Anti-DSM Sentiment Rises in France
Why French psychiatrists and psychoanalysts are opposed to the diagnostic manual
You don’t need to look very far to grasp why—or, indeed, to understand why Landman and his colleagues are so concerned. The day after their planning meeting, the New York Times published a balanced op ed by Weill Cornell Medical psychiatrist Richard A. Friedman entitled, “A Call for Caution in the Use of Antipsychotic Drugs.” Abilify, Seroquel, “and other antipsychotic drugs were prescribed to 3.1 million Americans at a cost of $18.2 billion,” Friedman noted, “a 13 percent increase over the previous year, according to the market research firm IMS Health. The number of annual prescriptions for atypical antipsychotics rose [in the U.S.] to 54 million in 2011 from 28 million in 2001,” he continued, “an 93 percent increase, according to IMS Health. One study found that the use of these drugs for indications without federal approval more than doubled from 1995 to 2008.” “Until recently,” Friedman concluded, “these drugs were used to treat a few serious psychiatric disorders. But now, unbelievably, these powerful medications are prescribed for conditions as varied as very mild mood disorders, everyday anxiety, insomnia and even mild emotional discomfort.” As this blog noted back in June 2009, Seroquel has even been tested in randomized trials on those with public-speaking anxiety.
Stop DSM not only is built on strong academic foundations, but also is well-organized, with a website that translates into up to ten different languages detailing its platform/manifesto, its objectives and activities, a forum for members, and articles from and for contributors detailing concerns and recommendations. Its membership includes prominent, highly acclaimed psychiatrists, psychologists, and psychoanalysts who have found common cause in their opposition to the language, nosology, and effects of the DSM. They are joining the now-global petition against DSM-5, organized by the Coalition for DSM-5 Reform and supported by numerous mental-health organizations around the world, including 15 divisions of the American Psychological Association.
Notes the manifesto of Stop DSM: “The nomenclature of the DSM, on which [the World Health Organization’s] ICD-10 has been modeled, has progressively become the single and obligatory classificatory reference of “mental disorders” [in France and around the world]:
—in epidemiology;“With the purpose of responding to specific and distinct requirements,” it continues, “the widespread use of this unique classification becomes a confusion, inadequacy and [source-risk]—especially since the WHO is not empowered to take decisions on scientific research, but instead … should recommend independence, diversity, and promote the coexistence of different approaches.”
—in the field of research and scientific publications;
—for social protection systems and insurances;
—in order to collect statistical data for care policy and financing;
—as an unique reference manual in the teaching of psychiatry in medical and psychology schools, for the training of professionals and lecturers in health, social and special education fields;
—[and] finally, for physicians, who, having no other relevant training, prescribe more and more psychotropic drugs, based on questionable diagnostic criteria.”
“Moreover, far short of scientific rigor, the DSM is based on unambiguously partial conceptions. It neglects … clinical data; multiplies … pathological categories; and lowers the threshold of diagnostic criteria for inclusion, which leads to false-positives and pseudo-outbreaks (as, for example, hyperactivity, bipolar disorder, [and] autism). It is misused for predictive purposes in children and adolescents, taking the risk of harming their development and integration. It also promotes what has become, for a large part of the population, a real addiction to psychotropic drugs.”
The manifesto, supported by individual and group signatures, insists that the World Health Organization “stop promoting internationally the ICD-10’s monopoly condition, [derived] from the DSM, … [which is] imposing its dictatorship over … clinical practitioners and researchers that base their practice on other clinical criteria.” It reminds us “that multiple references could coexist, that a single model would not be imposed for all purposes on a simple statistical basis,” and calls on the WHO—and the American Psychiatric Association—“to stop the manipulation of diagnostic categorizations that, under the guise of ‘good practice,’ dictate to practitioners of therapeutic lines for economic or political goals.”
“A simplified nomenclature,” concludes Stop DSM, is not “sufficient to respond to the categorizations needed to satisfy social protection.”
The group’s upcoming conference will be held on Saturday, October 20th, from 9:00-5:30 pm, in the Maison des Cultures du Monde, 101 blvd Raspail, 75006, Paris. Further information is also available on its website here.
Post a Comment
PLEASE ADD COMMENTS SO I CAN IMPROVE THE INFORMATION I AM SHARING ON THIS VERY IMPORTANT TOPIC.