DSM-V bun fight in full swing

The arguments over the forthcoming revision of the psychiatrists’ diagnostic manual, the DSM-V, have just been heated up again by an unusually acerbic response from the American Psychiatric Association attacking their main critic.

The article that condemns the new diagnostic manual committee by ex-DSM chairman Allen Francis’ has just been officially published, alongside an interview where he furthers his damning criticism.

The American Psychiatric Association has apparently written a response which seems to have been leaked online, and it contains some robust responses to Francis’ points as well as a surprising ad hominem attack – suggesting he is motivated by losing money after the DSM-IV goes out of print.

The APA makes some good replies to the main criticisms, defending their record of openness, their reliance on the scientific data and their proposed changes to the diagnostic process based on current best practice, but the final paragraph is quite suprising:

Both Dr. Frances and Dr. Spitzer have more than a personal ‘pride of authorship’ interest in preserving the DSM-IV and its related case book and study products. Both continue to receive royalties on DSM-IV associated products. The fact that Dr. Frances was informed at the APA Annual Meeting last month that subsequent editions of his DSM-IV associated products would cease when the new edition is finalized, should be considered when evaluating his critique and its timing.

This line of criticism is perhaps most surprising for the fact that, as recently reported in USA Today, 68% of the DSM-V committee report financial ties with drug companies.

While the committee rules require that members cannot receive more than $10,000 in drug company payments while at work on the DSM, I can’t help but thinking that they are better off not opening the Pandora’s box of conflict-of-interest criticisms.

Link to Frances article in Psychiatric Times.
Link to Frances interview in Psychiatric Times.
Link to leaked alleged APA response (via Carlat blog).

4 thoughts on “DSM-V bun fight in full swing”

  1. I find that argument odd given that the DSM-V is going to come out whether those specific changes are in place or not, so what’s actually in the DSM-V would be of no concern to him either way, really, from that standpoint.

    You make a good point about them playing the conflict-of-interest card, though.

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