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James Phillips, MD

James Phillips, MD

Dr Phillips is an Associate Clinical Professor of Psychiatry at the Yale School of Medicine. He is in the private practice of general and forensic psychiatry. In the Yale department, he is involved in residency training, the Hispanic Clinic, and the Global Mental Health Committee. He has a long involvement with the Association for the Advancement of Philosophy and Psychiatry, serving as Secretary and as editor of the Bulletin of AAPP. He has written extensively in the area of philosophy and psychiatry and edited Philosophical Perspectives on Technology and Psychiatry (Oxford 2008) and (with James Morley) Imagination and its Pathologies (MIT 2003). For the past few years, Dr Phillips has been involved in the development of a psychiatric clinic in a never-served Andean city (Ayacucho) in Peru.

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Despite the efforts of a dedicated Work Group, DSM-5 has not significantly changed the problems with PTSD that beset DSM-IV.

With DSM-5 now approved, all discussion has been removed from the DSM-5 Web site. According to the APA, the DSM-5 leadership moved to dimensional measures as one solution to the validity problem.

A recent case has caused a flurry of opposing opinions. Not surprisingly, transgender advocacy groups have praised the judge's decision that the inmate in question has an eighth amendment right requiring the state to support and pay for sex reassignment surgery.

With DSM-5 scheduled for publication a little more than a year from now, we may safely assume that, barring unannounced surprises from, say, the APA Scientific Review Committee, what we will see on the DSM-5 Web site is what we will get. With that in mind it’s time to review what we will indeed get.

Both the DSM-5 Web site and Psychiatry News have recently heralded the proposed DSM-5 revision for diagnosis of personality disorders.

Regretfully, if we are to judge the progress of DSM-5 by the incoherence of a recent commentary by the Chair and Vice-chair of the DSM-5 Task Force, we have a lot to worry about.

DSM-II was published in 1968. DSM-5 will be published in 2013. How much progress have we made? I propose that we approach this question with a quiz.

The NIMH Research Domain Criteria (RDoC) project raises many questions about DSM-5 and future DSMs.

In my previous blog, The Missing Person in the DSM, I questioned whether the DSM diagnostic manual classifies psychiatric disorders or the individuals suffering from diagnostic disorders—Ms Smith’s bipolar disorder, or Ms Smith, a person with bipolar disorder.

Here’s a question. As you sit across from your patient, what or whom are you treating: Ms Smith’s bipolar illness, or Ms Smith, a person with bipolar illness? The DSM leans toward the first choice.


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