Wednesday, May 16, 2012

Diagnosing the DSM

Allen Frances' May 11, 2012 op-ed piece in the New York Times "Diagnosing the DSM" is a wonderful piece of common sense. He argues that we don't need to insist that psychiatrists are in cahoots with drug companies to see that conflicts of interests render the American Psychiatric Association incapable of developing a diagnostic manual that does not overreach and medicalize much of everyday life. His suggestion that some presumably neutral arbiter such as the National Institutes of Health should take on this task is worth discussion.
As it happens I was just rereading a wonderful essay by Peter Sedgwick in his 1982 book Psychopolitics, titled "Illness--Mental and Otherwise." While it is aimed at the anti-psychiatry theorists of the day, its central point is that all diagnosis, whether of mental or of physical disorders, involves value judgments. The great success of the DSM as well as its scientific pretentions make it clear that we must take Sedgwick's arguments seriously if we are going to have an honest debate over the reasonable limits of psychiatric diagnosis.

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