The Illusions of Psychiatry - by Marcia Angell - part 2 - The New York Review of Books

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The Illusions of Psychiatry

July 14, 2011

Marcia Angell

http://www.nybooks.com/articles/archives/2011/jul/14/illusions-of-psychiatry/

excerpt:

Not only did the DSM become the bible of psychiatry, but like the real

Bible, it depended a lot on something akin to revelation. There are no

citations of scientific studies to support its decisions. That is an

astonishing omission, because in all medical publications, whether

journal articles or textbooks, statements of fact are supposed to be

supported by citations of published scientific studies. (There are four

separate " sourcebooks " for the current edition of the DSM that present

the rationale for some decisions, along with references, but that is not

the same thing as specific references.) It may be of much interest for a

group of experts to get together and offer their opinions, but unless

these opinions can be buttressed by evidence, they do not warrant the

extraordinary deference shown to the DSM. The DSM-III was supplanted by

the DSM-III-R in 1987, the DSM-IV in 1994, and the current version, the

DSM-IV-TR (text revised) in 2000, which contains 365 diagnoses. " With

each subsequent edition, " writes Carlat in his absorbing book,

" the number of diagnostic categories multiplied, and the books became

larger and more expensive. Each became a best seller for the APA, and

DSM is now one of the major sources of income for the organization. " The

DSM-IV sold over a million copies.

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