Allen Frances

Recently APA recruited a public relations guy from the Department of Defense to respond to my concerns that DSM 5 is way off track. He immediately went on the offensive and (in an interview for Time magazine) made the obvious PR mistake of calling me "a...

The American Psychiatric Association just reported a surprisingly large yearly deficit of $350,000. This was caused by reduced publishing profits, poor attendance at its annual meeting, rapidly declining membership, and wasteful spending on DSM-5. APA reserves are now below "the recommended amount for a non-profit (reserves equal to...

Ben Carey's front page story in the New York Times movingly recounts Bob Spitzer's apology for an ill-advised study he conducted more than a decade ago.

The background is dramatic. Spitzer had been a hero to the gay and lesbian community because he was the...

An accurate diagnosis is wonderful thing -- a giant step toward explaining what previously seemed unexplainable and starting what is very likely to be an effective treatment. An inaccurate diagnosis can be a disaster -- leading not only to inappropriate medication but also to stigma, ruined self confidence, reduced ambition,...

The whole purpose of having a manual of psychiatric diagnosis is to promote diagnostic agreement. The great value to the field of DSM-III was that it established reliability and preserved the credibility of psychiatry at a time when it was becoming irrelevant because it seemed that psychiatrists could not agree...

The prize for the most wayward of all the DSM 5 work groups must surely go to the sexual disorders group -- creators of three remarkably off-beat proposals. Fortunately, they have gradually been forced to abandon their entire wish list because each of the proposals triggered near universal opposition from...

Sigh of relief. The DSM 5 website announced Wednesday morning that two of its most controversial proposals have finally been dropped. We have dodged bullets on "psychosis risk" and "mixed anxiety depression." Both are now definitively rejected as official DSM 5 diagnoses and instead are being exiled to the appendix....

The sad truth is that most clinical research has absolutely no effect on clinical practice -- rarely does a study impact how we diagnose and treat patients. A paper by Morrison and colleagues in the British Medical Journal is that rare exception. For the pleasure of reading it,...

An article in the New York Times on April 4 describes a wonderful new initiative that may substantially improve the quality of U.S. health care while simultaneously also cutting its costs. Nine medical specialties have joined forces in a concerted and long-overdue effort to reduce unneeded diagnostic testing...

In common with all medicine, the history of psychiatry is filled with silly and sometimes dangerous fads in diagnosis and in treatment. Unfortunately, one of the most distressing fads is happening right now. Childhood bipolar disorder used to be vanishingly rare, but has recently become far too common -- in...

The relentless march to medicalize normality out of existence is opening a new and especially ridiculous front. The DSM-5 suggests providing a new section for "behavioral addictions." The category would begin life nested alongside the substance addictions and would start with just one disorder (gambling). Fortunately, none of the...

Up until now, the leadership of the American Psychiatric Association has stubbornly defended the indefensible DSM 5 proposal that would turn normal grief into clinical depression. APA has blithely ignored the contrary scientific evidence, the unified opposition of 47 professional organizations, two eloquent editorials in the Lancet, and critical articles...

According to last week's Time magazine, the American Psychiatric Association has just recruited a new public relations spokesman who previously worked at the Department of Defense. This is an appropriate choice for an association that substitutes a fortress mentality and warrior bluster for substantive discussion. The article quotes him as...

DSM 5 is pursuing an ambitious dream that could turn into a public health nightmare. The intention is admirable. Wouldn't it be great if we could predict who will later become psychotic and intervene early enough to prevent this from happening altogether -- or at least to reduce the severity,...

My last blog warned that Attention Deficit Disorder has become an overused fad diagnosis, with resulting excessive prescription of stimulant drugs. In the past 15 years, rates of ADD have tripled and stimulant use has doubled. For kids with severe and clearcut ADD, the medicine is often essential and enormously...

Rates of ADD in kids have tripled in just 15 years. This astounding jump has three possible explanations: 1) ADD was previously way underdiagnosed so that increased awareness accounts for the bulk of new cases; 2) ADD is now being way overdiagnosed, a fad greatly promoted by drug...

Donna Rockwell, Psy.D. was once a CNN reporter covering Capitol Hill. She is now a psychologist and a member of the petition committee calling for an independent scientific review of DSM 5. With her journalist's instinct for the crux of any story, Dr. Rockwell has focused on increasing...

Scary news. The Chair of the DSM 5 Task Force, Dr. David Kupfer, has indicated that 90 percent of the decisions on DSM 5 have already been made.

Why so scary? DSM 5 is the new revision of the psychiatric diagnosis manual, meant to become official in May...

DSM 5 has suddenly become a star press attraction. In just the last three weeks, more than 100 news stories featuring DSM 5 appeared in major media outlets located in more than a dozen countries. (For a representative sample see Suzy Chapman's post on Dx Revision Watch.) The...