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The APA is going to “Occupy Medicine?” Let’s show them a REAL occupation! 01/24/2012

Posted by ALT in Mental Health Policy and Inititatives, Patient Rights and Advocacy.
Tags: , , , , , , , ,
6 comments

The APA must have an almost supernaturally subtle sense of humor and irony – the finest and most unflinching I have ever encountered.

Or else they are so steeped in hypocrisy that even the most blatant contradictions, the most horrendous lies (cross-referenced, of course), are fervently preached as gospel truth.  A pack of true believers, indeed.

There’s a spirit of unrest sweeping this country – the recent and successful PIPA/SOPA internet blackout protest, the various “Occupy” movements, the multiple student protests on college and occasionally high school campuses being a few examples.  People are getting stirred up. 

Well, the APA doesn’t want to be left out.  Let it be known that they, too, can occupy something!

“Occupy Medicine: Reclaiming our lost leadership”

A call to arms was issued in the January edition of the APA’s journal, the Psychiatric Times.  It’s hard to know whether to laugh or cry bloody tears of frustration.  Let’s try to laugh, shall we?

It begins like this:

Maybe the “Occupy Wall Street” movement suggests a different kind of protest …What about “Occupy Medicine” for us psychiatrists? This may sound somewhat ridiculous, given that psychiatrists still make a good living, but we are surely in the 99% of medicine. In fact, we may be in the lower 1% for reimbursement… I’m often struck that plumbers make more per hour.

- H. Steven Moffic in “Occupy Medicine” Psychiatric Times article

Now this article is posted right next to the “Psychiatry Compensation Survey 2011,” an annual survey regarding income and income satisfaction of APA members, on the Psychiatric Times website. The average income of these 99%-ers was neatly displayed in colorful pie graphs just inches away from Moffic’s petulant cries for protest.

[click to enlarge

The majority of psychiatrists make over $175,000/yr, yet Moffic proudly proclaims them an oppressed part of the “99%”!  Is this that subtle sense of irony again?

Oh, and plumbers do NOT make more money.

As near as I can tell (and they didn’t include much information about their survey methods, so it’s hard to say for sure) – but it appears that this survey only counts money directly obtained through practicing psychiatry.  So it does NOT include any “extra” income, like money from pharmaceutical companiesYou know, honoraria, “lectures,” “consulting,” “research,” etc.  Considering that 1 in 4 doctors offer these kinds of “services” to pharma, adding that income would further enhance their salaries.

Nevertheless, over 40% of the psychiatrists surveyed were “disappointed” with their level of income. 

Yes, psychiatrists are a downtrodden lot.  Much has been taken from them.  For example:

Other medical and mental health professionals have taken over our business to a great extent.  Take primary care physicians, who now prescribe well over half of psychiatric medication prescriptions, despite evidence of limited expertise and success.

-Dr. Moffic

“Limited expertise and success,” eh?  One could surely say the same about psychiatrists!   But I digress…

Where psychiatrists are really bleeding money is in the land of diagnosis, which should, according to Moffic, be their own exclusive province. 

Where we’ve really given up our product is in diagnosis. Though the APA has put out the official diagnostic manuals in the United States for decades, it opened up its use to any clinician who claimed enough expertise and knowledge. The APA makes a lot of money selling these manuals to other clinicians, who far outnumber psychiatrists, but what does this do to our role and status? …

Psychiatry is a strange kind of business. We’ve given out our products for free, then watched as other businesses—whether they be other types of clinicians or insurance companies—take over what we do… as important as what the diagnostic criteria should be, so is who is qualified to use them.

- Dr. Moffic [emphasis added]

Their “products?”  But I thought the DSM was an objective, scientifically-derived set of criteria defining real, biologically-based diseases?  And psychiatry a scientific discipline, not a business?

