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Sunday 31 March 2013

GRIEF = MUST LISTEN TO DOCUMENTARY!!!! - On BBC Radio 4 - 31-03-13 - BEST YET PROGRAMME ON DSM-5 RISKS - "Medicalising Grief" - NEW tinyurl LINK

"We need a period of normal, healthy grieving to reconfigure our inner world gradually after loss of a loved one
NOT DRUGS."   - DT 2013

Inside Our Dreams

Where do people go to when they die?
Somewhere down below or in the sky?
'I can't be sure,' said a wise one, 'but it seems
They simply set up home inside our dreams.'

Jeanne Willis



 FROM 7TH APRIL LISTEN TO : as commentary to this youtube slide show of relevant pictures.

"Pathologising normal grieving is a road to collective insanity!" Dave Traxson 2013

Removing the 'bereavement exclusion' from DSM-5 completely opens the door to the mass medication of the 'normally grieving' population for
" Bereavement related depression(DSM-5 term)!"



Medicalising Grief

The Diagnostic and Statistical Manual of Mental Disorders - or DSM - is a book full of lists of symptoms, strange sounding names, codes and guidelines. It's also a book that changes lives. Its champions say it is simply a system of classification, a diagnostic tool. Its critics claim it is more - it decides what is and isn't a disease and that every time a new version is published an increasing number of people are labelled mentally ill.
And for every diagnosis in the DSM, there is a corresponding medical treatment waiting in the wings.
In May 2013, the American Psychiatric Association will publish the latest edition of their DSM and it is likely to cause tension within the American psychiatric establishment.
But why is this medical-looking manual causing such controversy?
Where some say the previous DSM was responsible for pathologising childhood, critics of the new edition will medicalise grief.
Are the intense feelings most people experience after the death of a loved one misery or melancholia? That is the ongoing debate, the result of which will have an impact on millions of people and our understanding of a fundamental human reaction.
In a post-Prozac world, when normal becomes abnormal, medication generally follows. An estimated 8 to 10 million people lose a loved one every year and something like a third to a half of them suffer depressive symptoms for up to a month afterward. How much does the pharmaceutical industry stand to benefit if an extra 5 million people a year are prescribed anti-depressants?
Matthew Hill investigates the DSM, its decisions over what is and is not a mental illness, and the people behind it.
Producer: Gemma Newby
A Sparklab production for BBC Radio 4.

Saturday 30 March 2013

'Antidepressants increase suicidal thoughts in under-25s' - Courtesy of Independent Newspaper website

There is a consensus that ADs can rtaise a clients energy before their mood which is why suicide and aggression can increase in the early stages of medication.

'Antidepressants increase suicidal thoughts in under-25s'

Wednesday 12 August 2009

Young adults under the age of 25 suffer an increased risk of suicide or suicidal thoughts when they take antidepressants and the risk is greatest after they take the drugs for anxiety and other mental problems not connected with depression, a study has found.
The same research concluded that antidepressants had a small but noticeable effect on protecting older people against suicide. However, the increased suicide risk to the under-25s was similar to that already seen in children and adolescents taking the drugs, scientists said.
Marc Stone, medical officer of the centre for drug evaluation and research at the US Food and Drug Administration (FDA) in Silver Spring, Maryland, said: "It doesn't mean that these drugs shouldn't be given to young adults but you have to think about the risks and the benefits. The findings tell you to watch people carefully. If someone on antidepressants talks of being suicidal, it may actually be due to the drugs."
When the scientists looked at the risks of suicide, attempted suicide or suicidal thoughts in the adult population as a whole they did not find any link between the use of antidepressants and an increased suicidal risk. But when they broke the data down into different age groups, a pattern emerged.
The study investigated previous clinical trials involving 12 antidepressants from eight different drug manufacturers, including older tricyclic antidepressants, as well as the newer selective serotonin re-uptake inhibitors, such as Prozac made by Eli Lilly, and Seroxat made by GlaxoSmithKline, which was prescribed to about 400,000 Britons last year.
In the cases of nearly 100,000 patients who were randomly given either an antidepressant or a harmless dummy pill and questioned about their suicidal thoughts or behaviour, there were eight suicides, 134 suicide attempts, 10 patients who had prepared for suicide without actually attempting it and 378 patients who had admitted to thoughts about suicide but had not acted on them. The study is published online in the British Medical Journal today although the findings were originally released by the FDA two years ago.
Professor John Geddes, an epidemiological psychiatrist at Oxford University, said it is important that patients taking antidepressants continued with their medication.
The Medicines Healthcare Products Regulatory Agency advises that patients taking SSRIs and related antidepressants, particularly young adults, should be carefully monitored during treatment for any worsening of symptoms or suicidal behaviour, a spokeswoman said.

