a first-round victory.
In Germany, voters in the northernmost state of Schleswig-Holstein appeared to have ousted their centre-right government made up of Ms Merkel’s conservatives and the pro-business Free Democrats, according to exit polls released by local broadcasters.
Although Ms Merkel’s Christian Democrats emerged as the strongest party in Sunday’s election, winning 30.5 per cent of the vote, that would not be enough to remain in power in the state with the Free Democrats, which slid from 14.9 per cent to 8.2 per cent.
The opposition Social Democrats gained about 4.5 per cent and secured 30.1 per cent of the vote, the Greens stood at about 13 per cent, followed by the Pirates with 8 per cent. It remains unclear which party will be able to form a coalition government.
The outcome of the vote was being viewed as setting the tone for next week’s election in Germany’s most populous state, North Rhine-Westphalia. It was also seen as a foreshadowing of things to come when Ms Merkel’s coalition is put to the test in elections next year. Agencies


Updated 04:05 PM May 07, 2012

LONDON – Prime Minister David Cameron said today that the coalition government must “focus on what matters” in the wake of dismal local election results for his Conservative party.
Mr Cameron said his party cannot use “familiar excuses”, such as low turnout and economic downturn, for the dip in its popularity.
“I get the message, loud and clear. I know that the familiar excuses aren’t enough,” Mr Cameron said in an interview with the Daily Telegraph.
Voters punished the government’s leading coalition partner, for unpopular austerity measures that failed to avert a double-dip recession.
“The message people are sending is this: focus on what matters, deliver what you promise – and prove yourself in the process. I get it.”
Mr Cameron said the government must not be seen as a “bunch of accountants,” but must encourage the “strivers, the battlers, the people with aspiration” and stop their lives becoming a “daily grind”.
The re-election of Boris Johnson in the London mayoral race softened the blow, but there was no mistaking the message from voters to the Conservatives and their Liberal Democrat coalition partners.
“People want to know that we’re not just a bunch of accountants trying to turn around the British economy like it is a failing company, but that we are resolutely on their side as we do this vital work,” said Mr Cameron. REUTERS

The work is done, there is only progress ahead, nothing will change what God has decreed, there is nothing no-one does that will change the outcome in 2012, everything has been predicted, even if France and Greece were to exit the Euro, all risks has been taken into account, everything will be on autopilot, the economies of US, China and Asia will recover and pull up the EU, everything will be cast in iron very soon, before the end of 2012.
Don’t take my words for it, watch how the public respond to Facebook IPO and you can relate to the “real investor’s sentiments”.
– Contributed by Oogle.

