Dr Pies is Professor Emeritus of Psychiatry and Lecturer on Bioethics and Humanities, SUNY Upstate Medical University; Clinical Professor of Psychiatry, Tufts University School of Medicine; and Editor in Chief Emeritus of Psychiatric Times (2007-2010). Dr Pies is the author of several books. A collection of his works can be found on Amazon.
Once Again: Grief Is Not a Disorder, But It May Be Accompanied by Major Depression
January 28th 2012The New York Times ran a front-page story regarding numerous controversies surrounding the DSM-5, most notably, the issue of eliminating the so-called bereavement exclusion in diagnosing a major depressive episode. Here, Dr Pies responds to Dr John Grohol, Psychologist and Editor of the Psychcentral Web site.
DSM-5: Petitions, Predictions, and Prescriptions
November 22nd 2011Some months ago, I received a stern admonition from my family doctor. My fasting blood sugar of 99 mg/dL was “right on the border”, he said, and I had better work on bringing it down. “But,” I protested, “when I was in medical school (in the 70s), the normal FBS range went up to 110 mg/dL!” "Well,” he replied a bit huffily, “they changed the criteria!”
Misunderstanding Psychiatry (and Philosophy) at the Highest Level
September 9th 2011In my view, Dr Angell’s assertions reflect both a serious misunderstanding of psychiatric diagnosis, and-equally important-a failure to address the core philosophical issues involved in her use of the terms “subjective,” “objective,” “behaviors,” and “signs.”
Alzheimer’s Redux: A Preliminary Take on the New Diagnostic Criteria
June 17th 2011If telling patients they have “pre-clinical Alzheimer’s” or “MCI due to Alzheimer’s Disease”-absent effective treatment-produces more emotional suffering than it relieves, a difficult ethical question arises; namely, can such a disclosure be justified under the foundational principle of non-malfeasance?
Bereavement and the Loss of a Child: The Need for Compassion and Careful Judgment
March 28th 2011I’d like to respond to Dr Cacciatore’s concerns and comments, as well as to some points raised by other readers. I also want to acknowledge the deep pain of those who have lost loved ones, and who have written in to this Web site.
Psychotherapy is Alive and Talking in Psychiatry
March 12th 2011The title of Gardiner Harris’s front-page story in the March 6 New York Times was blunt: “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy.” For those of us who see our profession as a humanistic calling, this piece is likely to provoke a mixture of sadness and anger.
Psychiatry and Anthropology, In Search of “Science”
December 21st 2010Have you been following the recent dust-up in the anthropology world? It all started, as Nicholas Wade wrote, “…after a decision by the American Anthropological Association at its recent annual meeting to strip the word “science” from a statement of its long-range plan.”
Grief and Depression Redux: Response to Dr Frances’s “Compromise”
September 28th 2010Clearly, we all share the goals of respecting-not “medicalizing”-ordinary grief; as well as recognizing and treating clinically significant depression. We differ with Dr Frances in how to achieve these goals, while remaining faithful to the best available scientific data.
The Flip-Side of “Good Grief” May be Missed Depression
August 25th 2010My colleague Allen Frances is rightly concerned with the risk of over-calling normal grief as major depression - - that is, the risk of "false positives" - - if the DSM-IV "bereavement exclusion" is dropped in the DSM-5 while the 2-week minimum duration criterion is retained.
FDA Lacks Desire for Flibanserin-But Does Hypoactive Sexual Desire Disorder Even Exist?
August 4th 2010Consider the predicament of Mrs M, a 38-year-old premenopausal mother of two. Mrs M tells her primary care physician, “I just don’t have a strong desire for sex. It’s been about 10 years now, and I hardly ever have sexual thoughts or fantasies.
Alzheimer’s Disease Without Dis-ease? New Conundrums for Psychiatric Diagnosis and Public Health
July 19th 2010Researchers who have spent their careers studying schizophrenia and mood disorders might be forgiven a bit of “biomarker envy.” At long last, it seems that the neurologists and neuropsychiatrists have developed some fairly sensitive and specific “lab tests” for Alzheimer’s Disease (AD).
Obama, the Oil Spill, and the Magic of Righteous Anger
July 7th 2010Many Americans seem angry at President Obama’s seeming lack of anger over the BP fiasco. Frustration with the environmental calamity in the Gulf is perfectly understandable. Anger with those who should have foreseen and prevented this horrendous situation is also understandable, and-up to a point-quite justifiable.
Psychiatrists, Physicians, and the Prescriptive Bond
June 2nd 2010Almost the first memory I have of a physician is our family doctor at my bedside, leaning over to press his warm fingers against my neck and beneath my jaw. I’m 5, maybe 6 years old. I have a fever and a sore throat, and Dr Gerace is carefully palpating my cervical and submandibular lymph nodes.
Sensitization and Its Discontents: Allergists, Psychiatrists, and the Limits of Medical Knowledge
May 26th 2010It’s an embarrassment, no doubt about it. For those of you who have been following the intense debate over the DSM-5, it’s high time to ask: how much longer will the public put up with a medical specialty like this?
The Psychologist Prescribing Bill Is Dead-Long Live Science in the Public Interest!
May 11th 2010Oregon’s Governor Kulongoski has vetoed a bill that would have allowed psychologists to practice clinical medicine without adequate training-otherwise known by the euphemism of “prescribing.” The Governor’s rationale was precisely the one opponents of the bill, such as I, had advocated.