Wednesday 27 March 2013

DSM-5 : British Medical Journal Press Release - Refers to Professor Allen Frances - Courtesy of BMJ website - ALLEN FRANCES IS A MEMBER OF THE INTERNATIONAL RESPONSE COMMITTEE TO DSM-5 SEE BLOG BELOW..

New disorder could classify millions of people as mentally ill

Monday, March 18, 2013  

New condition that may lead to “inappropriate medical decision making” warns expert

Personal View: The new somatic symptom disorder in DSM-5 risks mislabelling many people as mentally ill

Millions of people could be mislabelled as mentally ill when psychiatry's bible of diagnoses is updated in May, warns a senior doctor in this week’s BMJ.

The next edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – used around the world to classify mental disorders - will include a new category of somatic symptom disorder.

But Allen Frances, Chair of the current (DSM-IV) task force warns that the DSM-5 definition of somatic symptom disorder “may result in inappropriate diagnoses of mental disorder and inappropriate medical decision making.”

The new category will extend the scope of mental disorder classification by eliminating the requirement that somatic symptoms must be “medically unexplained” he explains. In DSM-5, the focus shifts to “excessive” responses to distressing, chronic, somatic symptoms with associated “dysfunctional thoughts, feelings, or behaviours.”

His concern is supported by the results of the DSM-5 field trial study. Somatic symptom disorder captured 15% of patients with cancer or heart disease and 26% with irritable bowel syndrome or fibromyalgia, and had a very high false-positive rate of 7% among health people in the general population.

He points out that, previous DSM criteria “have always included reminders to clinicians to rule out other explanations before concluding that any mental disorder is present. But his suggestions to the DSM-5 work group that similar reminders should be included this time were rejected.

Every diagnostic decision is a delicate balancing act between definitions that will result in too much versus too little diagnosis - the DSM-5 work group “chose a remarkably sensitive definition that is also remarkably non-specific,” warns Frances.

This, he argues “reflected a consistent bias throughout DSM-5 to expand the boundaries of psychiatric diagnosis with what I believe was insufficient attention to the risks of the ensuing false positive mislabeling.”

“The DSM-5 diagnosis of somatic symptom disorder is based on subjective and difficult to measure cognitions that will enable a “bolt-on” diagnosis of mental disorder to be applied to all medical conditions, irrespective of cause,” he adds.

“Clinicians are best advised to ignore this new category. When a psychiatric diagnosis is needed for someone who is overly worried about medical problems the more benign and accurate diagnosis is adjustment disorder.”

Allen Frances, Chair of the DSM-IV task force, Coronado, CA, USA

CLICK ON HYPERLINK THEN THEIR NAME TO GET SPEAKERS PRESENTATIONS of June 28th 2013 Conference at Old Trafford, Manchester - Division of Educational & Child Psychology One-day Event - "The Medicalisation of Childhood: Time for a Paradigm Shift." - PLEASE CIRCULATE



DSM-5 :How Many Billions a Year Will It Cost? - article by Professor Allan Frances - Courtesy of the Psychology Today website.


How Many Billions a Year Will the DSM-5 Cost?

