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Allen Frances
Allen Frances MD is Professor Emeritus at Duke University and former Chair of its Department of Psychiatry. He was Chair of the DSM IV Task Force. He is the author of "Saving Normal" and "Essentials of Psychiatric Diagnosis."

Allen Frances was the chairperson of the DSM-IV Task Force, a former chair of the Department of Psychiatry and Behavioral Science at Duke University School of Medicine, and is the author of two new books: Saving Normal and Essentials of Psychiatric Diagnosis.

Entries by Allen Frances

Psychotherapy Works, But Not For Everyone

(8) Comments | Posted February 10, 2015 | 4:52 PM

Treatments that work well for most don't work well for all. And even effective treatments have side effects and complications. This is true of medication and surgery- and it is also true of psychotherapy.

Psychotherapy is a proven effective treatment and should be the first choice for mild to moderate...

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Welcoming the Mentally Ill Back Into Our Community

(2) Comments | Posted February 2, 2015 | 6:45 PM

Brain research may be the greatest scientific adventure of our time, but it has had no practical payoff for the mentally ill. We have learned fantastic things about what makes us tick, but none of the findings has helped a single patient.

The National Institute of Mental Health is betting...

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The Latest Hypocrisy in SVP Expert Testimony

(2) Comments | Posted January 26, 2015 | 12:32 PM

The United States Constitution does not allow 'preventive detention' -- a much abused 18th century prerogative of royal power that was abhorrent to our founding fathers. We are meant to be a country of law, not arbitrary state power. No imprisonment on suspicion that someone might commit a crime and...

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How About Informed Consent for All Medication

(2) Comments | Posted January 21, 2015 | 9:50 AM

Doctors prescribe way too many medicines for patients who don't really need them. A lot of the pressure comes from intense drug company marketing. Some comes from patients who aren't happy leaving the office without a pill. And doctors have too little time with each patient to explain non-pill solutions...

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The Crisis of Confidence in Medical Research

(5) Comments | Posted January 12, 2015 | 2:46 PM

It's been many years since I have trusted anything I read in a medical or psychiatric journal. There is an enterprise wide positive bias; findings never seem to replicate; benefits are hyped; harms are hidden.

Drug companies bear most of the blame -- the research they sponsor is shoddy and...

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There's No Back Pain Surgery Can't Make Worse

(2) Comments | Posted January 5, 2015 | 11:32 PM

Surgery is much less science-based than the rest of medicine. It is almost impossible to subject it to studies that are double-blind and placebo-controlled. Surgical guidelines are therefore necessarily much more anecdotal than based on evidence.

Lots of elective surgery is probably unnecessary, and back operations are the most notorious...

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Having a Severe Mental Illness Means Dying Young

(39) Comments | Posted December 29, 2014 | 11:58 PM

People diagnosed with serious mental illness -- schizophrenia, bipolar disorder, or severe depression -- die 20 years early, on average, because of a combination of lousy medical care, smoking, lack of exercise, complications of medication, suicide, and accidents. They are the most discriminated-against and neglected group in the U.S., which...

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The Globalization of Attention Deficit Disorder

(0) Comments | Posted December 22, 2014 | 10:35 AM

Mental disorders have become a global commodity. A diagnostic fad heavily promoted first in the US now quickly spreads around the world.

Multinational corporations have perfected the profitable art of international marketing. The reach of Big Pharma stretches everywhere in the world with a sales pitch easily translated into every...

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Pro and Con: The British Psychological Society Report on Psychosis

(1) Comments | Posted December 15, 2014 | 5:57 PM

The original etymologies and current usages of the words "psychosis" and "neurosis" are confusingly topsy-turvy.

"Psychosis" literally means a disease of the soul or mind, but for more than 100 years this term has been used to describe only the severest forms of mental disorders, those that have at least...

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Diagnosing and Curing Our Sick Health System

(4) Comments | Posted December 10, 2014 | 3:25 PM

You couldn't invent a worse healthcare system than the nightmare we have created in the U.S. Our medical costs are almost twice as high per person as they are in most other similar countries but produce only mediocre outcomes.

