Washington Examiner: Corrupting Psychiatry by Max Borders

Washington Examiner: Corrupting Psychiatry by Max Borders

Post #58 Shortlink: http://wp.me/pKrrB-TU

Interesting commentary from writer Max Borders, last week, on the website of the Washington Examiner around the revision of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM):

Washington Examiner

Corrupting Psychiatry

By Max Borders 01/18/11 10:22 AM

The American Psychiatric Association (APA) has gone crazy — like a fox.

“There was a time when we could be more charitable about the vagaries in the APA’s Bible, the DSM. But not anymore. If you’ve never heard of the DSM, it’s the Diagnostic and Statistical Manual series the APA publishes. Psychiatrists all over the world use the DSM as a guidebook for treating people with some form of mental illness. But the APA may test credulity with its upcoming edition.

“I refer specifically to proposed changes in the DSM-V due out in 2013. It’s no accident these changes reflect new political realities about how psychiatric medicine gets paid for and by whom…”

Read rest of article at the Washington Examiner

Commentary in response to “Corrupting Psychiatry” from Dutch philosopher and psychologist, Maarten Maartensz, on Nederlog here More on the APA’s mockery of medicine and morality and here More on the APA and the DSM-5

Comments on Washington Examiner to article “Corrupting Psychiatry” by Max Borders

By: Skeeter
Jan 21, 2011 9:55 PM

Good article, that says things that need to be said, long and loud.

Both the APA, and the broader psychiatric profession, are currently indulging in a seriously unjustified power grab, and they and their claims are in desperate need of much closer and tougher (and ongoing) external scrutiny then they have been subject to date.

Generally speaking, I would have to agree that the profession is becoming much too closely aligned with and mutually reliant on both state and corporate interests, as opposed to the interests of the patient and the science on which they base their claims to authority.

One small point: I would not invoke British psychiatry as any counterbalance to the excesses of their American colleagues. The Brits have their own serious problems. Not least of which is that they are mired deep in the methodological and ethical swamp of somatoform disorders (aka conversion or psychosomatic disorders, and their related ‘treatments’), and a lot of patients are paying a very heavy price indeed for this obsession by certain influential members of the British psych establishment.

By: Suzy Chapman
Jan 22, 2011 7:28 AM

Erasing the interface between psychiatry and medicine

The previous commenter cautions against invoking members of the “British psych establishment”. Two very influential members of the British psychiatry and psychosomatics establishment, Professors Michael Sharpe and Francis Creed, have seats on the DSM-5 “Somatic Symptom Disorders” Work Group.

While many column inches by rightly perturbed journalists and a stream of often acerbic critiques from former DSM Task Force chairs, Allen Frances and Robert Spitzer, have focussed on the implications for introducing new additions into the DSM and broadening the definitions of existing diagnostic criteria, the DSM-5 “Somatic Symptom Disorders” Work Group (Chair, Joel E Dimsdale) has been quietly redefining DSM’s “Somatoform Disorders” categories with proposals that if approved would legitimise the application of an additional diagnosis of “Somatic Symptom Disorder” to all medical diseases and disorders.

Radical proposals for renaming the “Somatoform Disorders” category “Somatic Symptom Disorders” and combining a number of existing categories under a new umbrella, “Complex Somatic Symptom Disorder (CSSD)” and a more recently suggested “Simple Somatic Symptom Disorder (SSSD)”, have the potential for bringing millions more patients under a mental health banner and expanding markets for psychiatric services, antidepressants, antipsychotics and behavioural therapies such as Cognitive Behavioural Therapy (CBT) for all patients with somatic symptoms, irrespective of cause.

Professor Creed is co-editor of The Journal of Psychosomatic Research. In a June ’09 Editorial, titled “The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV – a preliminary report”, which expanded on a brief DSM-5 Work Group progress report published on the DSM-5 Development website that April, Joel E Dimsdale and fellow DSM-5 Work Group member, Francis Creed, reported that by doing away with the “controversial concept of medically unexplained symptoms”, their proposed classification might diminish the “dichotomy, inherent in the ‘Somatoform’ section of DSM IV, between disorders based on medically unexplained symptoms and patients with organic disease.”

If the most recent “Somatic Symptom Disorders” Work Group proposals gain DSM Task Force approval, all medical conditions, whether “established general medical conditions or disorders” like diabetes or conditions presenting with “somatic symptoms of unclear etiology” will have the potential for a bolt-on diagnosis of “somatic symptom disorder”.

Under the guise of “eliminating stigma” and eradicating “terminology [that] enforces a dualism between psychiatric and medical conditions” the American Psychiatric Association (APA) appears hell bent on colonising the entire medical field by licensing the application of a mental health diagnosis to all medical diseases and disorders.

By: KAL
Jan 23, 2011 1:36 PM

Who else might benefit? Disability Insurance. If you can be shown to have a “mental illness” then disability insurance only pays a maximum of two years of payments vs. a lifetime of payments for an organic disease.

Check the APA website for conflicts of interest for members of the working group for Somatic Disorders.

References:

DSM-5 Development website: Somatoform Disorders
http://www.dsm5.org/ProposedRevisions/Pages/SomatoformDisorders.aspx

Proposal: Complex Somatic Symptom Disorder
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=368

Proposal: Simple Somatic Symptom Disorder
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=491

The most recent versions of the two key documents associated with the proposals of the “Somatic Symptom Disorders” Work Group are:

Update @ 7 February 2011

The Justification of Criteria document was revised again by the SSD Work Group on 1/31/11 to incorporate the new proposal for SSSD and other revisions and is replaced by:

DRAFT 1/31/11  Justification of Criteria – Somatic Symptoms

Descriptions document version 1/14/11 Revised Disorder Descriptions: Version 1/14/11

Rationale document version 10/4/10 Previous revised Justification of Criteria: Version 10/4/10

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