In preparing the DSM-5, the revised manual that is to be the next bible of psychiatric diagnosis, the American Psychiatric Association has been extravagantly indifferent to all matters of cost.
There are profound economic consequences to where boundaries are set between what is normal and what is considered a mental disorder. Diagnosis of mental illness brings on a cascade of costs, including doctor visits, tests, medications (and treatment for their complications), forensic and prison costs, disability obligations, the siphoning of educational resources and absenteeism.
We are already experiencing an inflation in psychiatric diagnosis and an explosion in the use of expensive, and often unnecessary and harmful, psychotropic drugs.
Now, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders will add new categories of mental illness with very high prevalence rates in the general population. A new diagnosis here, a new diagnosis there, and pretty soon you have millions of new patients and billions of dollars in expenditure.
Seemingly small DSM-5 changes will make a big difference. Normal grief will become “major depressive disorder,” so that pills and medical rituals will be applied to a person’s natural emotional reaction to the loss of a loved one.
Excessive eating a dozen times in three months will become not mere gluttony but “binge eating disorder.” Forgetfulness in old age will be “minor neurocognitive disorder,” a label encompassing an enormous new patient population (only some of whom are at real risk of dementia) and incurring huge costs of unnecessary brain imaging when there is no effective treatment.

New ‘Patients’

At the other end of the age continuum, temper tantrums will be diagnosed as “disruptive mood dysregulation disorder.” And these are but a few of the many changes in the DSM-5 that will create millions of new “patients,” many of whom would do better without expensive, potentially harmful treatments.
The new manual will also encourage doctors to misdiagnose physical disorders as mental ones by creating a broad new category for patients who are anxious about their medical symptoms.
No one has calculated the total direct and indirect monetary costs of the DSM-5 to the U.S. economy, but the drain threatens to be enormous. And the extra money will probably be spent in the wrong places.
Our scarce mental-health resources are already distributed in an irrational manner. We badly shortchange those with clear psychiatric disorders while overtreating essentially normal people. Many psychiatric patients wind up filling our overcrowded prisons at an annual cost per capita greater than a year at Princeton University.
By further reducing the “normal” pool, the DSM-5 will divert even more resources away from those most in need of help.
How will DSM-5 raise costs?
First there are the direct and indirect costs of treating the newly diagnosed patients. These will be further amplified by the extension of health insurance under the Affordable Care Act to some 34 million more Americans, and its requirement that insurance include comprehensive care for mental disorders.
This is a desirable policy change; a greater investment is certainly needed to shore up our badly shortchanged mental- health system. But the costs should be predictable and the money spent where it is likely to do the most good.
Then there are indirect medical costs of treating complications from excessive medication use. Antipsychotics frequently cause enormous weight gain that can lead to diabetes and heart disease. Overdoses with prescription drugs now cause more visits to emergency rooms and expensive hospitalizations than overdoses with street drugs.
Disability payments, workers compensation and veterans benefits spent on psychiatric care will also rise. And the newly diagnosed will, of course, incur increased sick days, resulting in a loss of productivity.

Inadequate Reviews

The new DSM-5 diagnoses can be as dangerous as new drugs, but have not received the same kind of thorough risk-benefit review the U.S. Food and Drug Administration provides before approving a new medicine. And they have received no cost-benefit review.
Having been extremely profligate in its own expenditures -- the DSM-5 has already cost $25 million, five times as much as the DSM-IV in 1994 -- the association has taken no account of the potential costs to the public from its clinically risky diagnostic changes.
It is now desperately dependent on DSM’s perennial best- seller status to balance its books and is prematurely racing the new manual to press -- treating it as a publishing cash cow, not the public trust it should be.
We need a broader national dialogue on mental health, its costs, and how best to spend precious resources. The DSM-5 is a giant step in the wrong direction -- away from good clinical common sense and fiscal responsibility.
Clinicians and patients have a big stake in pushing back, and so do government and industry. The only sector that stands to benefit from the DSM-5 is the pharmaceutical business. The rest of us will pay the price.
(Allen Frances, a psychiatrist and professor emeritus at Duke University School of Medicine, was the chairman of the task force that produced the DSM-IV. The opinions expressed are his own.)
To contact the writer of this article: Allen Frances at allenfrances@vzw.blackberry.net.

