DSM5 in Distress

An accurate diagnosis is wonderful thing—a giant step toward explaining what previously seemed unexplainable and starting what is very likely to be an effective treatment. Read More

The prize for the most wayward of all the DSM 5 work groups must surely go to the sexual disorders group—creators of three remarkably off-beat proposals. Fortunately, they have gradually been forced to abandon their entire wish list because each of the proposals triggered near universal opposition from forensics experts and sexual disorders researchers. Read More

A British study has succeeded in definitively answering two of the most timely and consequential questions facing psychiatry today: 1) Is it a good idea to include a "psychosis risk syndrome" in DSM 5? and 2) Can early treatment programs prevent psychosis? Read More

Social workers make up by far the largest single constituency among all the potential users of DSM-5, a plurality of over 200,000 mental health clinicians. Until recently, they have been silent while psychologists, counselors, psychiatrists, the press, and the public have all strongly opposed DSM-5. Things are changing. Read More

The diagnostic boundary between Major Depressive and Bipolar II Disorder is one of the most difficult and also one of the most important in psychiatry. Difficult (and inherently at least somewhat arbitrary) because the distinction rests completely on how one defines a hypomanic episode. Read More

According to this week's Time magazine, the American Psychiatric Association has just recruited a new public relations spokesman who previously worked at the Department of Defense. This is an appropriate choice for an association that substitutes a fortress mentality and  warrior bluster for substantive discussion. Read More

The following letter was sent to the APA Trustees and to the DSM-5 Task Force on February 12, 2012, under the title, Heads Up And Recommendations. Read More

Until yesterday, there were only two reasons to stick with the projected date of DSM 5 publication (May 2013): 1) the need to coordinate DSM 5 with ICD-10-CM coding, which was scheduled to start Oct 2013; and, 2) the need to protect APA publishing profits in order to meet budget projections. The first reason just dropped out. Read More

The Lancet is probably the most prestigious medical journal in the world. When it speaks, people listen. The New York Times is probably the most prestigious newspaper in the world. Again, when it speaks, people usually listen. The Lancet and The New York Times have both spoken on the DSM-5 foolishness of turning grief into a mental disorder. Read More

In preparing DSM IV, we worked hard to avoid causing confusion in forensic settings. Realizing that lawyers read documents in their own special way, we had a panel of forensic psychiatrists go over every word to reduce the risks that DSM IV could be misused in the courts. Read More

Dr. Ray Blanchard, of the DSM 5 sexual disorders work group, has written a misleading blog that portrays the introduction of 'Hebephilia' into DSM 5 as no more than a minor change. In his rendering, DSM IV already permits the diagnosis of pedophilia if victims are 13 or younger and DSM 5 is just raising the age threshold to 14. No big deal.  Read More

The current fad of misdiagnosing 'Paraphilia, Not Otherwise Specified'' in Sexually Violent Predator hearings is the most glaring error now occurring at the difficult boundary between psychiatry and the law. Misguided and incompetent psychiatric diagnosis too often has paraded as expert testimony. Read More

My biggest concern regarding DSM 5 is that it will dramatically increase the rates of mental disorder and cheapen the currency of psychiatric diagnosis. The DSM 5 proposals do this two ways: 1) by reducing thresholds for existing disorders; and, 2) by introducing new high prevalence disorders at the boundary with normality. Read More

The designer of the DSM-5 field trials has just written a telling commentary in the American Journal of Psychiatry. She makes two very basic errors that reveal the fundamental worthlessness of these field trials and their inability to provide any information that will be useful for DSM-5 decision making. Read More