Expansion of Psychiatric Turf

INTRODUCTION The bereavement exclusion was formally eliminated in the spring of 2013, with the publication of DSM-5. The exclusion was a provision in earlier editions, that a “diagnosis of major depressive disorder” could not be assigned to a bereaved person, even though he or she met the criteria, unless certain additional considerations were met. The history of its elimination provides an interesting example of psychiatry’s relentless expansion of its net. The issues involved take us right to the heart of the psychiatric hoax. ...

On December 25, 2016, the Baltimore Sun published an excellent article titled Drug companies prey on children, by Patrick D. Hahn, PhD. Dr. Hahn is an affiliate professor of biology at Loyola University, Maryland. Here are some quotes: "I recently attended Youth Mental Health First Aid Training at a local public school. It was an eye-opening experience." "Youth Mental Health First Aid Training, sponsored by the National Council for Behavioral Health, is intended to enable teachers, parents and others in contact with young people to identify potential 'mental illnesses' in order to facilitate early detection and treatment by our mental health care system. My fellow attendees were surprisingly open about their own experiences with that system. One mentioned that her son became manic after being diagnosed for ADHD. Another said that both she and her roommate became bipolar after being diagnosed for depression. Neither our facilitators nor anyone else present pointed out that mania and bipolar disorder are toxic effects of medications commonly prescribed for ADHD and depression." ...

This morning I received an email from Oldhead, who has been active in opposing the Murphy Bill. Here are two quotes from the email: "As succinctly as possible -- the main language from MURPHY (including AOT funding) has been consolidated with another bill, the 21ST CENTURY CURES bill, which is being introduced as a House Amendment to the Senate Amendment to H.R. 34, Tsunami Warning, Education and Research Act of 2015.' In other words, Murphy is being slipped through on another bill’s coattails, if Murphy, Jaffee & Co. have their say." ...

On July 6, HB 2646 (the Tim Murphy Bill) passed the US House and was sent to the Senate. At the present time, a related bill is working its way through the Senate. This is SB 2680, The Mental Health Reform Act 2016. It is sponsored by Lamar Alexander (R-TN), Patty Murray (D-WA), Bill Cassidy (R-LA), Chris Murphy (D-CT), David Vitter (R-LA), and Al Franken (D-MN). The wording of the bill was finalized in March of this year, and it passed out of committee on March 16. ...

Integration of physical and “mental health” care has been a popular topic in psychiatric circles in recent years. During his term as President of the APA, the very eminent psychiatrist Jeffrey Lieberman, MD, made frequent references to this matter in his posts on Psychiatric News (the APA’s online newspaper). For instance, on December 6, 2013, Dr. Lieberman, with co-author Richard Summers, MD, wrote: "The momentum for patient-centered care, the medical home, and integration of behavioral health with primary care creates a new role for psychiatrists." [Emphasis added] ...

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 October 12, 2014, the eminent psychiatrist Allen Frances, MD, participated in a panel discussion at the Mad In America film festival in Gothenburg, Sweden. After the festival, he wrote an article – Finding a Middle Ground Between Psychiatry and Anti-Psychiatry – for the Huffington Post Blog, summarizing the positions he had discussed at the festival. The article was re-published on MIA on October 26, 2014. The article is ostensibly an attempt to find common ground between psychiatry and its critics, but the piece contains numerous distortions and omissions which I think need to be identified and discussed. ...

There’s an interesting article in the July-August 2014 issue of the AARP Bulletin. It’s called Drug Abuse: Antipsychotics in Nursing Homes, and was written by Jan Goodwin. AARP is the American Association of Retired Persons. Jan Goodwin is an investigative journalist whose career, according to Wikipedia, “…has been committed to focusing attention on social justice and human rights…” The article is essentially a condemnation of the widespread and long-standing practice of using neuroleptic drugs to suppress “difficult” behavior in nursing home residents. ...

On June 6, I wrote a post titled Psychiatry DID Promote the Chemical Imbalance Theory. The article was published on Mad in America, and generated a number of comments on that site, five of which were from TherapyFirst, who in his first comment identified himself as Joel Hassman, MD, a practicing psychiatrist. Dr. Hassman did not argue with the general notion that psychiatric practice today consists almost exclusively of the prescription of drugs. Indeed, in one of his own blog posts on June 16, 2013, he wrote in an open letter to newly qualified psychiatrists: ...

In November 2013, the journal Schizophrenia Research published a paper by Tsuji, T. et al. titled Premorbid teacher-rated social functioning predicts adult schizophrenia-spectrum disorder: A high-risk prospective investigation. Here’s the abstract: "Social functioning deficits are a core component of schizophrenia spectrum disorders, and may emerge years prior to the onset of diagnosable illness. The current study prospectively examines the relation between teacher-rated childhood social dysfunction and later mental illness among participants who were at genetic high-risk for schizophrenia and controls (n=244). The teacher-rated social functioning scale significantly predicted psychiatric outcomes (schizophrenia-spectrum vs. other psychiatric disorder vs. no mental illness). Poor premorbid social functioning appears to constitute a marker of illness vulnerability and may also function as a chronic stressor potentially exacerbating risk for illness." ...