Allen Frances; John Grohol on DSM-V revision process

January 4, 2010 by

Allen Frances, MD; John Grohol, PsyD, on DSM-V revision process

Post #6 Shortlink: http://wp.me/pKrrB-bS

There’s been no response, so far, on the DSM-V pages of Psychiatric Times to the news that the APA has extended its timeline by 12 months.

On 3 December, Dr Allen Frances, MD, who chaired the DSM-IV Task Force, had published that according to his sources, the APA’s original plan to schedule field trials before the proposed changes could be vetted by the field and with an “impossible publication deadline” of May 2012 was being shelved and that field trials would now follow the posting of options; the publication of DSM-5 was expected to be postponed until May 2013.

Psychiatric Times 

COMMENTARY
Alert to the Research Community—Be Prepared to Weigh in on DSM-V
by Allen Frances, MD
03 December 2009

Dr Frances was the chair of the DSM-IV Task Force and of the department of psychiatry at Duke University School of Medicine, Durham, NC. He is currently professor emeritus at Duke.

This commentary will suggest how the research community can be instrumental in improving DSM-V and helping it avoid unintended consequences. According to several converging, anonymous (but I think quite reliable) sources to which I have had access, the draft options for DSM-V will finally be posted between mid-January and mid-February 2010. There will then be just one additional month until mid-March for collecting comments.* The good news is that the products of a previously closed process will finally be available for wide review and correction. The bad news is that there will be only a very brief period allotted for this absolutely crucial input from the field…

…The research community has a central role and a great responsibility in taking advantage of this precious opportunity to carefully review and identify the problems in the DSM-V drafts and to suggest solutions…

Read full commentary here

The APA board has declined to comment on Dr Frances’ comments.

Catch up with the often acerbic exchanges between Drs Spitzer and Frances, APA board members and others with past and current involvement with DSM revisions on Psychiatric Times DSM-V Resource pages.

*APA has since rescheduled date of publication of draft options to 10 February 2010 

Commentary here on DSM revision controversies from Dr John M Grohol PsyD:

Psych Central
DSM-V: Suggestions for Change
by John M Grohol, PsyD

Dr. John Grohol is the CEO and founder of Psych Central.

Dr Grohol offers 8 suggestions for “Fixing the DSM Revision Process”

An earlier piece by Grohol around DSM-5:

Psych Central
Transparency, Kupfer and the DSM-V
by John M Grohol, PsyD

Filed under American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, Psychiatric Times

Christopher Lane on DSM revision and New Scientist article

January 4, 2010 by

Christopher Lane commentary on DSM revision and New Scientist article

Post #5 Shortlink: http://wp.me/pKrrB-bG

Update @ 9 January 10

On the Media | The Art of Diagnosis | 26 December 2008

Does very severe PMS constitute a mental disorder? That’s one of many questions facing psychiatrists as they work to revise the Diagnostic and Statistical Manual of Mental Disorders or DSM, the definitive compendium of our psychic maladies. Because the DSM influences not just doctors and patients but medical research, insurance companies, the pharmaceutical industry, advertising and the culture at large, controversy surrounding its new edition abounds. Brooke looks at this powerful book…

Audio and transcript: includes contributions from Christopher Lane, Brooke Gladstone, Dr Darrel Regier (Vice chair, DSM-5 Task Force), Dr Michael First and others.

Christopher Lane, PhD, is the Pearce Miller Research Professor at Northwestern University and author of Shyness: How Normal Behavior Became a Sickness.

On 12 December, Dr Lane published a commentary around the editorial and article published a couple of days before, by New Scientist:

Psychology Today

American Psychiatry Is Facing “Civil War” over Its Diagnostic Manual
What’s the real reason DSM-V has been delayed?

Yesterday, the American Psychiatric Association announced that it is pushing back the publication of DSM-V until 2013. The APA tried to put a good face on this rather embarrassing admission – embarrassing, because several spokespeople for the organization had insisted, quite recently, that they were on-track for publication in 2012 and that nothing would deter them…

Read full article here

On Friday, 18 December, Christopher Lane gave an interview on WNCY Radio, on the Brian Lehrer Show.  You can listen to the interview here:

The Brian Lehrer Show  |  18 December 2009  |  Mental Illness by the Book

http://www.wnyc.org/shows/bl/episodes/2009/12/18/segments/146466

http://www.wnyc.org/stream/ram?file=/bl/bl121809bpod.mp3

http://www.wnyc.org/flashplayer/player.html#/play/%2Fstream%2Fxspf%2F146466

“The Diagnostic and Statistical Manual of Mental Disorders, is commonly known as the “bible” of psychiatry. Christopher Lane, Northwestern University English literature professor and author of Shyness: How Normal Behavior Became a Sickness, discusses the controversy around revising this manual.”

