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Psychiatric bible bashing

The somewhat secretive ins and outs of the American Psychiatric Association’s DSM-V (Diagnostic and Statistical Manual of Mental Disorders V) seem to be all over the blogosphere – eg here and here.

Allen Frances, head of the body that coordinated DSM-IV, has recently set out his concerns about DSM-V, saying “The result… would be a wholesale imperial medicalization of normality that will trivialize mental disorder and lead to a deluge of unneeded medication treatments–a bonanza for the pharmaceutical industry but at a huge cost to the new false positive ‘patients’ caught in the excessively wide DSM-V net” – and that the current process of producing DSM-V suffers from weak methodology, overambitious goals, lack of transparency, and little relevance to population-level psychiatry.

Danny Carlat reports in his blog post that a member of one of the DSM-V workgroups has recently quit, with some of the grounds very similar to criticisms set out by Allen Frances.

The APA has since responded to several of these allegations, saying that “The process for developing DSM-V has been the most open and inclusive ever”; another respondent, Robert Spitzer, questions the validity of the APA’s proposals for field testing new psychiatric diagnoses.

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