Antibiotic Resistence and TB, HFMD, and STD outbreak

Antibiotic resistance is a type of drug resistance where a microorganism is able to survive exposure to an antibiotic. While a spontaneous or induced genetic mutation in bacteria may confer resistance to antimicrobial drugs, genes that confer resistance can be transferred between bacteria in a horizontal fashion by conjugation, transduction, or transformation. Thus, a gene for antibiotic resistance that evolves via natural selection may be shared. Evolutionary stress such as exposure to antibiotics then selects for the antibiotic resistant trait. Many antibiotic resistance genes reside on plasmids, facilitating their transfer. If a bacterium carries several resistance genes, it is called multidrug resistant (MDR) or, informally, a superbug or super bacterium.
Genes for resistance to antibiotics, like the antibiotics themselves, are ancient.[1] However, the increasing prevalence of antibiotic-resistant bacterial infections seen in clinical practice stems from antibiotic use both within human medicine and veterinary medicine. Any use of antibiotics can increase selective pressure in a population of bacteria to allow the resistant bacteria to thrive and the susceptible bacteria to die off. As resistance towards antibiotics becomes more common, a greater need for alternative treatments arises. However, despite a push for new antibiotic therapies there has been a continued decline in the number of newly approved drugs.[2][clarification needed] Antibiotic resistance therefore poses a significant problem.
There appears to be a connection with the outbreaks of TB, HFMD and STD due to antibiotic resistence that mutates into new forms of bacteria that will not be effective with today’s drugs.  
04:45 AM May 09, 2012
MUMBAI – A new superbug from India could spread around the world – in part because of medical tourism – and scientists say there are almost no drugs to treat it.
Researchers said yesterday they had found a new gene called New Delhi metallo-beta-lactamase, or NDM-1, in patients in South Asia and in Britain.
United States health officials said yesterday there had been three cases so far in the US – all from patients who received recent medical care in India, a country where people often travel to in search of affordable healthcare.
NDM-1 makes bacteria highly resistant to almost all antibiotics, including the most powerful class called carbapenems. Experts say there are no new drugs on the horizon to tackle it.
“It’s a specific mechanism. A gene that confers a type of resistance (to antibiotics),” Dr Alexander Kallen of the US Centers for Disease Control and Prevention in Atlanta said in a telephone interview.
With more people travelling to find less costly medical treatments, particularly for procedures such as cosmetic surgery, lead author Timothy Walsh, from Britain’s Cardiff University, said he feared the new superbug could soon spread across the globe.
In a study published in The Lancet Infectious Diseases journal, Prof Walsh’s team found NDM-1 is jumping beyond India. More than 40 countries have discovered the genetically altered superbugs in blood, urine and other patient specimens. Canada, France, Italy, Kosovo and South Africa have found them in people with no travel links, suggesting the bugs have taken hold there.
The researchers said the epicentre is India, where drugs created to fight diseases have taken a perverse turn by making many ailments harder to treat.
India’s US$12.4 billion (S$15.5 billion) pharmaceutical industry manufactures almost a third of the world’s antibiotics and people use them so liberally that relatively benign and beneficial bacteria are becoming drug immune in a pool of resistance that thwarts even high-powered antibiotics, the so-called remedies of last resort.
Poor hygiene has spread resistant germs into India’s drains, sewers and drinking water, putting millions at risk of drug-defying infections. Antibiotic residues from drug manufacturing, livestock treatment and medical waste have entered water and sanitation systems, exacerbating the problem.
As the super bacteria take up residence in hospitals, they are compromising patient care and tarnishing India’s image as a medical tourism destination.
“It’s a matter of time and chance,” said Dr Mark Toleman, a molecular geneticist at Cardiff University.
“There is a tsunami that’s going to happen in the next year or two when antibiotic resistance explodes. We need wartime measures to deal with this now.”
Mr R K Srivastava, India’s former Director-General of Health Services, said the government is giving top priority to antimicrobial resistance, including increasing surveillance of hospitals’ antibiotics use.
At the same time, it is trying to preserve the country’s health-tourism industry. Bristling that foreigners coined a name that singles out their capital to describe an emerging health nightmare, officials say the world is picking on India for troubles that impede all developing nations.
“These bacteria were present globally,” said Mr Nirmal K Ganguly, a former director-general of the Indian Council of Medical Research and one of 13 members of a government task force created in September 2010 to respond to the NDM-1 threat.
“When you are blamed, the only reaction is that you put your back to the wall and fight,” he said. Agencies

Never bite the hand that feeds you ; It is a political issue, so a political solution is required