Clearly, an occupation is needed, so that psychiatrists can reclaim the [additional] wealth that is rightfully theirs.  There are some barriers, however.  You see, according to Moffic “psychiatrists tend to caring and compassion,” and so they have passively allowed the oppression thus far.  But Moffic remains hopeful:

Thankfully, the anti-psychiatry movement has died down. In an unexpected way, there’s more of a pro-psychiatry movement becoming embedded in our systems. These are our patient consumers and peer specialists. Could they be recruited as our advance force for Occupy Medicine? Who knows better?  Most naturally our patients and their families know what the illnesses have caused them to lose and what they need to recover.

-Dr. Moffic

Oh, that’s rich.

What say ye, psychiatric survivors?  Would you like to join forces with the APA in demanding that psychiatrists make more money?  Let’s catapult them into the top 1%, where they belong! 

Anybody? No?

Let me present an alternative

One that may be more to your liking.

In the run-up to the release of the DSM-V on May 5th, Mind Freedom International [MFI] is urging its members to “Occupy Normal.”  It is a “fight to stop corporate and government sponsored brain damage, trauma and an epidemic of human suffering” by “occupying the mental health system.” 

They have a number of ways you can participate listed on their website.  Additionally, a large protest is planned for that fateful day – May 5th – in Philadelphia, the site of the APA conference where the DSM-V will officially be released.  Lots of influential folks in the anti-psychiatry movement (which is alive and well, thank you very much Dr. Moffic!) will be there, including Robert Whitaker, author of Mad in America and Anatomy of an Epidemic.

Now what say ye, psychiatric survivors, peer supporters, and people who think critically about mental health in our society?  Is this an occupation more to your liking?

Oh, yeah.

Flowers in the Bloodstream: one man’s quest to make the prescribing of long-acting antipsychotic injections an ethical obligation 01/19/2012

Posted by ALT in Mental Health News, Mental Health Policy and Inititatives, Pharmaceuticals.
Tags: , , , , , , , , ,
7 comments

This is an ad I saw in my sidebar the other day.  Look at what they did.  It’s so devilishly clever, isn’t it?

(click image to enlarge)

If you’re a real “psychiatrist who cares,” you’ll talk to your patients about [or, rather, talk them into] a long-lasting injection of anti-psychotic medication – essentially, Risperdal — directly into their bloodstream.

Now some patients are not going to be compliant when it comes to having these akathisia-, diabetes-, tardive dyskinesia-causing, brain-shrinking drugs with [at best] dubious efficacy forcibly slow-released in their bodies for a month.  So Janssen has kindly provided several little educational videos (accessible by clicking on the ad, or here) to help doctors figure out how to do that.

They’re set up to look like academic lectures, and they have nice-sounding titles like “Positive Engagement: Therapeutic Alliance & Long-acting Therapy Given by Injection in the Treatment of Schizophrenia.”  I felt really good after I read words like “positive,” “engagement,” and “therapeutic.”

But then I watched one of them.

It features a man by the name of Xavier Amador, Ph.D. giving a powerpoint lecture designed by Janssen.

Xavier Amador, for Janssen Pharmaceuticals

In it, he explains what is really meant by those lovely words I mentioned above.

Most fascinating is the manner in which he approaches “therapeutic.”  According to Xavier, part of the problem with schizophrenics is that they don’t always agree that they’re suffering from a lifelong illness, that recovery is impossible, and that they need drugs for the rest of their lives.*  They don’t know they’re sick!

There’s a special name for this in psycho-babble – it’s called anosognosia.

Here’s the key: folks who do know they’re sick (again, by the above definition), are the ones most likely to take their medications.  To be compliant.  And so the real role of the “psychiatrist who cares” is to therapeutically convince the patient that he is indeed sick in this manner, and that he should take his meds, preferably via injection.

Dr. Xavier Amador, funded by Janssen, has spent a good deal of his professional career hawking an evidence-based practice (he calls it “LEAP”) guaranteed to do just that.

He goes into greater detail in another presentation, also funded by Janssen, which he gave at a government-sponsored conference in New Jersey last year.

