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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. ...

THE CAFÉ study was published in the American Journal of Psychiatry in July 2007, and was funded by AstraZeneca. Its stated purpose was to compare AstraZeneca’s drug Seroquel (quetiapine) with other neuroleptic products. I have discussed the CAFÉ study here. Two of CAFÉ’s participants committed suicide during the study period. Both had been randomly assigned to the quetiapine treatment. There are very strong indications that one of these individuals – Dan Markingson, who was enrolled in the study at the University of Minnesota site – was coerced into the study and, because of his psychotic state, was incapable of giving informed consent anyway. He was not doing well on the Seroquel, and his mother, Mary Weiss, made repeated attempts to have him withdrawn from the study and taken off the drug, but without success. In particular, Mary had expressed the belief that Dan was in danger of killing himself. AstraZeneca paid the University of Minnesota $15,648 for each study participant who completed the treatment course. ...

One of the criticisms that I routinely make of psychiatry is that its primary agenda during initial evaluations is the assignment of a “diagnosis,” and that ongoing “treatment” consists of 15-minute “med checks,” during which drug regimens are changed and adjusted. The essence of my criticism is that this kind of approach inevitably oversimplifies human problems, and in practice does more harm than good. My contentions in this regard have from time to time been challenged. It has been said that my portrayal of psychiatry is a kind of misleading caricature, and that in reality, psychiatrists do, in fact, concern themselves with human issues over and above “diagnosis” and drugs. This debate will, of course, continue, but I recently read an article on Psychiatric Times that has some bearing on the matter. [Thanks to Nick Stuart for the link.] The title is Conduct Disorder, ADHD – or Something Else Altogether? The author is Steven Dilsaver, MD, and the piece is dated October 11, 2013. The article is a case study of the psychiatric “treatment” of an eight-year-old boy (John). ...

There’s a new article on Psychiatric News titled Change, Challenge, and Opportunity: Psychiatry Through the Looking Glass of Research. It’s dated October 17, and was authored by Steven Hyman, MD, and Jeffrey Lieberman, MD. Thanks to Mental Health Law on Twitter for the link. Dr. Lieberman is President of the APA. Dr. Hyman was Director of NIMH from 1996 to 2001, and is now the Director of the Stanley Center for Psychiatric Research at the Broad Institute. The Broad Institute is affiliated with Harvard University, and Dr. Hyman is a Harvard Distinguished Service Professor. ...

A few days ago I came across some text on Dr. Novella’s website that appeared to be his response to my recent critique. I drafted a response to this and posted it at 5:40 this morning. Dr. Novella has commented on this and has informed me that the material in question was not written by him. Apparently it was written by one of his commenters, who is also named Steve. ...

There’s an interesting article by Christopher Lane, PhD, in his blog site Side Effects, on Psychology Today. It’s called Crazy like Us: How the U.S. Exports Its Models of Illness, and is dated October 9. Christopher Lane is the author of Shyness: How Normal Behavior Became a Sickness. I wrote a post in April of 2010 that referenced this book. Here’s the opening paragraph from the Psychology Today article. "The fears of many European psychiatrists may soon be realized. Earlier this week, Psychiatric News reported that the American Psychiatric Association has begun petitioning the various agencies overseeing changes to the ICD, or International Classification of Diseases, to request that they adopt its most-controversial changes in DSM-5." ...

I have recently read De-Medicalizing Misery [palgrave macmillan, 2011]. It’s a comprehensive collection of articles, edited by Mark Rapley, Joanna Moncrieff, and Jacqui Dillon. The table of contents provides a sense of the book’s scope. Table of Contents Carving Nature at its Joints? DSM and the Medicalization of Everyday Life, Mark Rapley, Joanna Moncrieff, and Jacqui Dillon Dualisms and the Myth of Mental Illness, Philip Thomas and Patrick Bracken Making the World Go Away, and How Psychology and Psychiatry Benefit, Mary Boyle Cultural Diversity and Racism: An Historical Perspective, Suman Fernando The Social Context of Paranoia, David J. Harper From Bad Character to BPD: The Medicalization of 'Personality Disorder', James Bourne Medicalizing Masculinity, Sami Timimi Can Traumatic Events Traumatize People? Trauma, Madness, and Psychosis, Lucy Johnstone Children Who Witness Violence at Home, Arlene Vetere Discourses of Acceptance and Resistance: Speaking Out about Psychiatry, Ewen Speed The Personal is The Political, Jacqui Dillon 'I'm Just, You Know, Joe Bloggs': The Management of Parental Responsibility for First-episode Psychosis, Carlton Coulter and Mark Rapley The Myth of the Antidepressant: An Historical Analysis, Joanna Moncrieff Antidepressants and the Placebo Response, Irving Kirsch Why Were Doctors So Slow to Recognize Antidepressant Discontinuation Problems? Duncan Double Toxic Psychology, Craig Newnes Psychotherapy: Illusion with No Future? David Smail The Psychologization of Torture, Nimisha Patel What Is to Be Done? Joanna Moncrieff, Jacqui Dillon, and Mark Rapley Each author brings to the general topic his or her unique perspectives, and the result is persuasive and inspiring. Here’s a quote from the final chapter: ...

On Monday, October 7, 2013, The Sun, a British tabloid newspaper ran the following headline: 1,200 Killed By Mental Patients. Shock 10-year toll exposes care crisis. It took up almost all of the front page. The headline precipitated a great deal of protest from politicians, advocacy groups, mental health professionals, and others. The general points in most of these protests were that the headline was sensationalistic, misleading, and would serve to increase the stigma associated with “mental illness.” ...

I recently came across an APA article titled Change, Challenge, and Opportunity: Psychiatry in the Age of Health Care Reform. It was co-authored by Jeffrey Lieberman, MD, and Howard Goldman, MD, PhD, and dated October 3. The article discusses the implications of the Affordable Care Act (Obamacare) for psychiatry, and also reviews progress of the 2008 Mental Health Parity Act. The latter mandated that insurance coverage for “mental illnesses” be essentially on a par with coverage for general medical problems, but the act has not yet been implemented in its entirety. The authors also point out that there are provisions in the ACA that focus on reform of the actual health care services, as well as the reform of health care insurance. ...

I’ve been reading another great book: Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare, by Peter C. Gotzsche [Radcliffe Publishing, 2013]. The book is an exposé of pharma’s fraudulent research and marketing. The author is a Danish physician who has been involved in clinical trials of drugs, and in drug regulatory matters. He is a professor at the University of Copenhagen. He has published more than 50 papers, including papers in the BMJ, Lancet, JAMA, Annals of Internal Medicine, and the New England Journal of Medicine. ...