Psychiatry's civil war
When doctors disagree with each other, they usually couch their
criticisms in careful, measured language. In the past few months,
however, open conflict has broken out among the upper echelons of US
psychiatry. The focus of discord is a volume called the Diagnostic and Statistical Manual of Mental Disorders, or DSM,
which psychiatrists turn to when diagnosing the distressed individuals
who turn up at their offices seeking help. Regularly referred to as the
profession's bible, the DSM is in the midst of a major rewrite, and feelings are running high...
The wording used in the DSM has a significance that goes far beyond questions of semantics. The diagnoses it enshrines affect what treatments people receive, and whether health insurers will fund them. They can also exacerbate social stigmas and may even be used to deem an individual such a grave danger to society that they are locked up.
Some of the most acrimonious arguments stem from worries about the pharmaceutical industry's influence over psychiatry. This has led to the spotlight being turned on the financial ties of those in charge of revising the manual, and has made any diagnostic changes that could expand the use of drugs especially controversial...