On DSM-5

"Psychiatric diagnosis is certainly imperfect -- but so is much of diagnosis throughout medicine. And whatever the current limitations, psychiatric diagnosis is useful and essential. There are no 'paradigm shifts possible til we learn a lot more. To imply otherwise is misleading and confusing to patients."

Education and discussion will be the most powerful ways to mitigate the risks of DSM-5. The more people know about psychiatric diagnosis, the more safe, accurate, and useful it will be.

The British Psychological Society has issued a press release that rivals the silliness of DSM-5 and the National Institute of Mental Health.

With DSM-5 now approved by the APA Board of Trustees—and, to the dismay of this reader, all discussion removed from the DSM-5 Web site—how are we to evaluate the results of the field trials for the end product?

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.

Writers of diagnostic criteria should consider their work and all its implications. What about adding a new disorder? What might that do to epidemiological capture? Depending on the characteristics of the diagnostic criteria set, many possibilities exist.

I’ve been deeply worried about corruption and greed in psychiatry for a long time. In reading the new book from Wendell Potter, formerly head of public relations at CIGNA, my worry has escalated into panic anxiety. Before discussing Potter’s work, let me review some of the widespread greed-related corruption of recent years.

The doctor’s role is to go beyond the obvious and to detect subtle determinants. Good diagnosticians have been trained to look beneath the loud symptom and consider underlying factors.