Allen Frances on the Coming DSM-V Revision

While reviewing my out-of-date Big Pharma links I happened upon some news regarding the update of DSM-V. In case DSM-V is just a bunch of letters to you, it stands for Diagnostic and Statistical Manual (of Mental Disorders), and if that doesn’t clarify much either, it’s the list of approved psychiatric diagnoses published by the American Psychiatric Association. The DSM has a long and complicated history, but the upshot is it’s slated for an update around May 2013. It’s last revision was in 1994.

So, here, I’ve posted a video of Allen Frances, MD, speaking about what he sees as problematic about the proposed version. Dr. Frances is not just any curmudgeon with an ax to grind, he chaired the committee that did the revision of DSM-IV. In fact, he published a rather pointed Op-Ed in the New York Times not too long ago, entitled “Diagnosing the DSM.” Here’s a little taste from that piece:

Indeed, the D.S.M. is the victim of its own success and is accorded the authority of a bible in areas well beyond its competence. It has become the arbiter of who is ill and who is not — and often the primary determinant of treatment decisions, insurance eligibility, disability payments and who gets special school services. D.S.M. drives the direction of research and the approval of new drugs. It is widely used (and misused) in the courts.

You may well conclude that Dr. Frances does have an ax to grind. I don’t know him, so I can’t say. But watching his speech he appears quite sane and measured, and the video serves as an excellent introduction to the salient issues surrounding the revamp of what some call the “psychiatric bible.”


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Clinical Psychologist practicing in the Los Feliz neighborhood of Los Angeles, California.

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