Mental Health Blogs

I’d really rather not be writing about the forthcoming DSM-5 (come on everyone, let’s drop the Roman numeral already. Cicero and Seneca ain’t writing the dang thing), but Shirah Vollmer, a psychiatry and family medicine professor at UCLA, has written critically of the DSM on her Psychology Today blog. In other words, yet another academic within psychiatry is criticizing her colleagues who are putting together DSM-5. Who knows? Maybe they’ll listen.

Vollmer’s primary point:

“The biases of psychiatric diagnoses are powerful. The more people who are included in a mental disorder, the more research money there will be to fund the science, and the more drug companies have incentive to produce treatments. On the other hand, the more people who are included in a diagnosis, the more suspicious the public becomes about the quality of the diagnostic criteria. No matter how DSM V will be written, it will be flawed. There is no psychiatric diagnosis which has an objective measure. At the moment, all diagnoses are clinical diagnoses, meaning they are subjective. This is a field of humility. There is a lot that we do not know.

“I think there should be an introduction to DSM V which clearly states that this book is a product of work groups, and as such, the diagnostic criteria are subject to further revision. Perhaps this is obvious, but I think that this point needs to be stated clearly. The public needs to know that psychiatry is a field in its infancy, and as such, skepticism is warranted.”

Skepticism, yes. But ignoring the whole DSM altogether might not be such a bad idea.

It’s been a tough last year or so for DSM-5. The New Scientist called for an end to the DSM or at least its current clunky revision process. The APA delayed the release of DSM-5 by one year to 2013. In late 2008, DSM-3 creator Robert Spitzer slammed the DSM-5 process for its secrecy. And Christopher Lane busted the DSM-5 creators for a lack of transparency.

I’d say DSM-5 is in a lot of trouble. And it deserves to be. The DSMs have become so expansive that researchers could actually assert with straight faces, as they did last year, that almost 50 percent of college-age Americans have a psychiatric disorder. With assertions like that, the so-called Bible of psychiatry looks crazier than the Farmer’s Almanac.

Good for Vollmer for pulling up a chair at what’s becoming a hog killing, if I can put it that way.

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