By Ingrid Melander and Renee Maltezou

ATHENS | Tue May 8, 2012 9:00pm EDT

(Reuters) – Radical leftist Alexis Tsipras meets the leaders of Greece’s mainstream parties on Wednesday to try to form a coalition government, an effort seen as doomed after he demanded they first agree to tear up the country’s EU/IMF bailout deal.
An inconclusive election on Sunday has left Athens in political disarray, with no clear path to form a government, a new election likely within weeks and speculation escalating that Greece could be pushed out of Europe’s single currency bloc.
Voters enraged by economic hardship repudiated the two parties which led Greece for decades – conservative New Democracy and Socialist PASOK – the only groups that back the 130 billion-euro bailout which saved Greece from bankruptcy.
The remote chance of Tsipras forming a coalition faded even further on Tuesday when New Democracy leader Antonis Samaras promptly rejected his demand to scrap the bailout, warning such a move could drive the debt-choked country out of the euro.
“Mr. Tsipras asked me to put my signature to the destruction of Greece. I will not do this,” Samaras said. “The country cannot afford to play with fire.”
Tsipras’s leftist party placed second on Sunday, while New Democracy and PASOK – which between them had 77 percent of the vote just three years ago – saw their combined share fall to just 32 percent and PASOK reduced to third place.
Samaras was given the first chance to form a government but failed. On Tuesday Tsipras was given three days to try. He will meet Socialist PASOK leader Evangelos Venizelos at 1500 GMT on Wednesday and Samaras at 1600 GMT.
If, as increasingly seems likely, no politician is able to cobble together a majority in the 300-seat parliament, a new election would have to be held in 3-4 weeks. Samaras may be hoping Greeks will give him a stronger mandate in a new vote.
“After Samaras’s response to Tsipras today, that particular bridge (the chance of a coalition deal between these parties) has been exploded, burned,” said Theodore Couloumbis, political analyst for Athens-based think-tank ELIAMEP.
Rivals for decades, New Democracy and PASOK had been ruling jointly in an uneasy coalition that negotiated last year’s bailout, which saw lenders demand ever-deeper spending cuts in a country already suffering five straight years of recession.
Most Greeks say they want to keep the euro currency – widely seen as impossible without the bailout – but they are furious with the two mainstream political parties they blame for the recession, record high unemployment and endemic corruption.
Most believe spending cuts demanded by the EU and International Monetary Fund are only making the situation worse by increasing unemployment and preventing economic recovery.
Even with a system that gave first-placed New Democracy an extra 50 seats – designed to make it easier to form stable governments – it and PASOK together fell short of a majority to renew their coalition, with only 149 seats between them.
On the streets of Athens, voters voiced exasperation over the lack of a deal between parties.
“They are all saying they don’t want to cooperate with anyone else. What does this show? All they care about is being prime minister, nobody cares about the country,” said Vasilia Konidary, who voted for Drasi, a tiny liberal party.
Theoretically, it could still be possible for Tsipras to form a left-leaning coalition with PASOK, if New Democracy abstained in a confidence vote rather than opposing it.
Such a scenario seems extremely unlikely, but PASOK leader Venizelos left the door slightly open on Tuesday by renewing calls for all the country’s pro-European parties to form a coalition and avoid a second round of elections.
“The Greek people asked for two things: For Greece to stay safely in Europe and the euro and at the same time to seek the best possible change in (bailout) terms so that citizens and growth can be helped,” Venizelos said.
If Tsipras fails, the president will give Venizelos, whose party was the biggest loser in the election, the last chance to try to form a government. If he should fail, new elections loom.
ELIAMEP’s Couloumbis said many Greeks may still be hoping Europe will bail them out and keep them in the euro zone, even if they reject the austerity demanded by the EU and IMF.
“Many here think Europe cannot afford to let Greece go down that path – that all we have to do is tell them we’ll jump from the 10th floor and they will have a safety net for us,” he said. “I say: ‘Beware, you may hit the ground and break into many pieces.'”
(Additional reporting by Karolina Tagaris; Editing by Peter Graff)
Do you expect the EU/IMF bailout for Greece is without conditions and you expect a free handout? This expectation is only meant for kids asking for sweets from their parents. If you play with fire, expect to face the music and the results will be Greece will default on the terms of EU/IMF fundings and everything will stop there, an irregular default will sent Greece out of the Eurozone and the economy will be in shambles, there is enough firepower to isolate the rest of the Eurozone from a Greece exit, do you think austerity measures on a road to recovery is a safer bet? This is a political issue and you need a political solution, no use gathering votes when you cannot compound the problem.
– Contributed by Oogle. 

