Robert Whitaker & Allen Frances on Al Jazeera TV: “Redefining Mental Illness”
May 23, 2013
Robert Whitaker notes on Al Jazeera’s “Inside Story” that a helpful diagnostic text must be both reliable and valid, and the DSM is neither – resulting in a harmful expansion of diagnosis and medication. Allen Frances says that experts “always expand, they never reduce” their authority over a domain. 5% of the population has a psychiatric disorder that can be diagnosed and effectively treated, Frances says, but the DSM is misused such that more than 25% of the population is so diagnosed and a “ridiculous” 20% of the population is taking medication.
http://www.madinamerica.com/2013/05/...ental-illness/
And from Al Jazeera website (to watch the video, click on the link below);
The Diagnostic and Statistical Manual of Mental Disorders (DSM), known as the bible of psychiatry, is the most influential guide for helping doctors in the US define what a mental illness is.
Under the new guidelines a person who is grief-stricken after the death of someone close could be diagnosed with major depressive disorder.
[The DSM] it's not really a bible, it shouldn't be worshipped. It's a guide, it's mostly a guide to clinical care to help in deciding who has what disorder, and what's the best treatment for it. Unfortunately [it] has been taken out of context, and used in many real life decisions often beyond the competence of the manual … so it's moved out of the clinical arena ... and now it has all sort of society influences often beyond its competence.
Dr Allen Frances, a the former chair of the Psychiatry Department at Duke University
Elderly people who become forgetful but do not have dementia could be labelled as having minor neuro-cognitive disorder. And toddlers who throw tantrums could be diagnosed with disruptive mood dysregulation disorder.
Revisions like these have sparked a backlash among some respected psychiatrists in the US, who say the new guidelines are turning normal behaviour into illness, and will lead to the medication of patients that should not be.
The director of the National Institute of Mental Health issued a statement saying it was time to move away from the DSM-5 :
"The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure .... In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever."
But those who worked on the latest version of the DSM defend it as the "strongest science available" to help diagnose and treat those suffering from mental illness.
David Kupfer, the chairman of the committee that produced DSM-5, dismissed the criticisms of the manual as "A gross mischaracterisation of important changes instituted to help provide more precise diagnoses for people seeking help ... DSM-5 is a guide book representing the strongest science available to help clinicians provide the best care possible for their patients".
A study by professors from Harvard and Tufts universities published in March 2012 analysed the financial disclosures of 141 members of the work groups drafting the new psychiatry guide.
They found that 69 percent of the authors had ties to the pharmaceutical industry - that is a higher proportion than the 57 percent in the previous version of the book.
More at: http://www.aljazeera.com/programmes/...617473825.html