Entitled, “I am not sick, I don’t need help,” the presentation is all about anosognosia, how it “impairs common sense judgment about the need for treatment,” and how overcoming it is “one of the top predictors of long-term medication adherence.” [which he appears to equate with recovery]

What causes anosognosia?  Our beloved Amador posits that it may be

Psychological defense? “Culture” and/or Education?  Or Neuropsychological Defects??

- Xavier Amador, in his presentation “I am not sick, I don’t need help” [emphasis added]

Yes, it is somewhat funny that a self-proclaimed “academic” would stand – in all seriousness – in front of a slide bearing that message.

But as it turns out Amador has been standing in front of silly slides and saying equally ridiculous things for years.

Amador and anosognosia go way back

All the way back to 1997, in fact, when Amador was involved in the trial of Ted Kaczynski, also known as the “Unabomber.”  Kaczynski did not want to mount a defense based on a plea of mental illness or insanity and actually went to great lengths to block his attorneys from doing so.  He maintained that his actions were deliberate, a logical result of his personal philosophy as outlined in his Manifesto and extensive journals (which he stated he kept, in part, to prove that he was not “mentally ill”).  Kaczynski wanted people to understand the motivations for his actions and not have them be discredited as the “ravings” of a schizophrenic – and he was willing to risk the death penalty in order to so.

Nevertheless, a court-ordered psychiatric evaluation conducted found him to be schizophrenic (full text available here – also by court order, so that the public might gain a “better understanding of the Unabomber’s [schizophrenic] motivations”).

That he was found to be schizophrenic really comes as no surprise.  As one of my favorite studies shows, even people displaying no psychiatric symptoms whatsoever have little trouble obtaining that label.

And what were Kaczynski’s symptoms? His “lack of personal relationships,” his “delusional thinking involving being controlled by modern technology,” and (drumroll, please) anosognosia.

Amador, who served as an independent expert for the court, reviewed Kaczyinski’s extensive psychiatric records, neuropsychological test results, and the infamous unabomber diaries. Amador then supplied the court with mounting evidence that Kaczynski’s refusal to be evaluated related to anosognosia, a manifestation of Kaczynski’s schizophrenia.

- from this article on Amador’s anosognosia activism

That one of Kaczynski’s three main symptoms of schizophrenia was his detailed and carefully documented denial of having it and resistance to being labelled doesn’t appear to strike Amador as funny.  I might add that Kaczynski’s other main symptom — “delusional” worries about the all-important role technology seems to play in our society and the isolating effects that understandably follow — has troubled me, and hundreds of thousands of others, from time to time.  Does that make us all sick?

I guess it does if they say it does!

The article goes on to share some of Amador’s initial inspiration to coin and then promote the term “anosognosia:”

It was his experience as a clinician and as a brother of someone with schizophrenia, Amador said, that led him to do research on anosognosia, “which is not to be confused with denial,” he emphasized, although in the beginning, he did not make that distinction. “That’s what I called it when my brother refused to take his medications, and that is what I called it when after his third hospitalization, I found his Haldol in the trashcan,” said Amador.

I suppose there’s no other possible explanation for a thinking, feeling, decision-making, adult human being throwing his Haldol in the trash can.

From a made-up word to the DSM-V: Amador takes anosognosia to the next level

About a year ago, when the DSM-V Task Force was really going at it hot and heavy, Xavier Amador issued this appeal on the Internet:

Dear Friends,

 …Right now, there is no proposal to measure insight in persons with schizophrenia or bipolar disorder much less require that clinicians diagnose a subtype (with or without insight or with or without anosognosia). Such a requirement will drastically change treatment plans and hospital discharge plans. If a doctor has to diagnosis a lack of awareness of illness, then s/he is ethically obligated to address this problem, this symptom, and the non-adherence to treatment it causes. Rather than simply send the person on their way with a prescription they will never fill. I hope you will comment on the website Dr. Torrey recommends below.

