Psychiatric Manual Update

Confidentiality of Psychiatric Manual’s Update Draws Gripes [Excerpts]

The American Psychiatric Association is getting criticism for the secret process of putting together the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, a defining volume of mental disorders.

Published by the APA, the manual, known as DSM, is important for insurance payments as well as prescribing and research, and the process of putting it together leads to heated debate. So for the first time, the association has required its contributors to sign a nondisclosure agreement, the New York Times reported earlier this month.

Hot button topics under debate for the latest edition include gender identity and addictions such as shopping and eating, NYT said. And as we’ve noted, sex addiction was in the manual in 1980, dropped in 1994 and brought back up for consideration for the new edition.

The Los Angeles Times this morning quotes Robert Spitzer, the editor of the manual’s third edition, who has broken ranks and published a letter protesting the confidentiality. “If you don’t know what goes on at someone’s meetings, they’re suspect of having conflicts of interest,” Spitzer told LAT. And conflicts have become a significant issue for the psychiatric association, as Sen. Charles Grassley has been looking into payments to the association from drug companies.

The psychiatric association told LAT that psychiatrists working on the manual’s update are limited to $10,000 a year from drug makers and that transparency is a priority for those overseeing the process. “The field of psychiatry has gone from an ideology to a scientific pursuit,” Darrel Regier, who heads the association’s research arm, told LAT.

(Rubenstein, Wall Street Journal, December 29, 2008)

[TBC: The psychiatric industry continues to demonstrate that it operates under principles that are far from scientific. It is worth reconsidering Dr. Sigmund Koch’s comments concerning his own field of endeavor: “The hope of psychological science became indistinguishable from the fact of psychological science. The entire subsequent history of psychology can be seen as a ritualistic endeavor to emulate the forms of science in order to sustain the delusion that it already is a science” (The American Scholar, Autumn 1973, p. 66). Consequently, even secular psychologists recognize that psychology began as a theory, has never advanced beyond a theory, and will remain a theory, a “theory” that is often subject to the highest bidder.]