My Inventions will create jobs for thousands of programmers

More than 100 international technology companies have interest in becoming residents of a floating city located in international waters outside of Silicon Valley. The project, called Blueseed, was co-founded by Max Marty and Dario Mutabdzija and lead by venture capitalist and PayPal co-founder Peter Thiel. The company is looking to either convert a cruise ship or remodel a barge in into a pirate island that would provide living accommodations, working space and entertainment facilities for approximately 1,000 customers paying between $1,200 and $3,000 each per month. Read on for more.
The vessel will be stationed 12 nautical miles from the coast of California, in international waters, and it will have a crew of 200 to 300 people. The location would enable non-U.S. startup entrepreneurs to work close to Silicon Valley without the need for a U.S. work visa.
Research released by Blueseed revealed demand from interested U.S.-based companies sat at 20.3%, while Indian and Australian companies made up 10.5% and 6% respectively. The company also found that across the U.S., nearly 7,000 computer science Master’s and PhD graduates each year are foreign nationals, and many encounter difficulties finding jobs before being forced to go home. Blueseed is looking to change that when it launches in the third quarter of 2013.
My Timeline is such that I maybe able to complete my 3D search engine with intelligent search capabilities within 1 year, but I need at least 80-100 programmers and leaders working fulltime to assemble the billions of codes, funding by the government may not be enough, but the completed product will be worth hundred of billions, even greater than Facebook IPO, so I suppose there will be private equity willing to invest. My Intelligent Software will be a greater challenge, not only I have to wait for the high level Intelligent Programming language to be invented by someone, the hardware vendor’s invention of the next quantum computer’s specifications, to be able to finalised the Intelligent OS, so I guess it will take about 5 years, to complete the prototype. There is no way I can do this alone, so I will definitely need partners to collaborate, to create the greatest machine for problem solving for mankind.
There is no way I can participate in hundreds of other research projects with relates to the brain and solving sickness and diseases, but I have already provided the spark, and many have already succeeded from the leads I provide, and I will continue to provide the spark, until it becomes an inferno, until there is no longer any problem to solve, to ultimately solve Hunger and Poverty, Death and Disease for the UN, for peace and prosperity for everyone.
Since my objectives is not about money, and I do not require great riches to maintain myself, I can help the world solve problems without a single cost, only the resources you need yourself.
– Contributed by Oogle. 

Psychiatry's "Bible" Gets an Overhaul

By Ferris Jabr  | May 7, 2012 |
Editor’s Note: Read our blog series on psychiatry’s new rulebook, the DSM-5.
Psychiatry’s diagnostic guidebook gets its first major update in 30 years. The changes may surprise you

In February 1969 David L. Rosenhan showed up in the admissions office of a psychiatric hospital in Pennsylvania. He complained of unfamiliar voices inside his head that repeated the words “empty,” “thud” and “hollow.” Otherwise, Rosenhan had nothing unusual to report. He was immediately admitted to the hospital with a diagnosis of schizophrenia.
Between 1969 and 1972 seven friends and students of Rosenhan, a psychology professor then at Swarthmore College, ended up in 11 other U.S. hospitals after claiming that they, too, heard voices—their sole complaint. Psychiatrists slapped them all with a diagnosis of schizophrenia or bipolar disorder and stuck them in psychiatric wards for between eight and 52 days. Doctors forced them to accept antipsychotic medication—2,100 pills in all, the vast majority of which they pocketed or tucked into their cheeks. Although the voices vanished once Rosenhan and the others entered the hospitals, no one realized that these individuals were healthy—and had been from the start. The voices had been a ruse.
The eight pseudopatients became the subject of a landmark 1973 paper in Science, “On Being Sane in Insane Places.” The conclusion: psychiatrists did not have a valid way to diagnose mental illness.
Rosenhan’s experiment motivated a radical transformation of the essential reference guide for psychiatrists: the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA). The revamped DSM, dubbed DSM-III and published in 1980, paired every ailment with a checklist of symptoms, several of which were required for a diagnosis to meet the book’s standards. Earlier versions of the DSM contained descriptive paragraphs that psychiatrists could interpret more loosely. This fundamental revision survives today.
The APA is now working on the fifth version of the hefty tome, slated for publication in May 2013. Because the DSM-IV was largely similar to its predecessor, the DSM-5 embodies the first substantial change to psychiatric diagnosis in more than 30 years. It introduces guidelines for rating the severity of symptoms that are expected to make diagnoses more precise and to provide a new way to track improvement. The DSM framers are also scrapping certain disorders entirely, such as Asperger’s syndrome, and adding brand-new ones, including binge eating and addiction to gambling.
In the past the APA has received harsh criticism for not making its revision process transparent. In 2010 the association debuted a draft of the new manual on its Web site for public comment. “That’s never been done before,” says psychiatrist Darrel Regier, vice chair of the DSM-5 Task Force and formerly at the National Institute of Mental Health. The volume of the response surprised even the framers: 50 million hits from about 500,000 individuals and more than 10,000 comments so far.
Critics swarmed the drafts. Some psychiatrists contend that the volume still contains more disorders than actually exist, encouraging superfluous diagnoses—particularly in children. Others worry that the stricter, more precise diagnostic criteria may inadvertently give insurance companies new ways to deny medication to patients who need it.
The debates surrounding the manual’s revisions are not merely back-office chatter. Although many psychiatrists do not sit down with the DSM and take its scripture literally—relying instead on personal expertise to make a diagnosis—the DSM largely determines the type of diagnoses clinicians make. Insurance companies often demand an official DSM diagnosis before they pay for medication and therapy. Many state educational and social services—such as after-school programs for kids with autism—also require a DSM diagnosis. Consequently, psychiatrists cannot dole out diagnoses of their own invention. They are bound to the disorders defined by the DSM.

