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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

What Drives Our Dumb and Disorganized Mental Health Policies?

(25) Comments | Posted October 5, 2015 | 6:05 PM

In a rational world, the real needs of the mentally ill would be identified and addressed in an efficient and cost effective way. Those who need care would receive it. Those who don't, wouldn't. The national research portfolio would prudently balance studies aimed at practical solutions to urgent, current problems...

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A Non-Psychiatric Assessment of Donald Trump

(6) Comments | Posted September 22, 2015 | 5:44 PM

A TV producer called a few weeks ago to ask whether I would go on air to discuss Donald Trump's psychiatric diagnosis. I declined.

Because of embarrassing psychiatric pontificating that marred the 1964 presidential election, the American Psychiatric Association has an ethics policy that prohibits diagnosing-at-a-distance.


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My Summary of a Great Conference: 'Preventing Overdiagnosis' 2015

(0) Comments | Posted September 8, 2015 | 10:10 AM

Two years ago, I wrote that the first "Preventing Overdiagnosis" conference was easily the most important meeting I had ever attended.

Last week's third "Preventing Overdiagnosis" conference, held at the National Institutes of Health in Washington, D.C. was even better. The conference was sponsored by the...

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'Please Empathize With Me, Doctor!'

(3) Comments | Posted August 24, 2015 | 11:22 AM

The doctor/patient relationship has been the central instrument of healing throughout the history of medicine. Specific treatments come and specific treatments go. Some help patients; some hurt patients; many have no impact at all. But the constant of 4000 years of modern medicine has been the healing impact of the...

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Putting Humanity and the Humanities Back Into Medicine

(2) Comments | Posted July 28, 2015 | 12:43 PM

"Wherever the art of Medicine is loved, there is also a love of Humanity." -- Hippocrates

Medicine has always had a close relationship to the liberal arts. Many great thinkers have been physicians: Aristotle, Maimonides, Linnaeus, Darwin, Freud. And some great writers: Rabelais, Schiller, Keats, Chekhov, Conan Doyle. And there...

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A Checklist to Stop Misuse of Psychiatric Medication in Kids

(1) Comments | Posted July 20, 2015 | 6:06 PM

A perfect storm of interacting detrimental factors has resulted in the recent massive overuse of psychotropic medication in children.

Drug companies started to focus their marketing campaigns on kids when the adult market was saturated. Children make perfect customers -- get them used to psycho-active pills when they are young...

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The Magical Healing Power Of Caring and Hope in Psychotherapy

(4) Comments | Posted July 6, 2015 | 1:07 PM

There are three consistent research findings that should make a world of difference to therapists and to the people they treat.

First, psychotherapy works at least as well as drugs for most mild to moderate problems and, all things being equal, should be used first.

Second, a good relationship is...

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Privatization Has Been a Colossal Flop

(65) Comments | Posted May 23, 2015 | 4:07 PM

Let's get this straight. I am a penny pincher, who hates waste and wants a lean and efficient government.

But, that said, we have to face the fact that our massive privatization of what once were government functions has been a failure. There are some public services...

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Preventing and Treating School Refusal and Severe Social Withdrawal

(3) Comments | Posted May 14, 2015 | 1:15 PM

I first heard about 'hikikomori' on a visit to Japan 25 years ago. It was a new term then, used to describe severe and prolonged school refusal in teenagers, sometimes evolving into complete social withdrawal. The person's life would become confined to a bedroom, with no friends and minimal contact...

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Think Twice Before Getting Knee Surgery

(3) Comments | Posted May 6, 2015 | 9:12 PM

During the 4,000-year history of medicine, doctors have done terrible things to patients. We gave them arsenic and mercury; we bled them; we made them vomit, and we gave them laxatives; we made them hot, and we made them cold. A lot of this was nonsense, sometimes dangerous and even...

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Life Is Not a Premortality Condition, and Death Is Not Treatment Failure

(2) Comments | Posted April 21, 2015 | 8:43 PM

"Medical research is making such astounding progress that soon none of us will be well."
--Aldous Huxley

In my last blog post I discussed the importance of dying well and with dignity -- at home, at peace, sent off by a loving family, not in an impersonal...

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Dying Well Means Dying At Home

(2) Comments | Posted April 11, 2015 | 6:32 PM

"Count no man happy till his end is known." Herodotus

This was true in ancient Greece 2500 hundred years ago. It is even more true today -- aggressive end-of-life hospital care, the lack of sufficient palliative care, and unduly restrictive assisted suicide laws make it impossible for most people...

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Can We Replace Misleading Terms Like 'Mental Illness,' 'Patient,' and 'Schizophrenia'

(12) Comments | Posted April 5, 2015 | 4:50 PM

"When I use a word, Humpty Dumpty said in rather a scornful tone, it means just what I choose it to mean -- neither more nor less. The question is, said Alice, whether you can make words mean so many different things. The question is, said Humpty Dumpty, which is...

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Don't Give Up On the Difficult Patient

(0) Comments | Posted March 31, 2015 | 1:38 PM

Forty years ago, I had my most angry professional moment. It happened at a weekly meeting that included all our faculty, staff, and trainees- about two hundred people. A young and arrogant, not very bright, third year psychiatry resident rose to complain bitterly about the 'crappy patients' he and his...

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Falls End Lives; Good Balance Saves Them

(0) Comments | Posted March 24, 2015 | 7:02 PM

The wisest doctor I know says this to his elderly patients: "There are two keys to having a long and happy life: one is don't fall; two is stay away from doctors." (Nicholas Capazzoli)

Two is related to one because doctors often over prescribe medicines that increase the risk of...

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Buying and Selling Binge Eating Disorder

(8) Comments | Posted March 12, 2015 | 3:06 PM

A drug company recently received FDA approval to peddle its speed-like pill for 'Binge Eating Disorder' (the very same pill that is already widely overused for ADHD). And it is sparing no expense pushing the drug -- a former world tennis champ is the shill and commercials are everywhere.

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Wilderness Programs for a Struggling Child

(2) Comments | Posted March 10, 2015 | 3:38 PM

Psychiatry doesn't work well for behavioral problems. In the old days, psychotherapy was the primary treatment, but it didn't help much. You mostly hoped the kid's behavior would improve with age before he got into too much trouble (as happened two thirds of the time).

Now, antipsychotics have become the...

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'Diagnosisgate' Deconstructed and Debunked

(51) Comments | Posted March 6, 2015 | 5:03 PM

Paula Caplan has been peculiarly furious at me for more than 20 years. The enduring chip on her shoulder first formed when I didn't take seriously her written proposal that 'Delusional Dominating Personality Disorder' be considered for DSM IV. I honestly thought she had submitted 'DDPD' as a clever satire...

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Psychotherapy Works, But Not For Everyone

(8) Comments | Posted February 10, 2015 | 3:52 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 | 5:45 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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