To contact the editor responsible for this article: Mary Duenwald at mduenwald@bloomberg.net.

DSM - Psychiatric Diagnosis: Too Little Science, Too Many Conflicts of Interest - by Dr Paula Caplan Courtesy of the Association for Women in Psychologists Website

Psychiatric Diagnosis: Too Little Science, Too Many Conflicts of Interest

Paula J. Caplan, Ph.D.

Harvard University

The Concerns

There is a lot of pain and suffering in the world, and it is tempting to believe that the mental health community knows how to help. It is widely believed, both by mental health professionals and the general population, that if only a person gets the right psychiatric diagnosis, the therapist will know what kind of measures will be the most helpful. Unfortunately, that is not usually the case, and getting a psychiatric diagnosis can often create more problems than it solves, including a lifetime of being labeled, difficulties with obtaining affordable (or any) health insurance (due to now having a pre-existing condition), loss of employment, loss of child custody, the overlooking of physical illnesses and injuries because of everything being attributed to psychological factors, and the loss of the right to make decisions about one’s medical and legal affairs. The creation and use of psychiatric diagnosis, unlike, for instance, psychiatric drugs, is not overseen by any regulatory body, and rarely does anyone raise the question of what role the assignment of a psychiatric label has played in creating problems for individuals.[ii]

The Problematic History

Contrary to popular belief, the enterprise of psychiatric diagnosis is largely unscientific and highly subjective (Caplan, 1995; Caplan & Cosgrove, 2004). Therapists often disagree about which label to assign to a given patient, and there is perhaps surprisingly little definitive research to prove that, “A person with diagnosis X will benefit from and not be harmed by treatment Y.”

These serious limitations have not prevented the authors of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), sometimes known as “the therapist’s Bible,” from making expansive claims about their knowledge and authority and wielding enormous power to decide who will and will not be called mentally ill and what the varieties of alleged mental illness will be. The DSM’s current edition is called DSM-IV-TR, and it was preceded by the original DSM (in 1952), then DSM-II (1968), DSM-III (1980), DSM-III-R (Third Edition Revised) (1987), DSM-IV (1994), and DSM-IV-TR (2000). The DSM-V is currently in preparation and slated for 2013 publication. Each time a new edition appears, the media ask whichever psychiatrist is the lead editor why a new edition was necessary, and like clockwork, each editor replies that it was because the previous edition really wasn’t scientific (Caplan, 1995). And each time a new edition appears, it contains many more categories than does the previous one. For instance, DSM-III-R contained 297 categories, and DSM-IV contained 374 (Caplan, 1995).

I served as an advisor to two of the DSM-IV committees, before resigning due to serious concerns after witnessing how fast and loose they play with the scientific research related to diagnosis (Caplan, 1995). The DSM is widely used, not only in the mental health system, but also in general medical practice, in schools, and in the courts. I have been involved since 1985 in trying to alert both therapists and the public to the manual’s unscientific nature and the dangers that believing in its objectivity poses. Since then, I have watched with interest a national trend toward gradually increasing openness to the idea that psychiatric diagnosis (A)is largely unscientific, (B)is highly subjective and political, and (C)can cause untold harm, ranging from the patients’ lowered self-confidence to loss of custody of children to loss of health insurance (because any psychiatric label can be considered evidence of a pre-existing condition) to loss of the right to make decisions about their medical and legal affairs.

What many do not consider is that psychiatric diagnosis is at the foundation of much of the harm that is done in the mental health system. Without assigning a diagnosis, a therapist is not supposed to choose what treatments to use or even whether or not to suggest treatment. And rarely are patients prescribed psychotropic drugs or told they need psychotherapy unless they get a psychiatric label. This is not to say that psychotherapy and medication is never helpful for anyone but simply that the first step toward the harm that sometimes results from these is assignment of a diagnosis. Futhermore, increasingly people have learned about the connections between drug companies’ concealment of the harm their products can cause and some professionals’ pushing of particular drugs while being paid well by the drug companies. It has been well documented that some of the professionals who help write the DSM are on drug companies’ payrolls (Cosgrove, Krimsky, Vijayraghavan, & Schneider, 2006).

