Allen Frances, MD

Articles by Allen Frances, MD

After each violent tragedy, the politicians hypocritically mourn and harrumph, but wind up buckling under pressure from the NRA, fiscal constraints, and the prison and gun lobbies. Repeated dramatic events can shake the complacency and cowardice of a stalemated Congress and state legislatures.

DSM-5 must emphasize that physical symptoms deserve the respect of a thorough work-up before assuming their cause is psychiatric. And people with defined medical illnesses should not be casually mislabeled as also mentally ill just because they are upset about being sick.

The DSM-5 leadership is trying to put a brave face on its badly failed first stage of field testing and has offered no excuse or explanation for canceling its second and most crucial quality control stage. This field testing fiasco erases whatever was left of the credibility of DSM-5 and APA.

A recent article in the New York Times reports that doctors are prescribing stimulant drugs to compensate for the bad schools their child patients have to attend. Rates of ADHD have tripled in the last 15 years-precisely because many kids are being diagnosed with fake ADHD to make them eligible for medications and/or extra school services.

James Dao reports in the New York Times that the military is considering 2 steps to reduce its startling rate of active duty suicides-which is approaching an unacceptable one suicide every day. Both measures are completely sensible, but neither goes nearly far enough.

Improving our kids performance in school won't come from some vague, quixotic psychological fix. It requires they have better lives and better schools and that means us becoming a fairer society.

With understandable urgency, Secretary of Defense Leon Panetta has made suicide one of his top priorities, instructing commanders at all levels to feel acutely accountable for it. The numbers are startling. On average 1 active duty soldier is killing himself each day--twice the number of combat deaths and twice the civilian rate.

Seventy percent of antidepressants are prescribed by primary care doctors with little training in their proper use, under intense pressure from Big Pharma, drug salespeople, and misled patients, after rushed 7-minute appointments and subject to no systematic auditing. The cash-strapped FDA is beholden to industry for funding. And it gets worse.

"Internet Addiction" may soon spread like wildfire. All the elements favoring fad generation are in place . . . the profusion of alarming books; the breathless articles in magazines and newspapers; extensive TV exposure; ubiquitous blogs; the springing up of unproven treatment programs; the availability of millions of potential patients; and an exuberant trumpeting by newly minted "thought leading" researchers and clinicians. So far, DSM-5 has provided the only restraint.