Therefore, psychiatrists cannot ignore the new manual and go about business as usual. They must adapt, especially if they want to be sure that their patients keep receiving affordable treatment. Yet this diagnostic bible is a work in progress. In fact, although the revisions are 90 percent complete, the APA may still make significant changes and even delay the book’s official release. Even after its publication, the DSM will remain a snapshot of a field in flux—an ambitious attempt to capture an evolving, often ambiguous science.
Diagnosing the DSM
Psychiatrists have been kicking around the DSM-5 in a scientific scrimmage that dates back to 1999, when the APA and the NIMH sponsored a meeting to jump-start planning. More than 13 joint conferences later, committees of psychiatrists and psychologists have churned out dozens of white papers outlining how best to overhaul psychiatry’s bible. In April 2006 the APA appointed clinical psychologist David Kupfer and Regier as chair and vice chair, respectively, of a team of 27 scientists assigned to digest the research literature and propose revisions to this historic volume.

Right away researchers fingered several major failings of the DSM-IV. First, many of the symptom checklists were so similar that many patients left a psychiatrist’s office with several official diagnoses rather than just one. It is unlikely that large numbers of patients each have a variety of different disorders, says Steven Hyman, a task force member. Rather, he suggests, a single cognitive or biological process—maladaptive thought patterns, for instance, or atypical brain development—may manifest itself in symptoms of more than one ailment. To address this problem, curators of the new book eliminated over a dozen less distinct disorders, in some cases merging them into larger categories of illness, such as the autism spectrum [see “Psychosis Revisited”].
Patients and their psychiatrists often struggle with the opposite problem, too: a person’s symptoms might be fewer or milder than those listed in the DSM or simply do not match any disorder in the manual. As a result, psychiatrists slap large factions of their clientele with a “disorder not otherwise specified” label. The most frequently diagnosed eating disorder is “eating disorders not otherwise specified.” The predominant autism spectrum disorder? By most estimates it is “pervasive developmental disorder not otherwise specified.” The third most common personality disorder is, you guessed it, “personality disorder not otherwise specified.” Health professionals rely so heavily on catchall diagnoses because the current DSM has some serious gaps in its diagnostic offerings and has some superfluous entries.
In addition to eliminating ailments, the DSM-5 will encourage psychiatrists to collect more detailed information about patients’ symptoms. With more data to consider and more complete descriptions in the manual, the theory goes, psychiatri
sts are more likely to find a proper match between a patient and an illness.

Degrees of Dysfunction
To improve diagnoses, the DSM-5 asks doctors to grade the severity of their clients’ symptoms. A verdict of major depression, for example, will include a rating for each symptom—insomnia, say, or thoughts of suicide. Similarly, a child who is diagnosed with attention-deficit hyperactivity disorder would also receive an assessment of her ability to focus, ranging from poor to excellent.

