Why the Newest Psychiatric Diagnostic Bible Will Be a Boon for Big Pharma
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Frances’ “10 Worst Changes” in the DSM-5 also includes the following: “First-time substance abusers will be lumped in definitionally with hardcore addicts despite their very different treatment needs and prognosis and the stigma this will cause.” DSM-5 also introduces us to the concept of “behavioral addictions,” which Frances points out “eventually can spread to make a mental disorder of everything we like to do a lot.” Additionally, Frances reports that “DSM 5 will likely trigger a fad of adult attention-deficit disorder leading to widespread misuse of stimulant drugs for performance enhancement and recreation and contributing to the already large illegal secondary market in diverted prescription drugs.” And Frances adds that “DSM 5 obscures the already fuzzy boundary between generalized anxiety disorder and the worries of everyday life.”
Brief History of the DSM
The first DSM was published in 1952 and lists 106 disorders (initially called “reactions”). DSM-2 was published in 1968, and the number of disorders increased to 182.
Both the first DSM and DSM-2 included homosexuality as a mental illness. In the 1970s, coinciding with the heightened significance of the DSM was the rise of gay activism. Thus, the elimination of homosexuality as a mental illness became the most visible psychiatric-political issue. Gay activists staged protests at American Psychiatric Association conventions. The APA was fiercely divided on this issue, but homosexuality as psychopathology was ultimately abolished and then excluded from the DSM-3, published in 1980.
Though homosexuality was dropped from DSM-3, diagnostic categories were expanded in the DSM-3 to 265, with several child disorders added that would soon become popular, including “oppositional defiant disorder” (ODD).
DSM-4, published in 1994, has 297 disorders and over 400 specific mental illness diagnoses. L.J. Davis, in the February 1997 issue of Harper’s, wrote a book review of the DSM-4 titled “ The Encyclopedia of Insanity: A Psychiatric Handbook Lists a Madness for Everyone,” wrote that the DSM-4 “is some 886 pages long and weighs (in paperback) slightly less than three pounds; if worn over the heart in battle, it would probably stop a .50-caliber machine-gun bullet at 1,700 yards.”
Mental illness expansionism in the DSM-5 is no laughing matter for Allen Frances who reminds us: “New diagnoses in psychiatry are more dangerous than new drugs because they influence whether or not millions of people are placed on drugs—often by primary care doctors after brief visits.” Though the APA claims that DSM-5 will not significantly add to the DSM-4 total of mental illnesses, by one DSM-5 declaration alone —eliminating the bereavement exclusion to depression —they will have created millions more mentally ill people.
DSM: Dogma or Science?
How exactly do certain human behaviors become a mental illness? It comes down to the opinion of a board of trustees of the American Psychiatric Association. Davis writes in Harper’s, “First, and primarily, the DSM-4 is a book of dogma, though as theology it is pretty pedestrian stuff.”
Is the DSM dogma or, as establishment psychiatry would claim, science?
Two important aspects of a scientific instrument are validity and reliability. DSM scientific validity would mean that behaviors labeled as disorders and illnesses are in fact disorders and illnesses. And DSM reliability would mean that clinicians trained in DSM criteria agree on a diagnosis.
One historical example, a century before the first DSM, of a clearly invalid mental illness is drapetomania. Louisiana physician Samuel A. Cartwright was certain he had discovered a new mental disease. After studying runaway slaves who had been caught and returned to their owners, Cartwright concluded in an 1851 report to the New Orleans Medical and Surgical Journal that these slaves suffered from drapetomania, a disease causing them to flee.