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Allen Frances
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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

Do Antipsychotics Help or Harm Psychotic Symptoms?

(1) Comments | Posted February 1, 2016 | 1:19 PM

This is the latest, and perhaps last, of several debates with Bob Whitaker on the role of antipsychotics in treating psychotic symptoms. It was triggered by a recent email exchange that clarified our areas of agreement and disagreement. Bob's blog summarizing his views and how he arrived at them can...

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We Have Too Many Specialists and Too Few General Practitioners

(2) Comments | Posted January 21, 2016 | 12:17 PM

"It's more important to know the patient who has the disease, than the disease the patient has." This was true when Hippocrates said it 2500 years ago -- and it remains true today.

Unfortunately, doctors no longer know their patients. GP'S are overworked, underpaid, and must shuttle patients in and...

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Psychiatric Medicines Are Not All Good or All Bad

(7) Comments | Posted January 15, 2016 | 12:22 PM

To take or not to take psychiatric medicine? That is the question.

Far too many people answer yes and take meds they don't really need for problems that would get better just with the passage of time and/or brief counseling.

More than 20 percent of Americans are on at least...

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A Tribute to Robert Spitzer, the Most Influential Psychiatrist of His Time

(0) Comments | Posted January 8, 2016 | 11:56 AM

There is an ongoing debate whether the flow of history is pushed forward more by ineluctable forces or by the prominent people who represent them. I usually subscribe to the former opinion, but must admit the relevance of the latter in the one small piece of history I got to...

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The Social Cure For Mental Illness

(3) Comments | Posted December 21, 2015 | 10:05 AM

"Everyone is much more simply human than otherwise." - Harry Stack Sullivan

The United States is the worst place in the developed world to have a severe mental illness.

By failing to provide adequate care and housing, we have condemned 350,000 to jails and 250,000 to...

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'We Should Live' -- Surviving After Catastrophic Death

(1) Comments | Posted December 8, 2015 | 12:19 PM

Yutaka Ono has been a close friend of mine for 30 years and is one of Japan's most respected psychiatrists. Shortly after the massive earthquake and deadly tsunami that hit eastern Japan four years ago, he began regularly visiting Onagawacho, the hardest hit town. He became consultant to Yuri Sato,...

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The Harmful Hypocrisy of the 'Right to Life' Movement

(57) Comments | Posted November 29, 2015 | 8:06 PM

This is from Mathew Chapter 7:

Stop judging, that you may not be judged. For as you judge, so will you be judged, and the measure with which you measure will be measured out to you. You hypocrite, remove the wooden beam from your eye first; then you will...
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Why Are Drugs So Outrageously Expensive?

(7) Comments | Posted November 18, 2015 | 12:11 PM

The drugs industry is the most profitable on earth. It has two branches -- an illegal one consisting of drug cartels and a legal one consisting of drug companies.

The huge profits derived by both branches accrue from the same source -- monopoly price gouging. The monopoly on the...

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Why Are So Many College and High School Kids Abusing Adderall

(4) Comments | Posted November 9, 2015 | 6:44 PM

During the past 15 years, there has been a remarkable transformation in the drug trade. It used to be dominated by the illegal drug cartels. Now it it is dominated by the legal drug companies.

The most dangerous legal drugs are the prescription opioids, now responsible for twice as...

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High Tech Medicine Can Be Bad for Your Health

(3) Comments | Posted October 28, 2015 | 3:59 PM

You reach a certain age and all your friends are getting sick, going to lots of doctors, having lots of tests, and taking lots of medicine. No surprise there.

The surprise is how many of your friends tell you that their doctors have made glaring errors and that the tests...

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Are Women Really Inferior and Unclean?

(2) Comments | Posted October 21, 2015 | 2:32 PM

Women and men were pretty much equal during the hunting and gathering phase of our existence, but female status dropped dramatically once we switched to agriculture.

The ability to produce and store surplus wealth created power inequalities of all sorts. Stronger and richer men came to dominate weaker and poorer...

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Why Are Most Cancer Drugs so Expensive and so Ineffective?

(12) Comments | Posted October 15, 2015 | 2:47 PM

Monopoly is defined as: "a situation in which a single company or group owns all or nearly all of the market for a given type of product or service. By definition, monopoly is characterized by an absence of competition, which often results in high prices and inferior products."

The pharmaceutical...

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What Drives Our Dumb and Disorganized Mental Health Policies?

(29) Comments | Posted October 5, 2015 | 7:05 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 | 6:44 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 | 11:10 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 | 12:22 PM

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 | 1:43 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 | 7:06 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 | 2:07 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 | 5:07 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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