Coming Up Next: DSM-V and Secrecy

With the next edition of the DSM in preparation, and perhaps due to increasing scrutiny and questioning of the process of creating psychiatric categories and an increasing public awareness of the harm that results from their use, the current DSM team has tried to envelop the process of compiling the next edition in a shroud of secrecy (Frances & Spitzer, 2009). Interestingly, the editors of the current and previous editions, Allen Frances and Robert Spitzer, respectively, in a letter to the APA’s Board of Governors described the DSM-V process as characterized by a “rigid fortress mentality” that included asking that those compiling the new edition to sign a statement agreeing to keep confidential the deliberations about it (Frances & Spitzer, 2009). This seems a curious requirement for a group that has often claimed that it bases its decisions strictly on scientific evidence.

In addition to this secrecy, as I learned when asked by Ms. magazine in 2008 to write an article about the future of the category “Premenstrual Dysphoric Disorder” in the DSM-V, those joining DSM-V committees have been told that they must divest themselves of most drug company connections. However, it turns out that this divestment is only temporary, and connections can resume once work on the DSM is finished. Furthermore, as one DSM-V committee chair told me in a telephone interview, this requirement delayed the process of committee formation substantially, because it was difficult to find enough people who were willing to go through with the divestment (Fawcett, personal communication).

Some Problems Already Identified in DSM-V Plans

In keeping with the tradition of DSM editors claiming that, in contrast to previous editions, their edition will be scientific, a proposal apparently receiving serious consideration is the creation of an entirely new system of organizing categories within the DSM-V (Frances & Spitzer, 2009), yet this proposed system is riddled with problems and does not even appear to be a particularly useful – not to mention valid – system for helping people with emotional problems.

In addition, despite the secrecy surrounding the process, additional alarming information about what committee members are considering has already appeared. For instance, a committee was appointed to consider whether “racism” should appear in the DSM-V, a step that would disguise a social evil by making it seem “merely” an individual problem, a mental illness. One danger of such a diagnostic category is that people who commit hate crimes would blame their crimes on alleged mental illnesses and thus avoid criminal punishment (Profit, 2004). This is similar to the category of “rapism,” which was proposed for DSM-III-R and which feminists successfully battled (Caplan, 1995).

In a different realm altogether, one prominent DSM author has proposed that “relational disorder” be added to the manual (Caplan & Profit, 2004). “Relational disorder” would be applied to a couple, neither of whom individually might be considered mentally ill but whose relationship would be considered sick. One of the category’s inventors has suggested that this would provide a terrific opportunity to try out psychotropic drugs. But there are serious ethical problems involved in prescribing drugs to treat people who are not individually diagnosed as mentally ill. It is revealing to picture this scene: Two people sit in a psychiatrist’s office; neither of them is considered mentally ill, though their relationship is; the psychiatrist removes a pill from its bottle…where does the psychiatrist put the pill? Clearly, the ethics, absurdities, and dangers of DSM-V proposals must see daylight and be thoroughly debated as soon as possible.