Related information:

Previous commentary from Christopher Lane on the DSM revision process:

Los Angeles Times
Opinion
Wrangling over psychiatry’s bible
by Christopher Lane
16 November 2008

and

Slate
Bitterness, Compulsive Shopping, and Internet Addiction
The diagnostic madness of DSM-V
by Christopher Lane
24 July 2009

Filed under American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, New Scientist, Psychiatric Times

DSM-5: Revision controversies in New Scientist 09.12.09

January 3, 2010 by

DSM-5: Revision controversies in New Scientist 09.12.09

Post #4 Shortlink: http://wp.me/pKrrB-bv

Just one day before the American Psychiatric Association (APA) announced its intention to shift the publication date for DSM-5 one year on, to May 2103, New Scientist published an editorial and an article by Peter Aldhous [New Scientist’s San Francisco bureau chief] on the controversies around the revision of DSM-IV:

New Scientist

Editorial:
Time’s up for psychiatry’s bible
09 December 2009

“…The final wording of the new manual will have worldwide significance. DSM is considered the bible of psychiatry, and if the APA broadens the diagnostic criteria for conditions such as schizophrenia and depression, millions more people could be placed on powerful drugs, some of which have serious side effects. Similarly, newly defined mental illnesses that deem certain individuals a danger to society could be used to justify locking these people up for life…”

Read full editorial here

Article:
Psychiatry’s civil war
by Peter Aldhous
09 December 2009

“…Two eminent retired psychiatrists are warning that the revision process is fatally flawed.* They say the new manual, to be known as DSM-V, will extend definitions of mental illnesses so broadly that tens of millions of people will be given unnecessary and risky drugs. Leaders of the American Psychiatric Association (APA), which publishes the manual, have shot back, accusing the pair of being motivated by their own financial interests – a charge they deny. The row is set to come to a head next month when the proposed changes will be published online. For a profession that exists to soothe human troubles, it’s incendiary stuff.”

“…Some of the most acrimonious arguments stem from worries about the pharmaceutical industry’s influence over psychiatry. This has led to the spotlight being turned on the financial ties of those in charge of revising the manual, and has made any diagnostic changes that could expand the use of drugs especially controversial.”

Read full article here

*See: Letter to APA Board of Trustees July 7 2009 From Allen Frances and Robert Spitzer 06 July 2009

See also:

Psychiatric Times
News
A Warning Sign on the Road to DSM-V: Beware of Its Unintended Consequences
Allen Frances, MD
26 June 2009

Dr Frances was chair of the DSM-IV Task Force

 

See: Psychiatric Times DSM-V Resource page for further commentaries by Spitzer, Frances and others and responses from APA board officials

Filed under American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, New Scientist, Psychiatric Times

APA announces revised timeline for publication of DSM-5

January 3, 2010 by

American Psychiatric Association (APA) announces revised timeline for publication of DSM-5

Post #3 Shortlink: http://wp.me/pKrrB-aS

Update@ 10 February

The APA released draft revisions and proposals for DSM-5 criteria on new webpages on 10 February, here:  DSM-5 Development

In a news release issued on 10 December, the APA has announced that the timeline for the publication of DSM-5 (DSM-V) is being extended from May 2012 to May 2013.

APA President Alan Schatzberg, MD, said:

Extending the timeline will allow more time for public review, field trials and revisions

The extension will also permit the DSM-5 to better link with the U.S. implementation of the ICD-10-CM codes for all Medicare/Medicaid claims reporting, scheduled for October 1, 2013.

David Kupfer, MD, chair of the DSM-5 Task Force, said:

Draft changes to the DSM will be posted on the DSM-5 Web site in January 2010. Comments will be accepted for two months and reviewed by the relevant DSM-5 Work Groups in each diagnostic category. Field trials for testing proposed changes will be conducted in three phases.

