Ten years ago Igor Panarin began predicting the US will experience economic and moral collapse and civil war leading to disintegration of the Union in 2010.

No one took him seriously for the longest time but now many in his native Russia find him to be a good listen.

“There’s a 55-45% chance right now that disintegration will occur” he recently told the Wall Street Journal.

Uncle Sam’s death spiral also includes, according to the soothsayer, the collapse of the dollar, ethnic strife and a tax revolt followed by a spectacular break into 6 pieces with Alaska reverting to Russian control.

In addition, California will become the hub of a “Californian Republic” which either becomes part of China or simply falls under Chinese influence.

Meanwhile, Texas and surrounding locales will form the “Texas Republic” which promptly cedes itself to Mexico.

Panarin says he based his predictions on classified data from FAPSI, the Russian version of the National Security Administration where he worked at one time preparing reports for Boris Yeltsin.

Panarin also did a stint with the KGB and holds a PhD in political science.

Russian state media is eating this up right now. Panarin is interviewed twice daily about his predictions. And he has presented them to the Foreign Ministry and the nation’s top school of international affairs.

During one interview, a state TV station cut between Panarin head shots and canned footage of breadlines, soup kitchens and homeless people in the US.

Americans hope President-elect Barack Obama “can work miracles,” Panarin told the Journal. “But when spring comes, it will be clear that there are no miracles.”

DSM-V will be released 3 years hence, so the nation’s top psychiatrists have already begun debating whether compulsive shopping is a mental problem and Asperger’s syndrome is different from high-functioning autism.

When the answers appear in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, they’ll drive reimbursement policies, research agendas and the self-identity of millions for as long as it takes ‘em to release DSM VI.

“This is not cardiology or nephrology, where the diseases are well known,” said Edward Shorter, an expert on the history of psychiatry and a DSM critic.

“In psychiatry no one knows the causes of anything, so classification can be driven by all sorts of factors” including political, social and financial.

Three particularly contentious areas are gender identity, childhood mental illness and new social addictions like eating and shopping.

The current DSM characterizes transgender people for example as having “strong and persistent cross-gender identification,” which has caused a stir.

Some advocates have circulated petitions objecting to panel members they say have expressed demeaning views on the matter.

Others don’t believe the matter has anything to do with psychiatry and want the diagnosis expunged.

Still others want it to remain in DSM which would help assure insurance coverage for surgeries and treatments.

“The language needs to be reformed, at a minimum,” Mara Keisling told the New York Times.

“Right now, the manual implies that you cannot be a happy transgender person; you have to be a social wreck,” added the executive director of the National Center for Transgender Equity.

The gender identity debate reminded some of the protracted battle to scratch homosexuality from DSM.

In the 1970s, gay activist protests sparked a review resulting in replacement of the word “homosexuality” with “sexual orientation disturbance.” That was later changed to “ego-dystonic homosexuality” before finally being removed altogether in 1987.

In this post, we continue to summarize key findings from a December report by the Commonwealth Fund on the status of retail clinics in the US. An earlier post on the subject appears directly below.

The most common reason (48%) for visiting a retail clinic between 2006 and 2008 was for diagnosis and treatment of a new symptom or illness. Childhood ailments such as earache, sore throats and upper respiratory infections topped the list.

About half as many (23%) retail clinic visitors needed a vaccination and 14% visited the facility to obtain a physical exam required for school, camp or employment.

When asked why they visited a retail clinic over a traditional care setting, 64% of respondents said the clinic’s lengthy hours of operation were a major factor. Roughly the same percentage indicated that the location was more convenient. The ability to walk-in without an appointment was cited by 53%.

Just under half the visitors to retail clinics cited low costs as a principal reason for choosing the venue, while a third indicated they had no other source of care.

It appears that the brief period of unbridled growth in the number of retail clinics has ended. In the first 5 months of 2008 for example, 70 clinics in 15 states were shut down, and the nation’s largest clinic operator, MinuteClinic, announced it would pare back its expansion plans.

That may be so, but the expanding insurance coverage for services provided at retail clinics and rising problems accessing care at traditional venues assure that these convenient providers won’t be disappearing anytime soon.