Joseph M. Pierre, MD



Assessing Malingered Voice-Hearing

September 18, 2020

Malingering in clinical settings is usually motivated by an attempt to obtain care or social services (eg, hospital admission, medication, disability income) and often co-occurs with real mental illness, hence the dilemma.

Essentials of Psychiatric Diagnosis: Responding to the Challenge of DSM-5

June 27, 2014

This easy-to-read manual represents the author's concise views on how to achieve “more accurate” diagnoses with DSM-5, as well as when to avoid DSM-5 altogether.

A Psychiatry of Tomorrow: DSM-5 and Beyond

June 25, 2010

When I was an undergraduate studying molecular biology in the early 1990s when the Human Genome Project had just begun, my required coursework included several lectures on the ethical implications of sequencing, understanding, and ultimately being able to manipulate the “code of life.”

Challenging the "Dis-ease" Model

August 27, 2009

>I greatly enjoyed Dr Ron Pies’ editorial “What Should Count as a Mental Disorder in DSM-V?”1 in which he encouraged framers of DSM-V to critically examine the boundaries of mental illness and to more carefully distinguish between diseases, disorders, and syndromes. As I have noted elsewhere, current plans to integrate a “spectrum” approach into DSM-V require a careful consideration of these issues that must be defensible to critics of diagnostic expansion within psychiatry.2

“What Do You Mean, I Don’t Have Schizophrenia?”

February 02, 2009

My first job after residency involved working at a large Veterans Affairs hospital in an outpatient dual diagnosis treatment program that focused on the comorbidity of schizophrenia and cocaine dependence. Having recently completed a chief resident position at the same hospital’s inpatient unit that focused on schizophrenia without substance abuse, I was struck by how “unschizophrenic” my new patients were. They were organized and social. Their psychotic symptoms were usually limited to claims of “hearing voices,” for which insight was intact and pharmacotherapy was readily requested.