National Public Radio (NPR) in the US has posted an episode of its program “On the Media” centered on the debate over the contents of the forthcoming 5th edition of the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association. The episode is entitled “The Art of Diagnosis.” The issues discussed focus mainly on the social acceptance or stigmatization of people complaining of particular clusters of symptom and not, perhaps surprisingly, on access to insurance payments or pharmaceutical company windfalls.
Among the politically-charged syndromes under review are “Gender Identity Disorder,” an extreme form of PMS called “Premenstrual Dysphoric Disorder” (for which a specific pharmaceutical, Sarafem, has already been marketed), and “Social Anxiety Disorder” (better known as shyness). Questions about this sort of “diagnostic bracket creep” are discussed on the program. Continue reading DSM-V Debate on NPR→
Back on November 17 we wrote a short item on the current battle over how much transparency there would be in the process by which the forthcoming 5th edition of the Diagnostic & Statistical Manual of the American Psychiatric Association (DSM-V) is assembled. What is at stake is the level of influence that pharmaceutical companies will have on the people who decide which the psychiatric conditions (and their pharmacological treatments) will be insurable. In short, billions and billions of dollars are at stake. Today the New York Times published an article on the same topic. Continue reading More on the DSM-V Process→
Mind Hacks has a good piece on the current negotiations over how much transparency there will be to the development of the forthcoming (May, 2012) 5th edition of the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association. At stake is whether anyone apart from the DSM writing committee itself will know how much pressure is being brought to bear on the authors by pharmaceutical companies, which have a vested interest in diagnosable conditions being included in the Manual for which they claim to have specific treatments (i.e., billions of dollars are at stake). One of the major criticisms of the last edition of the DSM was that several of the authors had deep entanglements with major pharmaceutical companies, leading to questions about possible conflicts of interest.
In this keynote address, Professor Thomas Szasz appeals to the history of psychiatry in making his argument against the labeling of children as having, for example, ADD/ADHD. (In the speech, he calls this “stigmatization not diagnosis.”) But does the history to which he refers simply show progress in the medicalization of moral treatment? Or is it, as he claims, evidence of something more sinister?
This video has been edited, but not by us. (The full text of this speech, or one very much like it, can be found here.)
Professor Szasz is famous for, among other things, his anti-psychiatry bias. That, however, is not what’s on display for our purposes here.
AHP has covered similar issues in the past, most notably here (on changing the DSM), here (on how psychiatry is financed), and here (on the removal of homosexuality from the DSM). A bibliography of readings related to Professor Szasz’ comments, for interested students, is appended below the fold. Continue reading Thomas Szasz on diagnostic malpractice→
This item comes more from the category of history-in-the-making, rather than history proper.
The New York Times has just published an article on just how extensive the financial ties are between the pharmaceutical industry and the American Psychiatric Association (APA). According to the article, nearly 1/3 of the APA’s budget comes directly from the pharmaceutical industry, in the form of journal ads, convention exhibits, and the sponsoring of fellowships, conferences, and symposia. Continue reading Psychiatry, Pharmaceutical Funding, and Congress→
“The number of mental disorders that children and adults in the general population might exhibit leaped from 180 in 1968 to more than 350 in 1994.”
Lane, who spent time in the archives of the American Psychiatric Association, uses social anxiety disorder (first dubbed social phobia) as the lens through which to analyze American psychiatry’s extraordinary shift in the last 30 years from a psychoanalytic orientation relying on talk therapy to its current emphasis on neuroscience and drugs.
He draws on letters and memos written by the framers of the new disorders to argue that DSM revisions to social phobia or social anxiety disorder placed the diagnostic bar too low, turning social anxiety into a mental illness common enough to be considered, according to recent studies, third only to alcoholism and major depression. Continue reading Alterations to DSM “unscientific and arbitrary”→
This week, All in the Mind rebroadcast a documentary from This American Life on the deletion of homosexuality from the DSM in 1973. (Read the transcript or get the MP3.)
It’s a fascinating examination of a topic rarely discussed.
Homosexuality was once labeled a mental disease by psychiatry. But in 1973 the challenge came from within. The American Psychiatric Association had a change of heart. And with the tweak of the 81-word definition of sexual deviance in its own diagnostic manual, lives were reclaimed, and values confronted. Reporter and narrator Alix Spiegel tells the gripping story from the inside, revealing the activities of a closeted group of gay psychiatrists who sowed the seeds of change, amongst them her own grandfather, president-elect of the APA at the time.
AHP has previously presented a bibliography of the histories homosexuality in psychology, but a more precise version (specific to the APA decision in 1973) is appended below.