The APA news release does not confirm a date for the publication of draft category proposals but this MedPage Today write-up quotes 20 January* and also suggests a consultation period of “two to three months”:

*Since rescheduled for 10 February 2010

MedPage Today
DSM-V Publication Pushed Back to 2013
By John Gever, Senior Editor, MedPage Today
11 December 2009

On 1 January, the APA confirmed the draft publication date in this Psychiatric News article:

Psychiatric News  
Association News DSM-5 Postponed Until 2013; Field Trials Scheduled for Summer
by Jun Yan
Volume 45 Number 1 Page 2
01 January 2010

Proposed changes to the current diagnostic criteria will be posted on APA’s DSM-5 Web site at for public comments starting on January 20. After an open period of two to three months, feedback will be reviewed and incorporated by the appropriate work groups under the direction of the DSM-5 Task Force. The resulting draft criteria will then be tested in the first phase of field trials, which are set to begin this summer…

…Data collected in field trials will be analyzed to inform further revisions to the proposed criteria. The public will then have another window of opportunity to comment on the updated draft of DSM-5 criteria.

At the time of publishing, there is no information on the APA’s DSM-5 webpages around the draft consultation process. No progress reports have been issued by the DSM-5 Work Groups since April 2009.

 

The WHO is scheduled to publish its ICD-11 Alpha Draft in May, this year, but has yet to issue an ETA for the launch of iCAT, the wiki-like collaborative authoring platform though which the revision of ICD-10 and development of ICD-11 is being undertaken. ICD-11 Revision Steering Group has issued no comment on the APA’s decision to postpone publication of DSM-5 until 2013.

The PDF of the APA’s 10 December News Release is here 

Short link: http://DSM5toMay2013.notlong.com

and here is the full text of the APA News Release:

News Release  American Psychiatric Association

100 Wilson Boulevard, Suite 1825, Arlington, VA, 22209

For Information Contact:
Beth Casteel 703-907-8640
press@psych.org  Release No. 09-65
Jaime Valora 703-907-8562
jvalora@psych.org

For Immediate Release:
December 10, 2009
Release No. 09-65

DSM-5 Publication Date Moved to May 2013

ARLINGTON, Va. (Dec. 10, 2009) – The American Psychiatric Association revised the timeline for publishing the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, moving the anticipated release date to May 2013.

“Extending the timeline will allow more time for public review, field trials and revisions,” said APA President Alan Schatzberg, M.D.” The APA is committed to developing a manual that is based on the best science available and useful to clinicians and researchers.”

The extension will also permit the DSM-5 to better link with the U.S. implementation of the ICD-10-CM codes for all Medicare/Medicaid claims reporting, scheduled for October 1, 2013.

Although ICD-10 was published by the WHO in 1990, the “Clinical Modification” version (ICD-10-CM) authorized by the U.S. Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control (CDC) is not being implemented in the U.S. until 23 years later.

The ICD-10-CM includes disorder names, logical groupings of disorders and code numbers but not explicit diagnostic criteria. The APA has already worked with CMS and CDC to develop a common structure for the currently in-use DSM-IV and the mental disorders section of the ICD-10-CM.

The International Classification of Diseases (ICD) is published by the WHO for all member countries to classify diseases and medical conditions for international health care, public health, and statistical use. The WHO plans to release its next version of the ICD, the ICD-11, in 2014.

APA will continue to work with the WHO to harmonize the DSM-5 with the mental and behavioral disorders section of the ICD-11. Given the timing of the release of both DSM-5 and ICD-11 in relation to the ICD-10-CM, the APA will also work with the CDC and CMS to propose a structure for the U.S. ICD-10 CM that is reflective of the DSM-5 and ICD-11 harmonization efforts. This will be done prior to the time when the ICD-10-CM revisions are “frozen” for CMS and insurance companies to prepare for the October 1, 2013, adoption.

The Timeline

David Kupfer, M.D., chair of the DSM-5 Task Force, which is in charge of the DSM revision process, noted that draft changes to the DSM will be posted on the DSM-5 Web site in January 2010. Comments will be accepted for two months and reviewed by the relevant DSM-5 Work Groups in each diagnostic category. Field trials for testing proposed changes will be conducted in three phases.

The process for developing the DSM-5 began a decade ago, with an initial research planning conference under the joint sponsorship of the APA and the National Institute of Mental Health.

Additional global research planning conferences, under the auspices of the American Psychiatric Institute for Research and Education (APIRE), the World Health Organization, and three institutes of the National Institutes of Health produced a series of monographs, which helped lay the groundwork for the revisions. The APA’s DSM-5 Task Force and Work Group members were identified in 2007; they are tasked with reviewing scientific advances and research to develop draft diagnostic criteria in diagnostic categories of psychiatric disorders. Information about the revision process is available online at http://www.DSM5.org .

The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at http://www.psych.org and http://www.healthyminds.org .

Filed under American Psychiatric Association (APA), DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, ICD revision process, ICD-11, WHO (World Health Organization)

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