In preparing DSM-IV, we worked hard to avoid causing confusion in forensic settings. Realizing that lawyers read documents in their own special way, we had a panel of forensic psychiatrists go over every word to reduce the risks that DSM IV could be misused in the courts.
The DSM-5 attempt to “dimensionalize” the diagnosis of personality disorder has worthy goals, but has suffered from grievously incompetent implementation.
I recently experienced the odd coincidence of receiving 2 separate emails on the same morning each asking almost the very same question. . . how can I remain so high on psychiatry while at the same time being so critical of some of its recent trends and so fearful of the likely future harmful impact of DSM-5?
The entire field of psychiatric epidemiology has a systematic bias that leads it to misleadingly report what are highly inflated rates of psychiatric disorder.
A newly appointed DSM-5 scientific review group is meant to “review the reviews”-but it is working in secret and so far appears to be a remarkably porous filter . . .DSM-5 has shown no capacity to self-monitor and self-correct. An outside review is sorely needed-and fortunately a ready mechanism is in place.
I just read a blog by Dr Dayle Jones that could have an important influence in the endgame effort to save DSM-5 from itself.
Psychiatric symptoms are fairly ubiquitous in the general population- most normal people have at least one, many have a few. When present in isolation, a single symptom (or even a few) does not a psychiatric disorder make. Two additional conditions must also be met before a symptom can be considered to be part of a mental disorder.
Psychosis Risk (AKA attenuated psychotic symptoms disorder) has always had 3 strikes against it.
A dark cloud surrounds the silver lining of having one psychiatrist in a position of almost unopposed influence . . .
Bob Spitzer was prophetic 4 years ago when he warned that the closed DSM-5 process would lead to a flawed DSM-5 product. He advised the DSM-5 leadership to end its secrecy-- that a lack of openness would inevitably would lead to bad decisions not amenable to self-correction.
I never would have entered the DSM-5 controversy were it not for two of its proposals that risk furthering the already frightening overuse of antipsychotic medication, particularly in children and teenagers.
Polypharmacy has become so ubiquitous that more accidental overdoses are now caused by prescription drugs than by street drugs. The question naturally arises whether this almost routine use of multiple psychotropic medications make sense?
Martin Whiteley is an MP who represents Perth in the Australian parliament. He has been actively involved in mental health issues and succeeded in a crusade to curb what had been Perth's alarming overdiagnosis and overmedication of Attention Deficit Disorder (ADD).
The British Psychological Society is a highly esteemed organization representing 50,000 members. Recently, it released an open letter to the American Psychiatric Association offering a harshly critical view of DSM-5.
The DSM-5 Scientific Review Group was the last hope for an eleventh hour DSM-5 save. This hope recently died.
Those of you who have been following the SVP controversy know that "Paraphilia NOS, nonconsent" (PNOS) is a fake diagnosis that is losing traction as justification for committing rapists to psychiatric hospitals.
During the past year, I have been involved as an expert witness for the defense in 14 SVP cases (tried in California, Washington, and Iowa). My role has been to clarify what is meant by the wording of the Paraphilia section in DSM-IV. And it certainly does badly need explaining.
Dr McGorry’s promotion of primary prevention has been well-intended but is clearly premature and carries with it considerable risks of harmful unintended consequences.
Humans have just these 2 ways of sorting things--giving them a name or a giving them a number. We have been naming things since the days of Adam.
Marsha Linehan is the creator of Dialectical Behavior Therapy (DBT)-the best available method for helping self destructive people help themselves. I have never been more admiring of her than I am at this moment.
John Ioannidis, MD, of Stanford University has published a paper with wide implications for medicine and also for psychiatry. He finds that many influential studies have made exaggerated claims purporting to find connections between biomarkers and medical illness.
I just received a very important email from Dr Dayle Jones who chairs the DSM-5 Task Force of the American Counseling Association (ACA). The ACA has provided a much needed wake-up call for the American Psychiatric Association.
A charismatic psychiatrist, Patrick McGorry has recently gained heroic status. First he was chosen to be Australia's Man Of The Year. Now, he has convinced the Australian government to spend more than $400 million over 5 years to fund his plan for a nationwide system of Early Psychosis Prevention and Intervention Centres.
A large and comprehensive study recently performed in Korea has produced a surprising and disturbing result. The rate of autism is reported to be an astounding 1 in 38...
Attention Deficit Disorder is now two or three times more common than it was just twenty years ago. A recent study reported that a whopping 10% of kids in the general population would qualify for the diagnosis. There has also been an incredible explosion in the use of medication in treating it.
Psychiatry is a wonderful specialty. We have highly effective medication and psychotherapy tools. Forty years of accumulated clinical research have given us a pretty clear idea of optimal treatment guidelines. With an accurate diagnosis and an appropriate treatment, most of our patients benefit greatly and many recover completely.
The proposal to include "coercive paraphilia" as an official diagnosis in the main body of DSM-5 has been rejected. This sends an important message to everyone involved in approving psychiatric commitment under Sexually Violent Predator (SVP) statutes.
Rape is always a heinous, ugly, violent, and cruel crime. But the violence and cruelty that are part of all rapes should not be confused with the specifically motivated violence and cruelty that distinguish sexual sadism...
The personality proposals are certainly not the most dangerous part of DSM-5-but they do win the prize for being absolutely the silliest. They offer a riot of impossibly intricate detail with a level of complexity that could never be of any use in any real world setting.
Aside from its reckless proposals for dangerous new diagnoses, the most characteristic thing about DSM-5 has been its remarkably poor planning and its consistently missed deadlines.
