I had sworn off vetting any clinical trials or meta-analyses for a while, but sometimes something special comes along. Neuroskeptic has already had his way with this one, but it had some features that seemed worthy of note. It’s a failed study [and how were they going to write JNJ-18038683 on a pill anyway?]: Translational […]
Mental Illness — Comprehensive Evaluation or Checklist? by Paul R. McHugh, M.D., and Phillip R. Slavney, M.D. New England Journal of Medicine 2012 366:1853-1855. The debate over revising the Diagnostic and Statistical Manual of Mental Disorders is of more than intramural interest, for the way in which the promised fifth edition (DSM-5) resolves the debate […]
There are some paradoxes in the DSM-III: expunged of psychology, but adopted by the psychologists and other non-medical mental health specialties; etiology neutral but fostering a flowering of biology and neuroscience; called the Bible of Psychiatry but functioning more as the Bible of Industry – pharmaceutical, hospital corporations, and medical insurers; written for clinician use […]
So I’ll begin winding up this journey by starting over. The Psychiatric Department ay Washington University in St. Louis in the 1960s stood as the center of Bological Psychiatry in America. They thought psychoanalysis, a dominant paradigm at the time, had no place in psychiatry either as theoretical base or as political force in organized […]
In the ongoing quest to improve our psychiatric diagnostic system, we are now searching for new approaches to understanding the etiological and pathophysiological mechanisms that can improve the validity of our diagnoses and the consequent power of our preventive and treatment interventions venturing beyond the current DSM paradigm and DSM-IV framework. This thought-provoking volume produced […]
In an earlier series [the future of an illusion V…], I wrote about how the ambiguity of the DSM-III about etiology has been used to create the illusion of a biological basis for mental illness without proving it – claiming to be etiology neutral in the process. In this one, I’m on a similar tack, […]
The dreams of our fathers from St. Louis are undisguised. They were the mentors of John Feighner, Robert Spitzer, and made up a fourth of the DSM-III Committee. Click on the picture from their web-site above for their story of their contribution to the DSM-III and also look at their current view of the State […]
My apologies to those of you that already know these things, but I don’t, and blogging has become my late life way of thinking about things I don’t yet know. I take as my justification these overly quoted lines from Eliot: We shall not cease from exploration. And the end of all our exploring. Will […]
In a sense, the real controversy about DSM-III was a controversy about who were the leaders in the profession and whether progress in our field was most likely to come from empirical research studies or from clinical wisdom collected by intensive long-term psychotherapy. Robert Spitzer 2001 It’s easy to read Spitzer’s quote and allow it […]