We don’t have much time as the deadline for public comments is less that one month away…

Best wishes,

Xavier Amador

[emphasis added]

Doctors will be obligated to ensure adherence to treatment plan…  “psychiatrists who care” must make sure their patients take their meds (perhaps in the form of injection)…

Isn’t that the exact sales pitch Janssen is using for their long-acting injection of Risperdal?

If anosognosia is officially added as a “symptom” of schizophrenia in the DSM-V, it essentially would make prescribing long-acting anti-psychotic injections to folks who “don’t know they’re sick” an ethical obligation!

Sounds like Janssen, and any other pharmaceutical company that manufactures a “flowers-in-the-bloodstream” shot, is going to score.  Big time.

Thanks in part to the presumably very well paid** Amador.

And that’s just one more reason why we need to protest the DSM-V.

Join me in Philadelphia — or do it from anywhere else in the world! — on May 5thin saying “enough is enough.”


*This definition of schizophrenia, though it is endorsed by the APA [American Psychiatric Association] and NIMH [National Institute of Mental Health], is of course completely false.  See Robert Whitaker’s research, and also the work of Loren Mosher, as proof. Also, a few recovery stories as living proof.

**Just how well paid?  We’ll know his exact price in just a couple of months, but for this kind of a score, I’m expecting to see a lot of zeros.

Pharma will soon be legally obligated to disclose all money paid to doctors 01/17/2012

Posted by ALT in Mental Health News, Pharmaceuticals.
Tags: , , ,
1 comment so far

It is estimated that at least 25% of doctors in the US are paid by drug companies to actively participate in marketing efforts – be it standing in front of a powerpoint, “authoring” a ghostwritten scholarly article, or “consulting” in some other way.  That’s about 200,000 men and women that are informally on the payroll of big pharma.*  

Pharma certainly does not disclose these payments to the pubic, and the receipients of this easy money only have to disclose their ties to pharma if an institution they’re working with requires them to do so – and typically there are no professional consequences or reprimands no matter how big the conflict of interest they disclose is (see the DSM-V Task Force as an excellent example).  Also, specific dollar amounts are generally not required. 

But the times they are a-changing!  As The New York Times reported yesterday in this story, pharmaceutical and medical device companies will soon be legally bound to disclose payments made to doctors for research, consulting, speaking, travel, and entertainment.  That means everything from a $10,000 speaking “honorarium” to a $10 Cuban sandwich. 

Who must disclose

Any company that has even one product covered by Medicare or Medicaid.

What they must disclose

All payments to doctors that are not these companies’ official employees.  Also, royalty payments to doctors, “grants” to teaching hospitals or research institutions, and the value in dollars of “free” branded products (Serqouel pens, for example), food or other “goodies.”

ALL of the disclosures will be published on a Web site that any member of the public can freely access.  [You better believe I’ll be a frequent visitor!!]

When they must begin disclosing

Technically, this was supposed to happen by October 1, 2011.  But we’re running on government time here.  What they’re saying now is that the policy is open to public comment until February 17th, at which point Medicare officials will “deliberate,” and issue their final rules which will be legally binding.

If a company doesn’t disclose

There will be a $10,000 penalty for each failure to disclose.  If it is a knowing failure to disclose [not sure how they’re going to establish that…], the penalty could be as much as $100,000.

This is the only weak point in this entire policy — no company can be fined more than $1 million in a single year.  I know what you’re thinking… “$1 million; that’s a lot of money!! Nobody would risk losing that much.”

A lot of money to us… peanuts to them.  A million dollars is only a tiny fraction of their profits.  Fact is, they don’t mind paying billions of dollars in fines, because as Lon Schneider, off-label marketing researcher so nicely puts it:

There’s an unwritten business plan.  They [pharmaceutical companies] are drivers that knowingly speed.  If stopped, they pay the fine, and then they do it again.

-Lon Schneider, as quoted in the Washington Post’s excellent article, “When profits outweigh the penalties

Nevertheless, the new disclsoure policy is likely to put at least some kind of a damper on the uninhibited bribing of doctors that has been building to a slimy crescendo over the past decade or so. 

