London Community News
Psychiatrist says “buyer beware” of new diagnostic tool
By Craig Gilbert
September 22, 2013

Buyer, beware.

That’s the message one the most vocal critics of the latest edition of the manual used to diagnose mental disorders in North America delivered in London Thursday (Sept. 19).

Dr. Allen Frances, who chaired the task force that helped develop the fourth and previous edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and was involved with DSM-III, spoke at Regional Mental Health Care (RMHC) London.

He is a regular blogger for The Huffington Post, Psychology Today, and Education Update, and has authored several books on the subject.

He said the newest edition, DSM-V, which he was not involved in developing, is a waste of time and money that could mean misdiagnosis and over-medication for millions of people in the United States and Canada.

According to Lawson Research Institute, which sponsored the presentation, experts around the world have questioned the clarity, scientific validity, and objectivity of the changes, and have gone on record calling for an external review.

“It’s a waste of time, and a waste of the $25 million they spent on it,” Frances said after his off-the-cuff presentation to about 100 people in the RMHC auditorium. “It’s also likely to have very harmful long-term consequences for the many people who will be misdiagnosed and given treatments they don’t need.”

Frances said everyone displays some symptom of mental disorder, most very mild, but changes in the wording of definitions in the DSM-V could move the line that divides those with diagnosable disorders and those without in a way that could result in millions of people in the United States and Canada being misdiagnosed.

“There are some family doctors who have a real interest in psychiatry, expertise in it and take the time, but too often it’s done casually and I think people have to be informed consumers and protect themselves.”

He noted during his speech that the number of psychiatric patients in U.S. prisons has increased on a one-to-one ratio with the number of psychiatric beds closed in institutions: about one million.

“The biggest problem is that people who have clear-cut mental disorders aren’t getting the help they need, and at the same time, people who have, maybe some problems in life, are being carelessly diagnosed, especially by medical doctors and given medicine after seven-minute visits,” Frances said. “From my perspective, psychiatric diagnosis and psychiatric medicine is a very serious moment in a person’s life. No one should accept a diagnosis given in a casual way. They should make sure it’s a cure for them, that it fits and if it doesn’t get second and third opinions. Don’t treat psychiatric medicine as if it’s a cure-all for everything because if you don’t need it, it’s likely to cause more harm than good.”

He said drug companies are to blame for over-marketing anti-depressants and anti-psychotic medications, and the media is guilty for going along with it.

“Drug companies are selling psychiatric illness as a way of selling pills, so never believe commercials,” he said. “The commercials aren’t there to help you, they’re there to help the drug companies sell illness.”

He said the psychiatric diagnostic system needs to be trimmed down, drug companies need to be “tamed” and insurance companies need to allow doctors to meet with their patients long enough to get to know them so they aren’t “jumping to conclusions” when they diagnose.

“We have to get the media on board to point out not just the possible benefits of treatment but also its potential harm,” France said. “I think we have to inform consumers I think the readers have to take part in their own medical care. Everyone who ever goes to a doctor should ask at least two or three questions every visit and expect clear, common sense answers and if you don’t get them, it’s a good idea to get a second opinion.”

He said one in five people are on psychiatric medication and a lot of them don’t need it.

“It doesn’t mean anyone should go out and stop it right away, because there can be ill effects to stopping medicine quickly and some people do need it,” he said. “I think family members should be alert of the other problem, too. Very often someone severely depressed or anxious and they need help and they’re not getting it. So it’s not just having symptoms, it’s about how severe and impairing are. We have to focus our attention more, all of us, doctors and patients, on letting the symptoms that are mild take care of themselves but getting the urgently needed psychiatric treatment as well.”