This ideological shift signals a step away from the simplistic notion that mental illnesses are discrete conditions wholly distinct from a healthy state of mind. Instead the new volume reflects the idea that everyone falls on a spectrum that stretches from typical behavior to various shades of dysfunction. Where you land on that scale determines whether your symptoms merit treatment. This approach might assist, for example, psychiatrists evaluating a patient’s attention problems, which can seem almost ubiquitous in younger children. Considering an individual in the context of others can make it easier to flag the neediest cases. Psychiatrists, of course, already use many scales and questionnaires in their practice. The DSM-5 will standardize such ratings so that doctors use the same scales to measure a given disorder and increase the chances they will reach similar conclusions about comparable patients.

These detailed assessments should allow treatments to become more tailored. For example, a patient with mild signs of depression is more likely to benefit from therapy and lifestyle changes than from antidepressant medication, which recent findings suggest is more
effective for severe depression. Psychiatrists and patients will also gain a new way to track improvement. A shift in the depression gauge from “severe” to “moderate” may in itself lift a patient’s spirits, motivating him to stick to the regimen propelling his progress.

Although most psychiatrists support the idea of measuring severity, practitioners have also voiced various concerns. Placing several previously distinct disorders under the umbrella of autism, for example, has ignited fears that autistic people with less severe symptoms will no longer qualify for a diagnosis or treatment. Questions have also been raised about how insurance companies will respond: Could these scales create barriers to treatment? A simple diagnosis of depression may no longer be enough to qualify a patient for anti­depressants—insurance companies may demand that a patient’s depression meet a certain severity level.
The new procedures will require patients to complete more evaluations and surveys than ever before, culminating in larger amounts of paperwork and more time spent on every diagnosis. Some psychiatrists worry the extra effort will deter their peers from using the DSM properly—and a few have even proposed doing away with the severity ratings altogether. More broadly, psychiatrists have also objected to the addition of certain disorders that they consider dubious.
A Primitive Guide?
A second sweeping change to the DSM is the way it clusters disorders. The DSM-IV was organized around three categories of illness. One group captured all major clinical disorders, such as depression, bipolar disorder and schizophrenia. Another section encompassed all personality and developmental disorders. The third category contained “medical” problems that might play a role in mental illness: diabetes or hypothyroidism, for instance, can exacerbate depression. The DSM-5 throws these relatively arbitrary divisions out the window. Instead it arranges diseases chronologically, starting with illnesses that psychiatrists typically diagnose in infancy or childhood—such as neurodevelopmental disorders—and moving toward those frequently found in adults, such as sexual dysfunctions. When evaluating a toddler, for instance, a psychiatrist can focus on the front of the DSM-5 or the beginning of a chapter, say, on depressive disorders, where he or she will find the types of depression most likely to afflict children.

As genetic and neuroimaging studies improve our understanding of the relations among ailments, the DSM will be able to swiftly adapt. The APA plans to publish the new manual in print and as a “living” electronic document that can be updated frequently as version 5.1, 5.2, and so on. (The APA dispensed with Roman numerals to make this labeling practical.)
Eventually researchers aim to root the DSM in the biology of the brain. Someday scientists hope to find useful “biomarkers” of mental illness—genes, proteins or patterns of electrical activity in the brain that can serve as unique signatures of psychiatric problems. Lab tests based on such markers would make diagnosing mental illness easier, faster and more precise.
“The DSM has always been a primitive field guide to the world of psychological stress because we know very little about the underlying neural chemistry of psychological symptoms,” says psychiatrist Daniel Carlat of the Tufts University School of Medicine. “But over the past 60 or 70 years the categories have become more reliable and meaningful.” No one argues that the DSM flawlessly mirrors mental illness as people experience it, but every revision sharpens the reflection—and with it, people’s understanding of themselves. 

Fast Facts: A New Guide to Your Psyche
1.The fifth version of psychiatry’s bible, the Diagnostic and Statistical Manual of Mental Disorders, slated for publication in May 2013, represents the first substantial change to psychiatric diagnosis in more than 30 years.

