iOS app Android app

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

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...

Read Post

Diagnosing and Curing Our Sick Health System

(3) 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...

Read Post

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...

Read Post

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...

Read Post

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...

Read Post

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...

Read Post

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...

Read Post

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.


Read Post

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...

Read Post

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?

Read Post

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...

Read Post

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...

Read Post

Perverse U.S. Drug Policies Promote Drug Addiction and Deaths

(43) Comments | Posted October 5, 2014 | 7:19 PM

To get your mind around just how dumb and perverse are our drug policies, you first have to absorb these astounding facts:

  1. The U.S. has more deaths from drug overdoses than from car accidents.
  2. Most are due to prescription narcotics, not street drugs.
  3. Heroin...
Read Post

12 Ways Parents Can Protect Their Kids From Too Many Pills

(23) Comments | Posted October 2, 2014 | 3:28 PM

We are turning our kids into pill poppers. The rate of ADHD has tripled in just 20 years -- it is now diagnosed in 11 percent of all children aged 4-17 and is medicated in 6 percent of them. And the percentages get really crazy for...

Read Post

How Not to Talk to Someone Dying of Cancer

(3) Comments | Posted September 29, 2014 | 4:54 PM

A friend of mine has been living well with lung cancer for five years -- working, running several miles a day, traveling, doing good stuff with his family, and generally enjoying the pleasures of everyday life. He knows the cancer will eventually kill him, but has been making the most...

Read Post

Treating the Ailing Doctor-Patient Relationship

(3) Comments | Posted September 15, 2014 | 4:39 PM

The practice of medicine is probably almost as old as the human race. An important part of the Shaman's job was the diagnosis and treatment of the physical and mental symptoms afflicting sick members of the tribe. Ever since, doctors have been admired and well-rewarded despite the fact that few...

Read Post

The Hall of Shame -- Who Is Failing the Severely Ill?

(9) Comments | Posted August 28, 2014 | 3:12 PM

This is the fourth in a series of blogs devoted to our society's shameful neglect of people with severe mental illness.

'Stigmatizing and Shunning The Mentally Ill' described the lack of treatment and housing that has led to their massive imprisonment and homelessness.

In '

Read Post

Treatment Before Tragedy: A Mother's Plea

(1) Comments | Posted August 20, 2014 | 9:01 PM

This is the third installment of a trilogy of blog posts depicting a tragedy. The first installment, "Stigmatizing and Shunning the Severely Ill," described the deinstitutionalization movement of 40 years ago that resulted in the sudden and massive closing of psychiatric hospitals -- under the pretense that more...

Read Post

Is This the Worst Time Ever to Have a Severe Mental Illness?

(31) Comments | Posted August 6, 2014 | 1:11 PM

My personal response to this depressing question would have to be an ashamed 'Yes' for the United States; a relieved 'No' for most of the rest of the developed world.

Admittedly, though, I am not the best person to provide a long view answer. We will soon be...

Read Post

Stigmatizing and Shunning the Severely Ill

(10) Comments | Posted July 30, 2014 | 8:28 PM

We are civilized people in the United States. We don't set up leper colonies or concentration camps or psychiatric snake pits to banish people with severe mental illness. Instead we send them to jail or prison -- almost 400,000 of them, more than 10 times the number receiving care in...

Read Post