On March 4, 2020, the very eminent Allen Frances, MD, published an article in Aeon, which according to its About page is “a digital magazine, publishing some of the most profound and provocative thinking on the web. We ask the big questions and find the freshest, most original answers, provided by leading thinkers on science,… Continue Reading
Robert Spitzer’s Legacy
Robert Spitzer, MD, the architect of DSM-III (1980), died of heart disease on Christmas Day, 2015, at age 83. Most major media outlets published obituaries in which Dr. Spitzer was praised on the grounds that he had brought scientific rigor to psychiatry by naming and defining the various psychiatric illnesses. Here are a few illustrative… Continue Reading
Intermittent Explosive Disorder: The ‘Illness’ That Goes On Growing
According to the APA, intermittent explosive disorder is characterized by angry aggressive outbursts that occur in response to relatively minor provocation. This particular label has an interesting history in successive editions of the DSM. DSM I (1952) Intermittent explosive disorder does not appear as such in the first edition of DSM, but the general concept… Continue Reading
Allen Frances Saving Psychiatry From Itself?
On October 12, 2014, the eminent psychiatrist Allen Frances, MD, participated in a panel discussion at the Mad In America film festival in Gothenburg, Sweden. After the festival, he wrote an article – Finding a Middle Ground Between Psychiatry and Anti-Psychiatry – for the Huffington Post Blog, summarizing the positions he had discussed at the… Continue Reading
Allen Frances’ Ties to Johnson & Johnson
INTRODUCTION I recently came across an article titled Diagnosisgate: Conflict of Interest at the Top of the Psychiatric Apparatus, by Paula Caplan, PhD. The article was published in Aporia, the University of Ottawa nursing journal, in January 2015. Aporia is “a peer-reviewed, bilingual, and open access journal dedicated to scholarly debates in nursing and the… Continue Reading
Allen Frances and the Spurious Medicalization of Everyday Problems
On April 5, Allen Frances MD, published an article on the Huffington Post blog. The title is Can We Replace Misleading Terms Like ‘Mental Illness,’ ‘Patient,’ and ‘Schizophrenia’ It’s an interesting piece, and it raises some fundamental issues. Here are some quotes from the article, interspersed with my comments. “Those of us who worked on… Continue Reading
Psychiatric Diagnoses: Labels, Not Explanations
On March 16, Ronald Pies, MD, published an article in the Psychiatric Times. The article is titled The War on Psychiatric Diagnosis, and the sub-title synopsis on the pdf version reads: “A recent report that argues against descriptive diagnosis in medicine is historically ill-informed and medically naive, in the opinion of this psychiatrist.” Dr. Pies… Continue Reading
Psychiatry Is Not Based On Valid Science
BACKGROUND On December 23, I wrote a post called DSM-5 – Dimensional Diagnoses – More Conflicts of Interest? In the article I sketched out the role of David Kupfer, MD, in promoting the concept of dimensional assessment in DSM-5, and I speculated that at least part of his motivation in this regard might have stemmed… Continue Reading
Invalidity: The Nature of Psychiatry
There’s an interesting post from Duncan Double, MD titled Why does the APA need new editions of DSM? Dr. Double is a psychiatrist and a member of the Critical Psychiatry Network. In his current article, Dr. Double expresses the hope that there won’t be a DSM-6, essentially on the grounds that none of the revisions… Continue Reading
Autism Prevalence Increase Questioned
BACKGROUND A couple of days ago (June 12) I posted Autism Prevalence Increasing. The article drew attention to a post by Kelly Brogan, MD, called See No Evil, Hear No Evil which had appeared on Mad in America on June 9. Dr. Brogan’s article had cited an alarming increase in the incidence of autism over… Continue Reading
An Alternative to DSM
Last month (May 31), National Public Radio (NPR) ran an interview on Science Friday with Thomas Insel, MD, Director of NIMH, Jeffrey Lieberman, MD, President of the APA, and Gary Greenberg, PhD, practicing psychotherapist. I didn’t hear the interview, but I have read the transcript. Doctors Insel and Lieberman were spinning the barrage of criticism… Continue Reading
The Kinderman-Pies Debate
BACKGROUND On May 15, Peter Kinderman, PhD, of the University of Liverpool, posted an article on DxSummit.org. It was called So…What Happens Next? The gist of the article was that psychiatric “diagnoses” are conceptually spurious, unhelpful, and even hindersome in practice, and discourage practitioners from pursuing genuine explanations for the problems clients bring to their… Continue Reading
Live Video Chat: DSM-5
