SAN FRANCISCO — The American Psychiatric Association officially kicked off its annual meeting this weekend with the release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. To mark the occasion, incoming APA president Jeffrey A. Lieberman, MD, announced during the opening session that the profession of psychiatry has come of age. "This is the time for us to seize the moment, for mental illnesses to step out of the shadows, for mental health care to be made accessible and fairly reimbursed, and for psychiatry to take its rightful role in the field of medicine," he said… Despite some of the challenges, psychiatric medicine has grown by leaps and bounds, Lieberman said. He gave examples of the emergence of psychopharmacology, neuroimaging, molecular genetics and biology, which have propelled psychiatry to the forefront of modern medicine…
We’re all mad here by DR. ALLEN FRANCES – Human nature doesn’t change that fast, but the labels used to describe it can follow fickle fashions. The vehicle of today’s fashion shift is the publication yesterday of the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders,” the official compendium of psychiatric diagnoses. DSM 5 has added many new mental disorders that include many symptoms and behaviors previously accepted as simply part of the human condition. The resulting overdiagnosis of mental disorder will have many harmful unintended consequences — the misuse of medication, unnecessary stigma, high costs, misallocated resources, narrowed expectations, a reduced sense of personal responsibility, and the misapprehension that we are all becoming sick individuals living in an increasingly sick society…
Psychiatry faces another crisis of confidence – Psychotherapist Gary Greenberg is more blunt. “Even at its best … psychiatric diagnosis is fiction sold to the public as fact,” Greenberg writes in his new book, The Book of Woe: The DSM and the Unmaking of Psychiatry. “There is a huge disconnect between what psychiatry claims for itself, and what it can actually do,” he says… In other words, 200 years after psychiatry was recognized as a medical discipline, a stark question persists: Is psychiatry credible?…
Some moments are in no mood for seizure, and this appears to be one of them. The American Psychiatric Association with Drs. Scully, Kupfer, and Regier have spent a decade marching forward in spite of failed dreams, failed field tests, stalled research, remarkable changes in the political/social climate, and near universal criticism here and abroad. It appears that Dr. Lieberman has been handed the mantle and is continuing the march to the sea, dragging the APA along behind him. This is playing out like HBO’s The Game of Thrones or President George Bush’s landing on the Aircraft Carrier proclaiming Mission Accomplished.
Time present and time past
Are both perhaps present in time future,
And time future contained in time past.
If all time is eternally present
All time is unredeemable.
What might have been is an abstraction
Remaining a perpetual possibility
Only in a world of speculation.
What might have been and what has been
Point to one end, which is always present…
I know I always quote these same lines, but at a time like this one, "what might have been" is unavoidably on my mind. In the last decade, we’ve seen the dark side of too many things for this kind of circus. It was a time for a reformation – a time to set things right in psychiatry and that’s not what happened. The DSM-5 revision could’ve been a part of that with a rational review of the structure of the diagnostic manual – plugging of the loopholes exploited by industry. It could’ve been an influence as we enter a general era of healthcare reform. But what it became is a failed attempt at furthering an agenda of a segment of psychiatrists with dubious alliances, and an anachronistic testament to something that cried out for change. As of today, it became unredeemable and leaves us with a future with the same problems as the past – magnified by being perpetuated…
The profession has a culture, long-standing traditions that go back a couple of centuries….
“The more things change, the more they stay the same.” – Jean-Baptiste Alphonse Karr
Duane
Well, everything is everything, and these Lords of Biological Psychiatry have something close to nothing with which to account for themselves.