Allen Frances, MD

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.

The Alliance for Human Research Protection is attempting to draft me as an unwilling soldier in its dangerous campaign to discredit psychiatry and to discourage psychiatric patients from staying in treatment and taking medication.

The New York Times of February 14 carries the disturbing news of an alarming increase in deaths from accidental overdose among our active duty military personnel and our war veterans.

In previous blogs and papers, I have done my level best to skewer the misuse of the misdiagnosis "Paraphilia NOS." I regard it as no more than a flimsy justification, concocted to allow the psychiatric incarceration of rapists who would otherwise have to be released from prison to the street.

I was asked three interesting questions by a psychologist with 15 years experience evaluating sexually violent predators. She has testified often--both for the prosecution and for the defense in the hearings that determine the legitimacy of involuntary psychiatric commitment under SVP statutes.

A DSM critic, Andrew Hinderliter sent this perceptive email questioning the wisdom of the most fundamental decision we made in preparing DSM IV-- ie, our goal of keeping the system stable.

Gary Greenberg, PhD is a psychotherapist, author, teacher, and historian of psychiatric diagnosis. His writings are characterized by penetrating insight, elegant wordsmithing, entertaining story telling, and a dig-deep, no-holds-barred search for underlying meaning.

There have been three positive developments. The rest of the DSM-5 news continues to be extremely worrisome, and time is running out.