This Website

Even during the preparation of past editions of the manual, changes have been rapidly and often surprisingly made by various DSM subgroups and by those at the top of the hierarchy. For this reason, it would be almost impossible to write a book about concerns related to the DSM-V process. As a result, sponsored and supported by the Association for Women in Psychology (AWP), which has long had as a primary social action objective the understanding of psychiatric diagnosis and prevention of harm that results from it, a task force of academics and clinicians has produced the articles on this website. Most of the articles are about particular diagnostic categories, some are about particular “isms” such as sexism, classism, and racism, and many involve elements of more than one of these. This website is a grassroots project of AWP, and due to limitations of time and personnel, we have only attempted to critique some (though a wide variety) of the 374 different diagnostic categories listed in the current DSM and some that are being considered for inclusion. Furthermore, the secrecy surrounding the DSM-V process makes it impossible to know much the new categories being proposed. So with this website, we offer a sampling of the kinds of problems and concerns that we want to urge professionals and the public alike to watch for as the DSM-V steamroller moves on. In fact, several of the categories addressed on this site have been proposed in major mental health journals and books as DSM-V diagnoses. Unfortunately, many changes in past editions have been made at the last minute and without the public’s knowledge, so that serious problems have become widely known only after the editions were published; those problems have persisted for many years. Indeed, in the case of the widely publicized claim in the early 1970s that “homosexuality” was being removed from the next edition of the manual – a claim that is still generally believed to be true – it emerged that “ego-dystonic homosexuality” actually remained in the next edition after all (Metcalfe & Caplan, 2004).[1] Situations like this make it difficult to think how to protect the public and how to educate the public and professionals about ways to stop the DSM-V authors from causing harm. We hope that this website will provide some resistance to the DSM-V steamroller.


Caplan, P. J. (1995). They say you’re crazy: How the world’s most powerful psychiatrists decide who’s normal. Reading, MA: Addison-Wesley.

Caplan, P. J., & Cosgrove, L. (2004). Bias in psychiatric diagnosis. Lanham, MD: Rowman and Littlefield.

Caplan, P.J., & Profit, W.E. (2004). Some future contenders. In P. J. Caplan & L. Cosgrove (Eds.), Bias in psychiatric diagnosis (pp.249-54). Lanham, MD: Rowman & Littlefield.

Cosgrove, L., Krimsky, S., Vijayraghavan, M. & Schneider, L.  (2006). Financial ties between DSM-IV panel members and the pharmaceutical industry. Psychotherapy and Psychosomatics, 75, 154-160.

Fawcett, J. Personal communication.

Metcalfe, W.R., & Caplan, P. J. (2004). Seeking “normal” sexuality on a complex matrix. ”? In P. J. Caplan & L. Cosgrove (Eds.), Bias in psychiatric diagnosis (pp.121-6). Lanham, MD: Rowman & Littlefield.

Profit, W.E. (2004). Should racism be classified as a mental illness? In In P. J. Caplan & L. Cosgrove (Eds.), Bias in psychiatric diagnosis (pp.81-8). Lanham, MD: Rowman & Littlefield.

[1] The category “Ego Dystonic Homosexuality” appeared in the manual, thus leading to the labeling as mentally ill many people who were not thoroughly comfortable and happy with being homosexual. The fact that in a homophobic society, the lack of total comfort with being homosexual should hardly be construed as proof of mental illness was not acknowledged. Even today, although the words “homosexual,” “lesbian,” “gay,” and “bisexual” do not appear as diagnostic categories in the manual, the category “Sexual Perversion Not Otherwise Specified” does appear, and that is so broadly defined that it could certainly be applied to anyone who is not heterosexual, as long as their particular therapist decides that their sexual orientation is a perversion.

[i] see psychdiagnosis.net for more information about this subject, including stories about a variety of kinds of harm caused directly by psychiatric diagnosis and six different solutions to problems of diagnosis.

[ii] The Association for Women in Psychology, the Society for Menstrual Cycle Research, and the National Women’s Health Network, sponsored by Congresswoman Louise Slaughter and cosponsored by many other organizations, held a Congressional briefing about some of these concerns, and a second briefing was held by the author of this paper (Caplan, Paula J. (2002). You, Too, Can Hold a Congressional Briefing: The SMCR Goes to Washington About “Premenstrual Dysphoric Disorder” and Sarafem. The Society for Menstrual Cycle Research Newsletter, Summer, 1-5. Reprinted in Women’s Health: Readings on Social, Economic, and Political Issues. Fourth Edition. Nancy Worcester & Mariamne Whatley (Eds.). Kendall-Hunt: Dubuque, IA, pp.246-9.) However, no Congressional action to propose hearings or legislation about psychiatric diagnosis has yet resulted from these briefings.