2.In 2010 the American Psychiatric Association debuted a draft of the new manual on their Web site that has so far received 50 million hits from about 500,000 individuals, many of them critics.
3.The revised manual will very likely scrap psychiatry staples such as Asperger’s syndrome and paranoid personality disorder.
4.Additions to the diagnostic menu are likely to include an ailment for children marked by severe temper tantrums and for adults a type of sex addiction.
Psychosis Revisited
Schizophrenia is characterized by a tenuous grasp of reality, difficulty thinking and speaking clearly, and unusual emotional responses. In today’s diagnostic manual, the DSM-IV, this complex disorder is split up into the following “types”:

  • Paranoid: delusions and auditory hallucinations but normal speech and emotional responses.
  • Disorganized: erratic speech and behavior and muted emotions.
  • Catatonic: unusual postures and movements or paralysis.
  • Residual: very few typical symptoms but some odd beliefs or unusual sensory experiences.
  • Undifferentiated: none of the other types.

Yet another form of the illness is shared psychotic disorder: when someone develops the same delusions as a friend or family member with schizophrenia.
Soon you can forget all these variants. As with certain personality disorders, there is little evidence for the existence of these discrete categories. Catatonia, for instance—an intermittent “freezing” of the limbs—also accompanies bipolar disorder, post-traumatic stress disorder and depression. Therefore, psychiatrists say it makes little sense to call it a form of schizophrenia. Catatonia also does not respond well to the antipsychotic medications used to treat schizophrenia.
Even as it sheds these subtypes, the DSM-5 embraces novel forms of psychosis. The most contentious is attenuated psychosis syndrome, a cluster of warning signs that some researchers think precede the frequent delusions and hallucinations that characterize the full-blown disorder. Its purpose is to catch young people at risk and prevent this insidious progression. Critics contend, however, that two thirds of the children who qualify for the at-risk criteria never develop real psychosis and may unnecessarily receive powerful drugs [see “At Risk for Psychosis?” by Carrie Arnold; Scientific American Mind, September/October 2011]. After all, about 11 percent of us sometimes hear voices or engage in moments of intense magical thinking with little or no distress.
Another controversial addition is disruptive mood dysregulation disorder, a diagnosis for kids that carries less stigma than its predecessor, childhood bipolar disorder. Since about 2000, diagnoses of pediatric bipolar disorder have jumped at least fourfold in the U.S. Many psychiatrists, however, argued that their peers were mislabeling a condition that was not bipolar disorder at all and treating children with strong drugs before knowing what really ailed them.
Very few people younger than 20 develop true bipolar disorder, in which moods swing between depression and mania. The vast majority of the kids who received the label did not, in fact, oscillate in this way. Instead they were in a bad mood all the time and frequently exploded in anger and physical violence, even in response to a minor offense. Because of these differences, disruptive mood dysregulation disorder describes a child (younger than 10) who is constantly irritable and has extreme temper tantrums about three times a week.

The APA says this pediatric entry will “provide a ‘home’ for these severely impaired youth,” but some critics worry doctors will dole out the diagnosis like lollipops to droves of tantrum-prone toddlers. The treatment is the same, despite the new name: a mixture of mood stabilizers, antipsychotics, anti­depressants and stimulants. —F.J.
Personality Problems
To a psychologist, a personality consists of persistent patterns of thought, emotion and behavior. Someone with a personality disorder has rigid and dysfunctional patterns that disrupt his or her ability to maintain healthy relationships. The current encyclopedia of mental illness, the DSM-IV, describes 10 such conditions. These include paranoid personality disorder—the inability to trust others and an irrational belief that people are out to get you—and narcissistic personality disorder, an exaggerated sense of self-importance, a need for constant admiration and excessive envy of others.

