In Psychology Salon, Randy Paterson compares life in the present to life in the past, to try to see if there are any clues there as to why the incidence of depression seems to have been increasing so dramatically. More →
In The Lancet Psychiatry, three Australian psychiatrists analyze the modern history of bipolar disorder in children, and explore how it came to be that, "By 2004, bipolar diagnoses in children and adolescents had increased 40 times in US primary health care and become the most common diagnosis in preadolescent inpatient units." More →
In Medscape, three psychiatrists discuss the new definitions in the Diagnostic and Statistical Manual of Mental Disorders for grief, complicated grief, depression and major depression, and try to explain how to reliably distinguish between them all. More →
BrainBlogger has an interview with Gary Greenberg, psychotherapist and author of The Book of Woe: The DSM and the Unmaking of Psychiatry. "The (Diagnostic and Statistical Manual of Mental Disorders) provides the key to the health care treasury, whether you’re a person suffering from emotional distress and trying to get money from your insurance company for treatment, or a researcher trying to get a grant to study a particular mental problem," says Greenberg. More →
The Lancet Psychiatry's December issue includes two letters commenting on Mary Boyle and Lucy Johnstone's article, "Alternatives to psychiatric diagnosis," along with a new letter on the topic from Boyle and Johnstone. More →
The US National Institute of Mental Health is providing public access to a video of a webinar explaining the Research Domain Criteria initiative and how it compares to the Diagnostic and Statistical Manual of Mental Disorders for categorizing psychological states. More →
About 60% of the increase in the prevalence of autism spectrum disorders has been caused by broader diagnostic criteria and new reporting practices, according to a Danish study published in JAMA Pediatrics. Although the study was of Danish children, some of the findings would apply in the United States as well, a researcher not involved in the study told LiveScience. More →
Is there an alternative to the current, dominant way of making psychiatric diagnoses? If so, what would it look like? On his Critical Psychiatry blog, Duncan Double raises these questions and posts to freely-accessible versions of both a commentary about the topic in the Lancet by Mary Boyle and Lucy Johnstone as well as a Lancet letter retort to it. More →
More than a year on from the release of DSM-5, a Medscape survey found that just under half of clinicians had switched to using the new manual. Most non-users cited practical reasons, typically explaining that the health care system where they work has not yet changed over to the DSM-5. Many, however, said that they had concerns about the reliability of the DSM, which at least partially accounted for their non-use. Throughout the controversies that surrounded the development and launch of the DSM-5 reliability has been a contested issue: the APA has insisted that the DSM-5 is very reliable, others have expressed doubts. Here I reconsider the issues: What is reliability? Does it matter? What did the DSM-5 field trials show?
Note: This post originally appeared on August 18, 2014 on dxsummit.org. On August 5 and 6, 2014, a group of roughly twenty persons met in Washington, DC for the First Summit on Diagnostic Alternatives. The gathering consisted mostly of psychologists, but social work, …
"There are many practitioners, including psychiatrists, who wonder about the sanity and the soundness of the enterprise in general," Gary Greenberg tells the Australian Broadcasting Corporation's RN radio network about the Diagnostic and Statistical Manual of Mental Disorders. RN interviews various experts in a report on how "practitioners across the world are in open revolt" against psychiatry, "demanding that the practice be brought into the modern world and be anchored not in conjecture but in contemporary science." More →
A month ago, I published a critique of specific terminology of DSM-5. Like countless others, I have serious concerns about the overpathologizing of normal behaviors that appears to be occurring over the past few decades. The potential consequences of this trend have been widely articulated in many circles, and have raised a serious question, “What is normal?” But while this has been occurring in both psychiatric and lay arenas, another movement has been gaining significant support. It is the idea that mental illness (or disease) is a fabrication, and as Sera Davidow quoted E. Fuller Torrey in her recent moving article, “Mental illness does not exist, and neither does mental health.”
On May 16, 2014, I retired from a 35-year career as a professor of clinical psychology at Miami University. As a part of my retirement celebration, I gave a Final Lecture to my Department. These Final Lectures give retiring faculty members the opportunity to talk about anything they think is important for their colleagues and the attending students to hear. I focused on the changes I have witnessed in the profession of clinical psychology over my career; changes that were not for the better.
Imagine that you got upset. Is it very remarkable that I can “diagnose” that you are upset? After all, you are clearly upset. What expert thing did I accomplish by agreeing with you that you were upset? Or imagine that you are angry. Is it very remarkable that I can “diagnose” that you are angry? After all, you are clearly angry. Have I added anything meaningful by saying “I diagnose that you are angry” instead of “You seem angry”? “You look upset” is the simple, truthful thing to say and “I diagnose that you look upset” is a piece of self-serving chicanery.
