a dark cloud surrounds the silver lining of having one psychiatrist in a position of almost unopposed influence. Professor McGorry has developed the messianic blind spot that is so common in visionary prophets. His zeal has made him an unreliable evaluator of scientific evidence, allowing him to defend absolutely indefensible positions with the convincing, but inaccurate, force of a true believer. A review of Professor McGorry’s public statements shows his willingness to ignore any evidence contrary to his belief, to change stated views back and forth when he regards this to be necessary or convenient, and to unfairly attack those who point out the fallacies and inconsistencies in his comments. His are the skills of a prophet and rainmaker, not those of a policy maker or a program developer or a sober reviewer of scientific evidence.
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. DSM-5 plans to introduce two new and untested diagnoses that would offer natural targets for poor drug prescribing–psychosis risk syndrome (AKA attenuated psychotic symptoms) and temper dysregulation (AKA disruptive mood dysregulation). There is no evidence whatever that antipsychotics would confer any benefit on the kids so labeled (and too often mislabeled), but great reason to worry that this would not stop their being used needlessly and recklessly.
PSYCHIATRISTS, psychologists and patients’ groups say there is a growing backlash against the federal government’s mental health reforms and have accused its expert adviser, former Australian of the Year Patrick McGorry, of a conflict of interest.
Several mental health specialists have told The Sunday Age the focus on early intervention for adolescents and young adults has been ”massively oversold” by the ”McGorry lobbying machine”.
They claim he used his position on the government’s mental health expert working group to recommend funding for programs he founded.
We are already in the midst of a false epidemic of ADD. Rates in kids that were 3-5% when DSM IV was published in 1994 have now jumped to 10%. In part this came from changes in DSM IV, but most of the inflation was caused by a marketing blitz to practitioners that accompanied new on-patent drugs amplified by new regulations that also allowed direct to consumer advertising to parents and teachers. In a sensible world, DSM 5 would now offer much tighter criteria for ADD and much clearer advice on the steps needed in its differential diagnosis. This would push back ,however feebly, against the skilled and well financed drug company sell. DSM 5 should work hard to improve its text, not play carelessly with the ADD criteria in a way that may unleash a whole set of dreadful unintended consequences- unneeded medication, stigma, lowered expectations, misallocation of resources, and contribution to the illegal secondary market peddling stimulants for recreation or performance enhancement.
The DSM 5 child and adolescent work group has perversely gone just the other way. It proposes to make an already far too easy diagnosis much looser.
While the United States unfortunately leads the world in labeling its children with mental ‘disorders’ which cannot be scientifically proven to exist as medical conditions, Australia seems determined to take over the [dishonorable] title. And they just might do it. For poised to carry them into the winners circle is none other than psychiatrist and former “Australian of the Year” Patrick McGorry. The scam is called “pre-psychosis risk syndrome” which simply translates as this: Despite the fact there is not one proven scientific or medical test to prove any child has a mental “disorder,” Patrick McGorry maintains he can determine who will develop one. That’s right. He can determine who will develop a mental disorder before they develop a mental disorder that cannot be medically proven to exist. If that sounds a little crazy to you, rest assured, you’re not alone. In fact, the logic is so backwards that McGorry’s plan has come under fire from U.S. psychiatrist Allen Frances, who chaired the committee that produced the psychiatric diagnostic bible of “mental disorders” used the world over, ‘The Diagnostic and Statistical Manual of Mental Disorders (DSM) IV. That is called being attacked from altitude. And from your own profession nonetheless.