from within…

Posted on Tuesday 31 December 2013

It would be a gross understatement to say that I see psychiatry in need of reform. So I would’ve thought that on the last day of this particular year, the DSM-5 year, I would look back and feel like Job – sackcloth and ashes. The DSM-5 is many things, but a failed opportunity for reform is on the top of my list – though it’s not so bad as it tried to be. The APA leadership under Dr. Lieberman hasn’t been a plus either.

But when I think about what’s in need of reform, item number one would be the pharmaceutical industry’s invasion of academic and organized psychiatry and the willing collusion of the KOL Klan. They’ve taken major hits in the courts and in the press with more to come. The pipeline mirage has faded and the CNS drug machine is on sabbatical. The conduits for corruption, AKA Clinical Trials and distorted literature, are being plugged at a comforting rate. It’s been the year of escalating settlements, and palpable advances like AllTrials, RIAT, the EMA decision about data, etc. It feels like a healthy campaign. Psychiatry needs to re-locate itself, and the forces urging it to to do so are on the ascendency. Even all the attention focused on the DSM-5 has given the general populace a better view of the problems. Over-medication has become a frequently vilified topic in the press rather than only a spectator sport on Wall Street.

I would be reticent to declare it the dawn of a new day at this point, but a lot of the fog is definitely beginning to lift. So I’ll pass on the sackcloth and ashes this year and look for signs of the missing piece in 2014 – strong forces for change that are originating from within psychiatry itself…
    December 31, 2013 | 8:11 PM

    Tomorrow the APA will likely revise the number of members listed on their website on the ‘about’ page, as they have done Jan 1st of each year.

    The pattern for the last several years has been a steady decline of 2 or 3 thousand members each year. This year the APA received more attention then the previous few years; it should be interesting to see if that number moves up or down, or at all.

    Each member that leaves or simply doesn’t join the APA is another psychiatrist opposed to the current leadership of the APA; a silent sign of the strong forces that are so often hidden from view.

    For historical trends, one can use the ‘wayback machine’ available at to view the APA’s ‘about’ page as it was plucked from the web and archived and stored over the last 13 or so years on the vast servers of the first searchable ‘time machine’ web crawler.

    Here’s to a fresh new year.

    December 31, 2013 | 8:18 PM

    It’s looking way up.

    January 1, 2014 | 8:55 PM

    They must have run a Groupon.

    January 2, 2014 | 5:28 PM

    Well, no change is better then up, possible they’ll revise the figure in another month as they have done sometimes.

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