Suspiciously, between 40 and 60 percent of all psychiatric patients are diagnosed with a personality disorder, hinting that symptoms of at least some of these “disorders” resemble typical behavior too closely. In addition, psychiatrists often diagnose the same patient with more than one ailment, suggesting significant overlap. For example, people with both histrionic and narcissistic personality disorders insist on being the center of attention, take advantage of their families and friends, and have trouble reading others’ emotions.
The upshot: DSM-5’s editors nixed histrionic personality disorder. Paranoid, schizoid and dependent personality disorders are also gone. Your personality can still, however, be narcissistic, antisocial, avoidant, borderline, obsessive-compulsive or “schizotypal.” —F.J.
Good-bye to Asperger’s?
Certain behavioral quirks have long been thought to distinguish Asperger’s syndrome from other autistic disorders. “Aspies,” as people with this affliction sometimes call themselves, tend to develop intense fascination with very specific objects or facts—the wheels of toy cars or the names of constellations—in the absence of a general interest in, say, automotive mechanics or astronomy. Now the diagnosis will disappear, and Aspies may find an important part of their identity stripped away.

Currently Asperger’s is one of five so-called pervasive developmental disorders, along with autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and the lesser-known Rett syndrome and childhood disintegrative disorder (CDD). All these problems are characterized by deficits in communication and social skills as well as by repetitive behaviors. Indeed, the APA has decided that four of the five disorders—autistic disorder, Asperger’s, CDD and PDD-NOS—are so similar that they should all be placed into a new category called autism spectrum disorder (ASD). Psychiatrists using the new DSM will give anyone on the spectrum a diagnosis of ASD, along with a rating of illness severity.
Children whom psychiatrists would previously have diagnosed with CDD fall at the more severe end of the spectrum. They typically experience an almost complete deterioration of social and communication skills starting sometime between the ages of two and 10. Asperger’s patients will land on the milder end. They generally do not show language delays and, in fact, often display excellent verbal skills. Rett syndrome, in which known genetic mutations stunt physical growth, along with language and social skills, is gone from the manual entirely. Ironically, the APA is eliminating it because a genetic test for the condition makes diagnosis so precise and straightforward. For now the DSM prefers to limit itself to a blunter diagnostic measure: behavior.

Statistical studies published in 2011 and 2012 confirm that the DSM-5 criteria for autism are more accurate than those penned in the DSM-IV. The revised guidelines practically guarantee that anyone told they have the disorder really has it. To qualify as autistic by the new manual, a patient must meet five of seven symptoms—a higher bar than the six-of-12-symptom cutoff in the DSM-IV.
Some psychiatrists say the new rules are too strict: they worry some high-functioning autistic people, such those now diagnosed with Asperger’s, may not meet the criteria and may miss out on educational and medical services as a result. On the other hand, if people with milder autismlike symptoms do make it onto the spectrum, the lack of an Asperger’s label could benefit them. States such as California and Texas now provide educational and social services to people with autism that they deny to those with Asperger’s. Some parents argue, though, that limited resources should go to kids with more severe symptoms before anyone else. —F.J.
Craving Cash, Food and Sex
Several new types of addiction may appear in the upcoming version of psychiatry’s bible, the DSM-5. Gambling disorder is one. In the past decade studies have shown that people get hooked on gambling the same way they become addicted to drugs and alcohol and that they benefit from the same kind of treatment—group therapy and gradual withdrawal. Neuroimaging research has revealed that the brains of drug addicts and those of problematic gamblers respond to reminders of drugs and monetary rewards in similar ways: their reward circuits light up, much more than casual gamblers or one-time drug users. The DSM-5 may also include obsessions with food and sex:

Binge Eating Disorder
Consuming “an amount of food that is definitely larger than most people wou
ld eat in a similar period of time under similar circumstances” and lacking control over what, how much or how fast one eats.

Hypersexual Disorder
Having unusually intense sexual urges for at least six months or spending excessive amounts of time having sex in response to stress or boredom, without regard for physical or emotional harm to oneself or others, de­spite the fact that it interferes with social life and work.

Absexual Disorder
Feeling aroused by moving away from sexuality or behaving as though moralistically opposed to sex. As sex educator Betty Dod­son told Canadian news­paper Xtra! West, these are “folks who get off complaining about sex and trying to censor porn.” —F.J.

This article was published in print as “Redefining Mental Illness.”