Hell — in a couple of years, the APA or FDA** might even be able to put together some kind of advisory committee of doctors unencumbered by severe financial conflicts of interest, possibly even capable of making unbiased, ethical decisions!

"Oh, is THAT what we're supposed to be doing? I'm really just here for the Cuban sandwiches."

 


* As of 2007, according to this article.  Also plenty of examples in there of the whole we-pay-you-$500/hr-to-stand-in-front-of-our-powerpoint marketing scheme pharma is so fond of.

** APA = American Psychiatric Association; FDA = Federal Drug Administration. [I always define my terms!]

For the DSM-V Task Force, being greasy never been so easy! 01/16/2012

Posted by ALT in Mental Health Policy and Inititatives, Pharmaceuticals.
Tags: , , , , , , ,
14 comments

It’s not easy to balance a private medical practice, pharmaceutical company-sponsored lecture tours or research projects, and the invention of new psychiatric diagnoses… but at least 68% of the DSM-V Task Force is doing it!  Yup; 68% of them openly report financial ties to the pharmaceutical industry (that’s up from the last time around, when 56% of the DSM-IV Task Force reported financial ties to pharma).*

That's pretty greasy...

It’s the Conflict of Interest Championships!

The DSM-V task force is divided into 13 work groups: ADHD, Anxiety, Child-Adolescence, Eating, Mood, Neurocognitive, Neurodevelopmental, Personality, Psychosis, Sexual-GID, Sleep-Wake, Somatic Distress, and Substance-Related. [They're wild about hyphens over at the APA...]  Each task force has 8-12 members, and each one of those members is required to disclose all ties to industry, professional organizations, and any other conflicts of interest [COI].

So here’s a fun game: go to the APA’s “Meet the Work Groups” web page, pick your favorite task force, and do a little investigating.  How many members have financial ties to the pharmaceutical industry?  And what kind of ties… is their research funded by pharma?  Are they being paid for the use of their “expert opinion” in drug advertisements?  Or is it an out-and-out bribe?

I’ve been playing the game all morning.  Here’s the score:

Psychotic Disorders Work Group

80% (8 of 10 reporting members) have direct financial ties to the pharmaceutical industry.

4 of those 8 receive it in the form of what I like to call “free money” – they simply stand in front of a pharmaceutical company-designed powerpoint or give their name to a ghostwritten scholarly article, lending it an air of credibility, and win a cash prize!  It’s called “honoraria,” “consultation,” or sometimes just “other” in the COI disclosures published on the APA’s website.

All Star Member: Wolfgang Gaebel, Professor Dr. med., M.D.

9 reported ties to pharmaceutical companies, including: Astra-Zeneca, Bristol-Myers Squibb, Lilly, Janssen-Cilag, Novartis, and Wyeth.

Coincidentally [or not], the makers of the 5 most commonly prescribed atypical antipsychotic medications** — in order… Astra-Zeneca (Seroquel), Janssen-Cilag (Risperdal),Bristol-Myers Squibb (Abilify), Lilly (Zyprexa), Pfizer (Geodon) — have ALL sponsored one or more members of the Psychotic Disorders Work Group.

ADHD Work Group

57% (4 of 7 reporting members) have direct financial ties to the pharmaceutical industry.

All 4 are receiving “free money.”

All Star Member: Rosemary Tannock, Ph.D.

8 reported ties to pharmaceutical companies, including: Pfizer, Lilly, and McNeil.  She also helped make an “informational” video about ADHD for teachers.  Great.

Mood Disorders Work Group

56% (5 of 9 reporting members) have direct financial ties to the pharmaceutical industry.

All 5 receiving “free money.”

All Star Member: Trisha Suppes, M.D.

46 reported ties to pharmaceutical companies including: Abbot Laboratories, Astra-Zeneca, GlaxoSmithKline, JDS Pharmaceuticals, Janssen, Lilly, Novartis, Pfizer, and Wyeth.  And she’s a professor at Stanford to boot!  She might just be our league MVP.

