DSM

In just two decades, pointing out the pseudoscience of the DSM has gone from being an “extremist slur of radical anti-psychiatrists” to a mainstream proposition from the former chairs of both the DSM-3 and DSM-4 taskforces and the director of NIMH. In addition to the pathologizing of normal behaviors, another explanation for the epidemic — the adverse effects of psychiatric medications — is also evolving from radical to mainstream, thanks primarily to the efforts of Robert Whitaker and his book Anatomy of an Epidemic. While diagnostic expansionism and Big Pharma certainly deserve a large share of the blame for this epidemic, there is another reason.

The American Journal of Psychiatry (January, 2103) recently published a series of articles that analyzed the outcomes of the field trials that were conducted by the DSM-5 Task Force, to determine the inter-rater reliability of the multiple diagnostic categories that will comprise the DSM-5. A table below tracks the downward progression of inter-rater reliability from DSM-III through DSM-5.

While a great deal of the excitement about advances in psychological treatments comes from the potential for research in neuroscience to unlock the secrets of the brain, many mental health experts would like to temper this enthusiasm. A special issue of the Behavior Therapist released this month calls into question the predominant conception of mental illnesses as brain disorders.

Amid calls for a retraction, Lancet Psychiatry publishes articles criticizing the original finding and a response from the authors.

The latest issue of the journal Behavioral and Brain Sciences features several prominent researchers arguing that mental health concerns are not “brain disorders.”

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?

A new article suggests counselors and psychotherapists are dissatisfied with current diagnostic systems and outlines some potential alternatives.

Revealing the false information provided about psychiatry should cause any thinking person, patient, thought-leader or politician to wonder: “how many otherwise normal or potentially curable people over the last half century of psych drug propaganda have actually been mis-labeled as mentally ill (and then mis-treated) and sent down the convoluted path of therapeutic misadventures – heading toward oblivion?”

‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another. Re-defining someone’s reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong - scientifically, professionally, and ethically. The DSM debate presents us with a unique opportunity to put some of this right, by working with service users towards a more helpful understanding of how and why they come to experience extreme forms of emotional distress.

A discussion of the role of epistemic injustice in the experiences of patients diagnosed with psychiatric disorders.

Why all the fuss over DSM-5? Why did Robert Spitzer, the editor of DSM-III, begin to protest about the “secrecy” surrounding its production as early as 2007? Why did Allen Frances, editor of DSM-IV, begin in 2009 to challenge the American Psychiatric Association’s (APA) announced goal that when making DSM-5 “everything is on the table”? Why did he dispute the APA’s position that there had been enough progress in neuroscience to call for a “paradigm shift”, and why did Frances and others go on to protest repeatedly what they viewed as DSM-5’s “medicalization of normality?”

Researchers detect disparity between white and African American patients diagnosed with schizophrenia when symptoms of a mood disorder are present.

A case analysis of an American Indian woman illustrates how the DSM diagnostic criteria misrepresent the lives of indigenous people.

Neuroscience researchers find no differences in brain connectivity between children with diagnoses of autism, ADHD, and those with no diagnoses.

In a new report, the United Nations Special Rapporteur on the right to health, Dr. Dainius Pūras, calls for a move away from the biomedical model and “excessive use of psychotropic medicines.”

In recent months, two teams of researchers in the UK and the US published complementary findings about the epigenetic origins of schizophrenia that have scientific communities who indulge in ‘genetic conspiracy theories’ abuzz. While these results are intriguing, and no doubt involve pathbreaking research methodologies, this line of thought represents a decontextualized understanding both of the symptoms that are typically associated with schizophrenia, and their causes.

I am returning to the subject of psychological formulation after rather a lengthy gap, during which controversy about the forthcoming 5^th edition of DSM has continued to grow – sign the petition ‘Stop the Insanity’ at  www.dsm5response.com if you share others’ concerns about the creeping medicalisation of everyday life and the risks that it poses.

A new review highlights the effects that psychiatric diagnosis has on children and adolescents’ social relationships and views of self.

Study examines the effects on participants of being told they are at risk of developing psychosis.

Dr. Raskin discusses psychotherapists’ dissatisfaction with current psychiatric diagnostic systems and explores alternatives.

Researchers offer a critical take on the inclusion of the Disruptive Mood Dysregulation Disorder in the DSM-V.

-A special issue of Public Affairs Quarterly examines "the moral and political implications" of the Diagnostic and Statistical Manual of Mental Disorders.

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.

The Critical Psychiatry Network is concerned with the way the controversy over the publication of DSM-5 is being portrayed in the media and by some academic psychiatrists. The issues raised by the DSM are complex and require careful and studied consideration. There are two aspects in particular that concern us. These relate to the portrayal of the controversy as a guild dispute, and the polarisation of the debate as one of nurture versus nature.

by Eugene Epstein, Manfred Wiesner, and Lothar Duda Over the past 50 years, the psychiatric and psychotherapeutic discourses of the western first world have infiltrated...