Sunday, February 21, 2010

The Draft DSM-5 - Another Blogger Speaks Out

I'll be quick: Blogger comrade-in-arms Willa Goodfellow (pictured here) of Prozac Monologues has written a terrific critique of the Draft DSM-5. Sample:

Particularly disturbing is the failure to include new knowledge about Bipolar II.  The proposed revisions do not even keep pace with practice among psychiatrists who do listen to their patients' experience.  The evidence for a link between antidepressants and suicide is most compelling for those who are diagnosed with Bipolar II or those who could be diagnosed with Bipolar II, if the criteria shifted to include them.  The continued narrow definition leads to inappropriate treatment with antidepressants (translation: more sales of antidepressants), and deterioration, including a tripled risk of suicide

Say no more. Check it out ...

9 comments:

Paul said...

This will be a good test of the "public feedback" portion of the process!

Will they listen?

Willa Goodfellow said...

That depends on who is talking. Moving from last week to this, I have found a bit of hope. There is one place where the interests of inappropriately diagnosed persons with cycling depression and at least one pharmaceutical company come together. -- That is a sneak peek at this weekend's Prozac Monologues.

Willa Goodfellow said...

And by the way, John -- thanks. This tandem series is fun!

John McManamy said...

Hey, Paul. My answer is no: the DSM-5 is pretty much already set in stone. The only debate will concern academic quibbles over the fine points, so forget about public involvement.

But by raising our voices, we do have the power to strip the DSM-5 of its authority, so this is a very vital advocacy issue. In fact it could be the #1 advocacy issue, as our well-being and lives are at stake.

If the diagnosis is wrong, the treatment is going to be wrong. And I've already cited enough instances where the DSM-5 does not address vital misdiagnosis issues.

Back to advocacy:

Imagine, for instance if every patient and family group out there condemned the DSM-5? Imagine if we found allies among various researchers and clinicians and administrators? Then the DSM would no longer be the diagnostic bible, just a guide for billing.

Then we could set to work creating and distributing our own alternative DSM (I'm serious about this), based on the best real world info we have.

More later ...

John McManamy said...

Hey, Willa. Very much looking forward to your next installment. I very much appreciate our fortuitous tandem. I guess if you see some hope, that makes you the good cop (or Third Isaiah). It says a lot about my personality that I am far more comfortable as a prophet of doom. :)

Willa Goodfellow said...

Oh, by no means is this a time of Third Isaiah. More like Esther, definitely within captivity, but not without resources. Happy Purim!

John McManamy said...

Hey, Willa. The plot thickens. Who is your choice for Haman? :)

Willa Goodfellow said...

If ECT is on the table, Sackheim -- no hands down, for his past insistence that ECT does not cause long-term memory loss, and that patients who insist that it does are, after all, mental patients. If we're talking medication, it's a tie between Bristol-Myers Squibb and the FDA for Abilify, with Wyeth getting the bronze for Effexor, the one that turned my brain to Swiss cheese and nearly killed me. So there's a little judge's bias. Oops -- switched metaphors.

Your choice?

Willa Goodfellow said...

On further thought -- on all treatments, the buck always stops with the FDA. On so many issues, shameful.