Again, this strange coincidence: The makers of the 5 most commonly prescribed antidepressants – in order… Zoloft (Pfizer), Prozac (Lilly), Cymbalta (Lilly), Effexor (Pfizer), and Wellbutrin (GlaxoSmithKline) – are all contributing to the various bank accounts of our Mood Disorders Work Group workers.

The makers of 3 common “mood stabilizer” medications — Abbot Laboratories (Depakote), GlaxoSmithKline (Lamictal), Pfizer (Gabapentin) — are doing the same.

And our All Star, Trisha Suppes, represents the makers of ALL of these drugs, by herself!

Looks like greasy goes down real easy with her.

Anxiety Disorders Work Group

56% (5 of 9 reporting members) have direct financial ties to the pharmaceutical industry.

All 5 receiving “free money.”

All Star Member: Murray B. Stein, M.D., M.P.H., FRCPCC [they should have him guest star on Sesame Street!]

 

12 reported ties to pharmaceutical companies including:Forest, GSK, Astra-Zeneca, Lilly, Bristol-Myers Squibb, Johnson & Johnson, and Avera.  Plenty of free money to be had from these folks!

Now you know what I’m going to say; the makers of drugs commonly prescribed to patients labeled in this category are well represented in those COI statements released by the Anxiety Disorders Work Group.

“But we thought the more hyphens and COI disclosures, the better!”

Sorry, APA.  I don’t think you guys get it.

Let me make it real simple:

Hyphens for the sake of hyphens don’t make you look smart, and COI disclosures made with no fear of penalty or reprimand don’t make you look ethical.

The whole point of disclosing conflicts of interest is determining whether someone is unencumbered enough to participate in a decision-making/fact-finding process.   So when Trisha Suppes says, “I have 46 financial ties to pharmaceutical companies, many of whom are trying to sell drugs to the people I’m trying to label,” … that should raise some red flags.   She should not be included in the Mood Disorders Work Group, because she is clearly NOT capable of making unbiased contributions.

Indigestion…

With this level of greasiness going down, you guys are in for some serious indigestion.  But, hey, don’t worry — there’s a pill for that!


*The figures for the DSM-V Task Force come from this article; for the DSM-IV, they come from here.

**As of 2009, according to this ranking.  It appears to be the most recent ranking available.  I’ve used it for all subsequent classes of drugs, as well.

The human right to be psychiatrized? 03/22/2011

Posted by ALT in Children's Mental Health, Mental Health News.
Tags: , , ,
10 comments

Yesterday, under the headline “Psychologists seek authority to prescribe psychotropic medications,” The Washington Post published a re-hash of a familiar frame story, one which I like to call the “undiagnosed and untreated” frame.  It goes something like this:

1.  Lots of people — adults and kids, American or otherwise — are suffering from mental illness; and many of them are not being treated (the implication typically being that “treatment” = primarily drug therapy).  Something must be done.

2.  People don’t have proper access to mental health experts, folks who can provide them with the treatment [medications] they require.  That’s because a. states are cutting spending on mental health services and b. there just aren’t enough psychiatrists, especially in non-urban areas.  Something must be done.

3.  Mental illness is serious and real [insert mention of chronic physical illness like “diabetes” here].  After all, “people with serious mental illness die 25 years earlier, on average, than the rest of the population.*  Something must be done.

4.  Finally, after the case for doing something has been so irrefutably established, the recommendation is usually along the lines of making medication more accessible, either by reforming insurance reimbursement practices, integrating mental health care with primary health care, or (as is the case in this article) recommending that all psychologists – not just clinical psychologists with training in psychopharmacology – be allowed to prescribe medications.