There is massive overtreatment of people who don't need it, while...

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Is Expert Testimony in Court Cases Really Expert?

(0) Comments | Posted December 6, 2014 | 12:05 PM

Dostoevsky's Brother's Karamazov cleverly spoofs the careless inexpertness of what often passes for expert legal testimony.

Three medical experts are called to testify whether Dmitri Karamazov was sane or insane when committing the alleged murder of his father. Naturally, the experts all disagree, with each completely convinced of the incontrovertible...

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Putting The Mind And Soul Back Into Psychiatry

(4) Comments | Posted December 2, 2014 | 11:22 AM

All medicine should be bio/psycho/social. Illness is never just a biological phenomenon -- more than 80 percent of health outcomes are determined by economic, social, and behavioral factors.

And the psychosocial part is especially important in psychiatry. As Hippocrates pointed out 2,500 years ago, it is more important to know...

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Why Are Medical Mistakes Our Third Leading Cause of Death?

(1) Comments | Posted November 20, 2014 | 7:48 PM

"If doctors do no other good, they at least prepare their patients early for death, undermining little by little and cutting off their enjoyment of life."

These words from Montaigne are 350 years old, but, sadly, too often they describe the results of modern medicine, particularly when it is mindlessly...

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Psychiatry and Recovery: Complementary or Competitive?

(3) Comments | Posted November 12, 2014 | 4:28 PM

In my last blog post, Fuller Torrey described the dramatic deterioration of our mental-health (non)system and the resulting torment for the 600,000 severely ill who are either homeless or in prison (or rotating between the two).

There will be general agreement with Dr. Torrey that all of us...

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We Should All Be Ashamed

(6) Comments | Posted November 4, 2014 | 4:14 PM

For those suffering from severe mental illness, this is the worst of times.

The most dispiriting moments in my entire life have been spent visiting solitary confinement units in state and federal prisons. Many of the inmates have obvious psychiatric symptoms, talking to themselves, screaming and/or pacing agitatedly back and...

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Are Homegrown Terrorists 'Lone Wolves' or 'Stray Dogs'?

(2) Comments | Posted November 3, 2014 | 2:50 PM

Recently, there has been a cluster of terrorist murders committed by individuals acting alone, under the influence of extremist propaganda they accessed on the Internet. It is too soon to tell whether this is a statistical blip or the beginning of a new and dangerous trend.


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Recovery From 'Schizophrenia': One Man's Journey From Patient to Therapist

(3) Comments | Posted October 29, 2014 | 12:49 PM

"Schizophrenia" is a name, not a disease. It presents in many different ways and has many different outcomes. There is certainly not one cause of "schizophrenia"; there may be hundreds of contributing factors working through bewilderingly complex interactions. Figuring all this out will likely be the painstaking work of many...

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Are Religious and Political Extremists Crazy?

(20) Comments | Posted October 24, 2014 | 2:43 PM

Every time there is a terrorist act or a mass murder, reporters start calling with questions on the psychiatric diagnosis of the perp. The default position seems to be that every religious extremist or political fanatic or mass murderer must be crazy. How else to account for their weird behavior?

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Finding a Middle Ground Between Psychiatry and Anti-Psychiatry

(14) Comments | Posted October 20, 2014 | 11:14 PM

There will never be any compromise acceptable to the die-hard defenders of psychiatry or to its most fanatic critics.

Some inflexible psychiatrists are blind biological reductionists who assume that genes are destiny and that there is a pill for every problem.

Some inflexible anti-psychiatrists are blind ideologues who see only...

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Surviving Suicide: A Mother's Search for Meaning

(0) Comments | Posted October 16, 2014 | 8:41 PM

If a mother can only be as happy as her unhappiest child, the unhappiest of mothers are those whose children have died, particularly when the death was intentional. For them, time seems doubly out of joint. It never feels right to survive a child, particularly one who has deliberately chosen...

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