DSM-5

According to the APA, intermittent explosive disorder is characterized by angry aggressive outbursts that occur in response to relatively minor provocation. This particular label has an interesting history in successive editions of the DSM. DSM I (1952) Intermittent explosive disorder does not appear as such in the first edition of DSM, but the general concept is clearly discernible in “passive-aggressive personality, aggressive type”: "A persistent reaction to frustration with irritability, temper tantrums, and destructive behavior is the dominant manifestation." (p 37) ...

On March 25, Joseph Johnston, Juvenile Court Justice in Boston, Massachusetts, issued a disposition order in the case: Care and protection of Justina Pelletier. The background to the case is well-known. Justina is 15 years old. Judge Johnston did not return Justina to the care of her parents, but instead granted permanent custody to the Massachusetts Department of Children and Families (DCF), with a right to review in June. In paragraph 4, the disposition order states: ...

In DSM-5 – Dimensional Diagnoses – More Conflicts of Interest? which I posted on December 23, 2013, I drew attention to the fact that David Kupfer, MD, in his position as head of the DSM-5 Task Force, was vigorously promoting a dimensional model of assessment while at the same time was positioning himself to benefit financially if such a system were to be adopted by psychiatry generally. ...

There’s a debate on this topic scheduled for 12:00 p.m., March 11, 2014, at Wasserstein Hall, Cambridge, Massachusetts. The event is free, and open to the public. The debate is sponsored by the Petrie-Flom Center For Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. This is the same group that produced the recent symposium on Institutional Corruption and Pharmaceutical Policy. The debate will be moderated by I. Glen Cohen, Professor Law at Harvard and Co-Director of the Petri-Flom Center. ...

A short editorial piece by James Bradshaw in the current issue (Jan/Feb) of the National Psychologist discusses the trial of a 16-year-old male who killed four people and severely injured two others while driving under the influence of Valium (diazepam) and alcohol. He had stolen the alcohol from a store earlier, and his blood alcohol level was three times the legal adult limit. He was driving 70 mph in a 40 mph zone at the time of the incident. ...

I have just read a very interesting and insightful article on this topic. It’s called After DSM-5: A Critical Mental Health Research Agenda for the 21st Century. It was written by Jeffrey Lacasse, PhD, and is a guest editorial published in Research on Social Work Practice. Here are some quotes: "At times, it has seemed that the APA has behaved very much like a corporation seeking profit and influence rather than a scientific organization charged with the crucially important task of defining mental disorders." ...

BACKGROUND On November 20, JAMA Psychiatry (formerly Archives of General Psychiatry) published an interesting letter. It was headed: Failure to Report Financial Disclosure Information, and was signed by Robert D. Gibbons PhD, David J Weiss PhD, Paul A. Pilkonis PhD, Ellen Frank, PhD , and David J. Kupfer MD. The letter is an apology for failing to disclose a financial interest in an article, Development of a Computerized Adaptive Test for Depression, that had appeared in Archives of General Psychiatry a year earlier (November 2012). The article described a computerized questionnaire for depression (the CAT-DI) and was generally positive with regards to the potential usefulness of the test in clinical settings. In the article, the authors had clearly stated that they had no conflicts of interest, but that: ...

On October 28, Allen Frances, MD, Chairperson of the DSM-IV task force, published an article on Psychology Today. It is titled Does It Make Sense To Scrap Psychiatric Diagnosis? and is essentially a response to the British Psychological Society’s Division of Clinical Psychology’s (DCP) call to abandon the medical model in situations where it is not appropriate, and to embrace a psychosocial approach. You can see a copy of the DCP’s May 13, 2013, statement here. ...

DSM-5 was published on May 18, 2013, amidst great criticism. The fundamental criticism was, and is, that the problems listed in the manual are not illnesses in any ordinary sense of the term. Other critics focused on the pathologizing of normality, the expansion of the diagnostic net by the lowering of thresholds, and the lack of reliability of the so-called diagnoses. The response from the psychiatric community has been mixed. Some, probably most, psychiatrists are keeping their heads down, getting on with the business of selling pills, and hoping that the gravy train won't derail. Others are busy at damage control ...

BACKGROUND On 3-4 June, the Institute of Psychiatry in London hosted an international conference to mark the publication of DSM-5. On June 10, Sir Simon Wessely, a department head at the Institute, published a paper called DSM-5 at the IoP. The paper is a summary of the conference proceedings, and also, in many respects, a defense of DSM-5. The article touches on many issues that are central to the current anti-psychiatry debate, and for this reason, I thought it might be helpful to take a close look at the piece. ...