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I have been following this subject ever since Nursing school, and I assure you I never found such a comprehensive and scientific trashing of the farse of psychiatry, as in this brilliant work by Dr James Davies, PhD.
The DSM expanded faster than any other medical manual in history; in the 60s it included about a hundred disorders and today it includes more than 300.
Davies
Half of the highest payments made by the whole of pharma to the whole of US medicine were made to doctors in a single specialty and that was psychiatry.
Davies
56% of the people who were involved in the DSM construction had one or more financial ties to the pharma industry.
Davies
The development and the distribution of the two major diagnostic surveys used in the British NHS for anxiety and depression (PHQ9 and GAD7) were payed for, and their copyright was owned by, Pfizer.
Davies
Six months after publication, the highest selling book in the US was DSM-V. At the time, Harry Potter was at 7th and Fifty Shades of Grey was 9th. But each paperback version of DSM costed 88 USD. It happens that it was the pharmaceuticals that were buying the DSM in bulk and distributing it for free to clinicians all over the country. This is consistent with what has been happening in the last 20 years. Since the 90s, the pharma industry has been a major financial sponsor of the UK and US academic psychiatry.
Davies
I couldn’t speak to the people who were involved in the DSM-V construction, through the American Psychiatric Association (APA), because all of them were asked to sign confidentiality agreements with the APA (who publishes and profits from the DSM sales) prohibiting them from speaking to anybody. I couldn’t consult the APA archives because it has all been embargoed for 20 years post publication.
Davies
The clinical trials that where the basis for drug efficacy approval were just about 8 to 12 weeks long.
Davies
No biological markers have been identified for about 95% of the mental disorders.
Spitzer (chairman of the DSM-III)
Our general principle was that if a large number of clinicians felt that a diagnostic concept was important in their work then we were likely to add it as a new category. It was a question of how much consensus there was to recognize and include a particular disorder.
Spitzer
There was very little systematic research and much of the research that existed was really a hodgepodge – scattered, inconsistent, ambiguous. The majority of us recognized that the amount of good solid science upon which we were making our decisions was pretty modest.
Theodore Millon (member of the original DSM taskforce)
It is true that for many of the disorders that were added, there wasn’t a tremendous amount of research, and certainly there wasn’t research on the particular way that we defined these disorders. I think that Millon is mainly referring to the personality disorders.
Spitzer (answering the previous statement from Theodore)
There are very few disorders whose definition was a result of specific research data.
Spitzer
We had very little in the way of data, so we were forced to rely on clinical consensus, which admittedly is a very poor way to do things.
Donald Klein (vice to Spitzer on the DSM)
We trashed it out basically. We had a 3 hour argument. If people were still divided in later meetings, the matter would be eventually decided by a vote.
Donald Klein (about how consensus was achieved in the DSM)
What I saw happening on these committees wasn’t scientific, it more resembled a group of friends trying to decide where they want to go for dinner.
Rennie Garfinkel (intern psychologist at the APA who participated in the DSMIII meetings)
Our team was not typical of the psychiatric community; it allowed a small group with a particular viewpoint to take over psychiatry and change it in a fundamental way. We took over because we had the power.
Spitzer
The way the world uses the manual is not always the way you intended it to be used.
Allan Frances (chairman of DSMIV)
From the DSM point of view it is responsibility of the people using it, from the user’s point of view it is responsibility of the DSM to justify its usage. This is an artifact that is used by society to perform the most atrocious and unethical acts, with the particularity that it is the very same society that qualifies things as atrocious and unethical that performs the actions thus qualified. Shooting platoons use this mechanism to perform executions; authoritarian regimes use this mechanic to repress civil liberties, and so on. The common ground here is that individual responsibility is socially erased, the same individual responsibility that otherwise the same society would use as argument to punish the same exact behaviors.
Bipolar, Asperger’s and ADHD inclusion on the DSM created 3 major faux epidemics in psychiatry. There is no gold standard for psychiatric diagnosis, but when the diagnosis rates triple over 15 years, my assumption is that medicalization is going on.
Frances
We knew that everything that came before was arbitrary; we knew that most decisions that came before were arbitrary. It felt better to stabilize the existing arbitrary decisions than to create a whole assortment of new ones.
Frances (about the work on DSM III under Spitzer)
Compliments of the Author 