Thanks to Gianna Kali for alerting me to this article (article no longer available) in the Psychiatric Times: Opening Pandora’s Box: The 19 Worst Suggestions For DSM5. Dr. Allen Frances was the chair of the DSM-IV Task Force and is professor emeritus at Duke University School, Durham, NC. An excerpt from Dr. Frances’s article appears below.
The road to hell is paved with good intentions. Since when is a risk a syndrome? When the DSM says so, apparently. Watch Psychosis Risk Syndrome take off. What could be more humane, after all, than preventing young people (and their families) from (in theory) the avoidable pain of mental illness? The reason I am raising my own alarm here is that early intervention programs appear to pay no heed to mental illness as a deep-rooted coping mechanism that is a response to a trauma in the particular individual’s family background. Mental illness comes from somewhere, and you need look no further than than your own family to begin to understand that the problem is psycho-spiritual not biochemical in origin.
Sure, early intervention programs have staffs of psychiatrists, social workers, psychologists, etc. Their presence lulls people into believing that the psychospiritual and personal origin of mental illness is being paid attention to, and it is not. Resolving schizophrenia, for example, often takes some very intense therapies that don’t exist in these programs. If there is any early intervention program where Transactional Analysis, Family Constellation Therapy, Direct Confrontation Therapy, etc. are the mainstays, please let me know. Let me know, too, if there is a program that incorporates energy medicine into its daily routine. People are duped into believing that the mere presence of staff psychiatrists and other professionals is sufficient focus on the problems of the individual, whereas in reality they are there to deal with the effects of the medication while treating all individuals alike.
Dr. Frances writes
The Psychosis Risk Syndrome is certainly the most worrisome of all the suggestions made for DSM5. The false positive rate would be alarming―70% to 75% in the most careful studies and likely to be much higher once the diagnosis is official, in general use, and becomes a target for drug companies. Hundreds of thousands of teenagers and young adults (especially, it turns out, those on Medicaid) would receive the unnecessary prescription of atypical antipsychotic drugs. There is no proof that the atypical antipsychotics prevent psychotic episodes, but they do most certainly cause large and rapid weight gains (see the recent FDA warning) and are associated with reduced life expectancy―to say nothing about their high cost, other side effects, and stigma.
This suggestion could lead to a public health catastrophe and no field trial could possibly justify its inclusion as an official diagnosis. The attempt at early identification and treatment of at risk individuals is well meaning, but dangerously premature. We must wait until there is a specific diagnostic test and a safe treatment.