Today I received the following email from Emily Underwood, a reporter with Science Magazine. I am a reporter with Science magazine — after reading your Twitter feed and blog I thought you might be interested in a live video chat I’m hosting this week on the controversy surrounding the DSM V. My guests are Allen Frances of Duke… Continue Reading
The Problem with DSM
There’s an interesting article in the NY Times Sunday review. You can see it here. It was written by Sally Satel MD, a psychiatrist, currently a resident scholar at the American Enterprise Institute. The article is called: “Why the Fuss Over the DSM-5?” Dr. Satel’s central point is that psychiatrists only treat symptoms anyway and… Continue Reading
Dr. Insel Changes His Mind
Well, as I guess everybody knows by now, Dr. Insel has changed his mind. On April 29, he stated that the weakness of DSM “…is its lack of validity.” He went on to express the view that his agency, NIMH, (the US government’s mental health research arm) “…cannot succeed if we use DSM categories…” You… Continue Reading
The Empire Strikes Back: APA Responds to NIMH
BACKGROUND On May 3, 2013, David Kupfer MD (DSM-5 Task Force Chair) responded to Thomas Insel’s April 29th unequivocal attack on the validity and usefulness of DSM. You can see Dr. Kupfer’s response here. Essentially Dr. Insel said that the categories set out in the DSM did not correspond to anything in the real world,… Continue Reading
Mental Distress Is Not An Illness
BACKGROUND Sam Thompson (University of Liverpool) posted the following tweet on April 27: Can anyone point me to a good, succinct summary of the case for equating mental distress with illness? (serious, non-sarcastic question) On the face of it, this looks like a straightforward question, and one might think that a straightforward answer could be… Continue Reading
Transforming Diagnosis: The Thomas Insel Article
BACKGROUND On April 29, Thomas Insel, Director of NIMH, published a paper called Transforming Diagnosis. You can see it here. Dr. Insel is critical of DSM: “While DSM has been described as a ‘Bible’ for the field, it is, at best, a dictionary, creating a set of labels and defining each.” “The weakness is its… Continue Reading
Social Effect of DSM
I keep two dictionaries on my desk. The first is a 1964 Webster’s; the second is a 2009 Webster’s. This morning I looked up the word “depression” in both books. 1964: n. 1. a depressing or being depressed. 2. a depressed part or place; hollow or low place. 3. low spirits; dejection. 4. a decrease in… Continue Reading
Internet Addiction: A Bad Habit, Not An Illness
The DSM-5 drafting committee considered including Internet addiction in the upcoming revision, but eventually backed off, at least for now. Apparently they decided to put it in the category “requiring further study.” So it’ll be in DSM-6. Meanwhile, people are being given the “diagnosis” anyway – and of course, the “treatment.” AN ILLUSTRATIVE CASE I’m… Continue Reading
The Bereavement Exclusion and DSM-5
In DSM-IV, a “diagnosis” of major depressive disorder is based on the presence of a major depressive episode. A major depressive episode, in turn, is defined by the presence of five or more items from the following list during a two-week period: (1) depressed mood most of the day, nearly every day, as indicated by… Continue Reading
Defining Mental Illness
There’s a take-no-prisoners article by Paula Caplan on Psychology Today. You can see Paula’s article here. (Thanks to @yobluemama2 on Twitter for the link.) Here are some quotes: “…the now well-established facts that psychiatric diagnosis is unscientific, does not reduce human suffering, and causes many kinds of serious harm.” “…the chances even that two therapists… Continue Reading
Freudian Psychoanalysis is Better than Drugs
Today I received a short comment from Ruth Elliot on my post Psychiatric “Diagnoses” for Children. Ruth linked to an article by Claudia Gold, MD. Claudia is a Freudian psychoanalyst. My ideological orientation is behavioral, and if you were to ask people in this business: what is the opposite of a behaviorist? you would probably… Continue Reading
DSM-5 Inter-Rater Reliability is Low
BACKGROUND There’s an article by Jack Carney, DSW, on this topic on Mad in America. Jack refers to the DSM-5 field trials published earlier this year in the American Journal of Psychiatry. Inter-rater reliability is measured by a statistic called a kappa score. A score of 1 means perfect inter-rater agreement; a score of 0… Continue Reading
Psychiatric “Diagnoses” for Children
Today, courtesy of Monica, I came across an article by Marilyn Wedge, PhD. It’s called Six Problems with Psychiatric Diagnosis for Children. You can read it here. Here are some quotes: “Psychiatric diagnoses contained in the Diagnostic and Statistical Manual of Mental Disorders are not classified by causes like genuine medical diseases.” “Perhaps worst of… Continue Reading