My name is Leah Harris and I’m a survivor. I am a survivor of psychiatric abuse and trauma. My parents died largely as a result of terrible psychiatric practice. Psychiatric practice that took them when they were young adults and struggling with experiences they didn’t understand. Experiences that were labeled as schizophrenia. Bipolar disorder. My parents were turned from people into permanent patients. They suffered the indignities of forced treatment. Seclusion and restraint. Forced electroshock. Involuntary outpatient commitment. And a shocking amount of disabling heavy-duty psychiatric drugs. And they died young, from a combination of the toxic effects of overmedication, and broken spirits.
The safety of our children is a sacred obligation we strive to preserve. Anything or anyone that harms them becomes the object of our distrust and potential wrath. I want to raise the possibility that psychiatry, for all its accomplished …
I have been immersed in the field of psychiatric diagnosis – and resistance to it – for more than a quarter of a century. In the late 1980s, I was a consultant to two committees appointed by DSM-IV Task Force head Allen Frances to decide what DSM-IV should contain. I resigned from those committees after two years because I was appalled by the way I saw that good scientific research was often being ignored, distorted, or lied about and the way that junk science was being used as though it were of high quality . . . if that suited the aims of those in charge.
A study from Lisa Cosgrove at Harvard's Safra Center for Ethics of potential conflicts of interest among DSM-5 committee members, investigators of new DSM-5 diagnoses, and drug companies finds that neither increased transparency (e.g., registration on ClinicalTrials.gov) or mandatory disclosure were sufficient to prevent the appearance of bias in either the DSM revision process or in clinical decisions about treatment of DSM disorders.
The New York Times' profile of National Institute of Mental Health Director Thomas Insel traces his path from research on the biology of attachment in voles to controversial stances toward the DSM ("At best a dictionary" that lacks scientific validity) and questions about long-term drug treatment for schizophrenia. "The future of psychiatry is clinical neuroscience, based on a much deeper understanding of the brain,” Insel concludes.
Schizophrenia Bulletin follows the movement change to the name and concept of "Schizophrenia", revealing that Japan has taken the lead. Japan, to remove the stigma, social and professional consequences, notions of dangerousness and lack of hope that the old name and model conveyed, was the first country to update and revise the schizophrenia concept by embracing the name "Integration Disorder", and the stress vulnerability model, along with evidence that people "recover and lead a normal life."
The January 2014 issue of Research on Social Work Practice is dedicated to a critical appraisal of the new DSM. It is guest-edited by MIA blogger Jeffrey Lacasse, whose editorial, "After DSM-5: A Critical Mental Health Research Agenda for the 21st Century", summarizes the challenges facing researchers, clinicians, clients and the general public in the wake of DSM-5.
Yes, the boycott of the DSM-5 continues. I can’t tell you how many fewer DSMs have so far been purchased as a result of the boycott; and conversations I have had with professionals in New York’s public mental health system lead me to believe that the great majority continue to accept the validity of the biomedical model and the centrality of psychoactive medications in the treatment of persons caught up in the public system. Perhaps that’s the most important argument in support of the boycott’s continuation – we have so many more folks to reach.
Allen Frances adds to his catalog of DSM-5 mistakes with the return of the controversial - and ultimately rejected - "Psychosis Risk Disorder", under a new name; "Attenuated Psychosis Syndrome." Under the new name, insurance companies can be billed for an 'Other Specified Schizophrenia Spectrum Disorder/Other Psychotic Disorder.' "It makes absolutely no sense to pin the misleading and stigmatizing label 'Other Specified Schizophrenia Spectrum Disorder' on someone who, in typical settings, will have only about a 10% chance of ever becoming psychotic," says Frances, "And certainly it makes no sense to follow this misdiagnosis with an unproven and potentially very harmful antipsychotic treatment. Preventing psychosis would be a great idea if we could really do it; but there is no reason to think we can. And reaching beyond our grasp is likely to harm those we hoped to help."
The American Psychiatric Association (APA) has revised its description of pedophilia in the DSM-5 from a "sexual orientation" to "sexual interest", and affirmed its strong support of efforts to criminally prosecute those who sexually exploit children, and to develop treatment for those diagnosed with pedophilic disorder. Decoded Science reviews the APA's fraught history of categorizing sexuality.
Analysis in the British Medical Journal concludes that the lowered thresholds for Attention Deficit Hyperactivity Disorder diagnosis in DSM-5 will mean "that many children and their families may be harmed due to costs of medication, particularly if it is not needed, medication side effects, and psychological labels," according to the lead researcher. "The drugs used to treat ADHD have side effects such as weight loss, weight gain, and growth problems, and we don't know whether they work in the long term."
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