This frame story presents undiagnosed/untreated mental illness almost as a human rights issue.  From this point of view, it is a basic human right to a. be informed that you are suffering from a mental illness [this fact being objectively determined, of course] and b. be medicated, therapized, or in some other way treated for that disease [the treatments being scientifically proven to address those aforementioned objective diagnoses].  Keeping in mind the funny way that informed consent operates in mental health “care,”** it’s fair to say that it doesn’t really matter if you agree with the label you’re given or the means of addressing that label [treatment].  For your own good, and the good of society, you must be treated; otherwise harm to yourself or others is the inevitable result – or so we’re told.  The glut of editorials following the Tuscon shooting warning that untreated mental illness will lead to violence (not supported by any evidence beyond conjecture) is an excellent example of this particular misconception at play.

     

Case Study: the right of children to be bipolar

A recent study from the Archives of General Psychiatry, detailing the prevalence of diagnosed bipolar spectrum disorders in different countries, showed the following results: essentially, the United States has the highest rate of diagnosed bipolar disorders (4.4%), almost twice the estimated worldwide average (2.4%).

click to enlarge

[citation: Merikangas, K.R. et al (2011).  Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey InitiativeArchives of General Psychiatry, 68(3), pp 241-251.]

The interpretation of this data was another homage to the “undiagnosed and untreated” frame story; bipolar disorders are real but they’re not being diagnosed properly worldwide (just look at the disparity between the US and other countries!).   Folks in under-developed countries are being denied their basic human right! Something must be done.

In fact, before the 1990s, the US’s rate of bipolar disorder was much lower, mainly because the phenomenon of childhood bipolar disorder was unknown.  It was something a clinician could expect to see maybe “once or twice in his lifetime.”  But then in 1994 two influential child psychologists from Harvard University, Dr. Joseph Biederman and Dr. Janet Wozniak, hypothesized that the disease is common in children – and is often misdiagnosed as ADHD. 

Overnight, bipolar disorder diagnoses in children soared; there was a 40-fold increase between 1993 and 2003 in bipolar labeling (4000%!).   

This precipitous increase in diagnosis (and corresponding increase in profits for the manufacturers of medications used to “treat” the disorder) doesn’t look… natural.  Especially when you have child psychiatrists admitting on primetime TV that the whole thing is an “experiment.”  So there’s been a bit of a backlash, and the DSM-V [Diagnostic and Statistical Manual, 5th Edition, currently in development] will address the problem—a new diagnosis for what is now called “childhood bipolar disorder” has been invented.  They’re calling it “Temper Dysregluation Disorder.”  It is a “biological dysfunction,” to be treated with medication, of course.

I fear that we’ll soon be meeting individuals who insist that they suffer from “Temper Dysregulation Disorder,” that the label finally puts a face to the beast of the problems they’ve been facing for years.  Maybe so — but I won’t be able to stop myself from remembering the days when that label was just the figment of a DSM-V editor’s imagination…

... and Pluto was still a planet.

    

A pertinent question

If this new diagnostic category does indeed become the psychiatric law of the land in the DSM-V, what will this mean for the thousands of children who suddenly had the human right of being bipolar thrust upon them?  Will it be their new human right to be “reclassified” into another diagnostic/pathologic category? 

Will we soon be informed that the rates of “Temper Dysregulation Disorder” diagnosis are pathetically low in foreign countries, and that those poor suffering individuals need to have their human right to diagnosis and treatment met, whether they like it or not?

One thing is certain; as long as new psychiatric disorders are invented solely in the US (and it appears that for now at least the APA has a monopoly on that activity), the rest of the world is just going to have to put up with shrill condemnations of their human rights violations.  Unless, of course, they have the money, time, and will to subject their populations to the kind of psychiatrization so popular here in the US.

    


* Bonus points if you can spot the inaccuracies surrounding the Washington Post’s presentation of this statistic…

** Someone who says “yes” to treatment is almost always “competent to give consent;” someone who says “no” is demonstrating his pathology, inability to make good judgments about his own care, legally incompetent – and subject to involuntary treatment and confinement.  Like the case of Paul Henri Thomas, to cite just one example.

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