Allen Frances
Professor Emeritus, Duke University
Newsflash from APA Meeting: DSM-5 Has Flunked Its Reliability Tests
Posted: 05/08/2012 1:24 pm
http://www.huffingtonpost.com/allen-frances/dsm-5-reliability-tests_b_1490857.html (http://www.huffingtonpost.com/allen-frances/dsm-5-reliability-tests_b_1490857.html)
The whole purpose of having a manual of psychiatric diagnosis is to promote diagnostic agreement. The great value to the field of DSM-III was that it established reliability and preserved the credibility of psychiatry at a time when it was becoming irrelevant because it seemed that psychiatrists could not agree on diagnoses. Everyone knew that the reliability achieved in DSM field testing far exceeds what is possible in clinical practice, but DSM-III took the major step of proving that reliability could be achieved at all. Until now the DSMs have facilitated communication across the clinical/research interface, promoted research, and provided credibility in the court room.
But bad news was recently reported from the annual meeting of the American Psychiatric Association in Philadelphia. The hard-won credibility of psychiatric diagnosis is compromised by the abysmal results reported by the DSM-5 field trials. This failure was clearly predictable from the start:
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Diagnosing the D.S.M.
By ALLEN FRANCES
Published: May 11, 2012
http://www.nytimes.com/2012/05/12/opinion/break-up-the-psychiatric-monopoly.html (http://www.nytimes.com/2012/05/12/opinion/break-up-the-psychiatric-monopoly.html)
AT its annual meeting this week, the American Psychiatric Association did two wonderful things: it rejected one reckless proposal that would have exposed nonpsychotic children to unnecessary and dangerous antipsychotic medication and another that would have turned the existential worries and sadness of everyday life into an alleged mental disorder.
But the association is still proceeding with other suggestions that could potentially expand the boundaries of psychiatry to define as mentally ill tens of millions of people now considered normal. The proposals are part of a major undertaking: revisions to what is often called the "bible of psychiatry" — the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M. The fifth edition of the manual is scheduled for publication next May.