While sipping drinks from coconut shells, psychiatrists from around the world recently met in Honolulu to discuss more ways to capitalize on human behavior and promote drug dependency. The occasion was the annual meeting of the American Psychiatric Association (APA), held in a Hawaiian convention center lined with mental disorder displays and pharmaceutical booths.
As the DSM-V looms closer to becoming a reality, I can’t help but think of words from the man who chaired the committee for the DSM-IV. Allen Frances, M.D., wrote in the in the LA Times:
As chairman of the task force that created the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which came out in 1994, I learned from painful experience how small changes in the definition of mental disorders can create huge, unintended consequences.
Our panel tried hard to be conservative and careful but inadvertently contributed to three false ‘epidemics’ – attention deficit disorder, autism and childhood bipolar disorder. Clearly, our net was cast too wide and captured many ‘patients’ who might have been far better off never entering the mental health system.
(NaturalNews) “There is no definition of a mental disorder. It’s bull___. I mean, you just can’t define it,” states Allen Frances, MD, lead editor for the Diagnostic Statistical Manual (DSM-IV). As DSM-IV is the imperial doctrine used by psychiatrists in diagnosing mental disorders, prescribing powerful psychotropics to the masses, and commanding health care dollars, this is quite a confession. “We made mistakes that had terrible consequences,” Frances concedes.
Gary Greenberg who interviewed Frances and wrote an in-depth article for Wired Magazine, describes how Frances’ conscience has been hitting him in the gut. “Diagnoses of autism, attention-deficit hyperactivity disorder, and bipolar disorder skyrocketed, and Frances thinks his manual inadvertently facilitated these epidemics — and, in the bargain, fostered an increasing tendency to chalk up life’s difficulties to mental illness and then treat them with psychiatric drugs,” writes Greenberg. DSM-IV led to a 40X increase in child bipolar diagnoses and an epidemic of dangerous antipsychotic prescriptions for children, even as young as 3.
The American Psychiatric Association’s Diagnostic and Statistical Manual, or DSM, updated roughly every 15 years, has detailed descriptions of all the mental disorders officially recognized by psychiatry. It’s used by psychiatrists, insurance companies, drug researchers, the courts and even schools.
But it’s not without controversy: The proposed changes suggested this year have sparked a kind of civil war within psychiatry.
In a small condo on the beach in San Diego lives Allen Frances, who blames himself for what he calls the “Epidemic of Asperger’s.” Frances edited the last edition of the DSM, and he’s also the new DSM’s most prominent critic. Frances is the one who put the word Asperger’s in the DSM in the first place, thereby making it an official mental disorder
Every so often Al Frances says something that seems to surprise even him. Just now, for instance, in the predawn darkness of his comfortable, rambling home in Carmel, California, he has broken off his exercise routine to declare that “there is no definition of a mental disorder. It’s bullshit. I mean, you just can’t define it.”
The insurgency against the DSM-5 (the APA has decided to shed the Roman numerals) has now spread far beyond just Allen Frances. Psychiatrists at the top of their specialties, clinicians at prominent hospitals, and even some contributors to the new edition have expressed deep reservations about it. Dissidents complain that the revision process is in disarray and that the preliminary results, made public for the first time in February 2010, are filled with potential clinical and public relations nightmares. Although most of the dissenters are squeamish about making their concerns public—especially because of a surprisingly restrictive nondisclosure agreement that all insiders were required to sign—they are becoming increasingly restive, and some are beginning to agree with Frances that public pressure may be the only way to derail a train that he fears will “take psychiatry off a cliff.”