Wired magazine: Inside the Battle to Define Mental Illness, Gary Greenberg

Wired magazine: Inside the Battle to Define Mental Illness, by Gary Greenberg, 27 December 2010

Post #55 Shortlink: http://wp.me/pKrrB-S8

Updated @ 4 January 2011: Added DSM-5: Dissent From Within by Allen Frances, MD, Psychiatric Times


An interesting article in Wired by Gary Greenberg with Allen Frances, MD, who had chaired the DSM-IV Task Force.

“Wired is a full-color monthly American magazine and on-line periodical, published since March 1993, that reports on how technology affects culture, the economy, and politics. Owned by Condé Nast Publications, it is published in San Francisco, California.”


Inside the Battle to Define Mental Illness
By Gary Greenberg
27 December 2010

Wired January 2011

“We made mistakes that had terrible consequences,” [Frances] says. Diagnoses of autism, attention-deficit hyperactivity disorder, and bipolar disorder skyrocketed, and Frances thinks his manual inadvertently facilitated these epidemics—and, in the bargain, fostered an increasing tendency to chalk up life’s difficulties to mental illness and then treat them with psychiatric drugs…

…At stake in the fight between Frances and the APA is more than professional turf, more than careers and reputations, more than the $6.5 million in sales that the DSM averages each year. The book is the basis of psychiatrists’ authority to pronounce upon our mental health, to command health care dollars from insurance companies for treatment and from government agencies for research. It is as important to psychiatrists as the Constitution is to the US government or the Bible is to Christians. Outside the profession, too, the DSM rules, serving as the authoritative text for psychologists, social workers, and other mental health workers; it is invoked by lawyers in arguing over the culpability of criminal defendants and by parents seeking school services for their children. If, as Frances warns, the new volume is an “absolute disaster,” it could cause a seismic shift in the way mental health care is practiced in this country. It could cause the APA to lose its franchise on our psychic suffering, the naming rights to our pain.

Read full article

Note that at the time of writing, the link for “APA” (Wired article, third paragraph) has been incorrectly given as http://www.apa.org/ which is the site of the American Psychological Association. 

The correct link should be http://www.psych.org/ – it is the American Psychiatric Association that is publisher of the Diagnostic and Statistical Manual of Mental Disorders (current edition known as DSM-IV). Go here for the American Psychiatric Association’s DSM-5 Development website. 

Psychiatric Times


DSM-5: Dissent From Within
By Allen Frances, MD
03 January 2011

 Many people associated with DSM-5 have privately expressed their serious doubts to me, but felt muzzled into public silence by constraining confidentiality agreements and loyalty to the process. Gary Greenberg’s recent DSM-5 piece in Wired offers a set of dispirited quotes from discouraged Work Group members–but again he elicited them only under the promise of strict anonymity. Until now, the only people connected to DSM-5 to express public displeasure were the two who have resigned from it.

John Livesley, a highly respected member of the Personality Disorders (PD) Work Group, has now broken this fortress defensiveness and enforced wall of silence. He has published a brilliantly reasoned critique titled “Confusion and Incoherence in the Classification of Personality Disorder: Commentary on the Preliminary Proposals for DSM-5.”

Read full article

Another recent commentary on the development of DSM-5 from John Gever, Senior Editor, MedPage Today:

MedPage Today


Year in Review: More Bumps in Road to DSM-V
By John Gever, Senior Editor, MedPage Today
26 December 2010

As part of the Year in Review series, Medpage Today reporters are revisiting major news stories and following up with an analysis of the impact of the original report, as well as subsequent news generated by the initial publication. Here’s what’s happened on the DSM-5 front since we published the first 2010 piece on the topic.

Read full article

Note the projected period for public comment on the beta draft is much shorter than the public review period for the alpha draft had been – which had been around 10 weeks.

APA research director, Darrel Regier, MD, told MedPage Today’s senior editor, John Gever, that an update of the central DSM-5 website, where current versions of the draft may be seen, is likely to take place in January. The Task Force anticipates that all the revisions going into the field trials will be posted and that the site will reflect the new classification scheme envisioned for the final DSM-5.


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