What’s A Mental Disorder? Even Experts Can’t Agree

The American Psychiatric Association’s Diagnostic and Statistical Manual, or DSM, updated roughly every 15 years, has detailed descriptions of all the mental disorders officially recognized by psychiatry. It’s used by psychiatrists, insurance companies, drug researchers, the courts and even schools.

But it’s not without controversy: The proposed changes suggested this year have sparked a kind of civil war within psychiatry.

In a small condo on the beach in San Diego lives Allen Frances, who blames himself for what he calls the “Epidemic of Asperger’s.” Frances edited the last edition of the DSM, and he’s also the new DSM’s most prominent critic. Frances is the one who put the word Asperger’s in the DSM in the first place, thereby making it an official mental disorder

Drug-Company Tweeting: Still Awaiting FDA Rules

Note from CCHR: Let’s see if we’ve got this straight…..last year, Pfizer paid $1.2 billion for illegal off-label promotion -the largest criminal fine in U.S.history. The company also paid $2.3 billion to settle claims that it had marketed numerous drugs for unapproved purposes Other corporate violators included GlaxoSmithKline, Eli Lilly, Schering-Plough, Bristol-Myers Squibb, AstraZeneca, TAP Pharmaceutical, Merck, Serono, Purdue, Allergan, Novartis, Cephalon, Johnson & Johnson, Forest Laboratories, Sanofi-aventis, Bayer, Mylan, Teva and King Pharmaceuticals. Criminal or civil illegalities included (1) overcharging government health programs, (2) unlawful promotion, (3) monopoly practices, (4) kickbacks, (5) concealing study findings, (6) poor manufacturing practices, (7) environmental violations, (8) financial violations and (9) illegal distribution. And after all that, the FDA is going to allow Big Pharma to launch into social media? Seriously?

Electroconvulsive Therapy: Will The FDA Whitewash It?

For decades the FDA has allowed electroconvulsive therapy (ECT) to be used without requiring any proof of safety or efficacy. The machines and the treatment has been “grandfathered” into use rather than tested. A few years ago the FDA proposed to test the treatment but heavy pressure from the American Psychiatric Association caused the agency to reverse itself. ECT remains untested and widely used. Imagine that — the American Psychiatric Association doesn’t want an obviously dangerous treatment to be tested at all. It just wants psychiatrists left alone to inflict it upon hapless patients. The sad truth is that psychiatry has always promoted brain-damaging treatments, including lobotomy, electroshock and toxic chemical substances. In the 1970s I conducted an intensive international campaign to stop the resurgence of lobotomy and others forms of psychosurgery, and if my campaign had not been successful, lobotomy would have once again become widely accepted within contemporary psychiatry. Using media citations and other sources, that campaign and its success is documented in The Conscience of Psychiatry: The Reform Work of Peter R. Breggin, MD.

Drug Industry Fraud—The Whistle Has Been Blown, But Where’s the Enforcement?

by Ralph Nadar
One of the worst violations involves companies promoting unproven, often dangerous uses for their medicines. Last year, Pfizer paid $1.2 billion for illegal off-label promotion -the largest criminal fine in U.S.history. Other major corporate violators were GlaxoSmithKline, Eli Lilly, Schering-Plough, Bristol-Myers Squibb, AstraZeneca, TAP Pharmaceutical, Merck, Serono, Purdue, Allergan, Novartis, Cephalon, Johnson & Johnson, Forest Laboratories, Sanofi-aventis, Bayer, Mylan, Teva and King Pharmaceuticals.

The violations by these and other drug companies point to the wide range of impacts, including taking many lives of patients, which stems from these recurrent activities. These criminal or civil illegalities cover (1) overcharging government health programs, (2) unlawful promotion, (3) monopoly practices, (4) kickbacks, (5) concealing study findings, (6) poor manufacturing practices, (7) environmental violations, (8) financial violations and (9) illegal distribution.

DSM: The Book of Woe—Inside the Battle to Define Mental Illness

Every so often Al Frances says something that seems to surprise even him. Just now, for instance, in the predawn darkness of his comfortable, rambling home in Carmel, California, he has broken off his exercise routine to declare that “there is no definition of a mental disorder. It’s bullshit. I mean, you just can’t define it.”

The insurgency against the DSM-5 (the APA has decided to shed the Roman numerals) has now spread far beyond just Allen Frances. Psychiatrists at the top of their specialties, clinicians at prominent hospitals, and even some contributors to the new edition have expressed deep reservations about it. Dissidents complain that the revision process is in disarray and that the preliminary results, made public for the first time in February 2010, are filled with potential clinical and public relations nightmares. Although most of the dissenters are squeamish about making their concerns public—especially because of a surprisingly restrictive nondisclosure agreement that all insiders were required to sign—they are becoming increasingly restive, and some are beginning to agree with Frances that public pressure may be the only way to derail a train that he fears will “take psychiatry off a cliff.”

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