THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM)

…there is ample reason to conclude that the latest versions of DSM as a clinical tool are unreliable and therefore of questionable validity as a classification system.– Herb Kutchins of California State University and Stuart A. Kirk of UCLA

DSM-IV is the fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than scientific document… DSM-IV has become a bible and a money making bestseller—its major failings notwithstanding. It confines and defines practice, some take it seriously, others more realistically.” And, “It is the way to get paid. Diagnostic reliability is easy to attain for research projects. The issue is what do the categories tell us? Do they in fact accurately represent the person with a problem? They don’t, and can’t, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder.– Loren Mosher, M.D., Clinical Professor of Psychiatry

Actual examples of “disorders” currently listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV):

Mathematics Disorder
Nocturnal sleep-related eating disorder
Avoidant Personality Disorder
Transient Tic Disorder
Disorder of Written Expression
Intermittent Explosive Disorder
Female and Male Orgasmic Disorders
Adjustment Disorders
Phonological Disorder
Caffeine Intoxication/Withdrawal Disorders
Conduct Disorder
Nicotine Use or Withdrawal Disorder
Non Compliance With Treatment Disorder
Sibling Rivalry Disorder
and the all-encompassing, Unspecified Mental Disorder
– Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

Given their farcical ’empirical’ procedures for arriving at new disorders with their associated symptoms lists, where does the American Psychiatric Association get off claiming a scientific, research-based foundation for its diagnostic manual? This is nothing more than science by decree. They say it is science, so it is.” – Margaret Hagen, author of Whores Of The Court

In short, the whole business of creating psychiatric categories of ‘disease’, formalizing them with consensus, and subsequently ascribing diagnostic codes to them, which in turn leads to their use for insurance billing, is nothing but an extended racket furnishing psychiatry a pseudo-scientific aura. The perpetrators are, of course, feeding at the public trough.” – Dr. Thomas Dorman, internist and member of the Royal College of Physicians of the United Kingdom and Fellow of the Royal College of Physicians of Canada

The notion of scientific validity, though not an act, is related to fraud. Validity refers to the extent to which something represents or measures what it purports to represent or measure. When diagnostic measures do not represent what they purport to represent, we say that the measures lack validity. If a business transaction or trade rested on such a lack of validity, we might say that the lack of validity was instrumental in a commitment of fraud. The Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association and used by licensed psychotherapists throughout the country is notorious for low scientific validity. Yet it is instrumental in securing insurance reimbursement for psychotherapy services….– Jeffrey A. Schaler, Ph.D.

The developers of DSM assume that if a group of psychiatrists agree on a list of atypical [new] behaviors, the behaviors constitute a valid mental disorder. Using this approach, creating mental disorders can become a parlor game in which clusters of all kinds of behaviors (i.e. syndromes) can be added to the manual.”

“…there is ample reason to conclude that the latest versions of DSM as a clinical tool are unreliable and therefore of questionable validity as a classification system.”

“There are indeed many illusions about DSM and very strong needs among its developers to believe that their dreams of scientific excellence and utility have come true….” The “bitter medicine” is that DSM has “unsuccessfully attempted to medicalize too many human troubles.”

[DSM] “…cannot be used to distinguish mental disorders from other human problems. In practical terms, this means that many people who do not have any mental disorder (although they may have other difficulties) will be inappropriately labeled as mentally ill and those who have a mental disorder will not have it recognized…If the unreliability of diagnosis were widely recognized and if there were no scientific patina [surface appearance]” to it, “the use of everyday behaviors as indicators of mental disorder would be more rigorously questioned by the public. The illusion that psychiatrists are in agreement when making diagnoses creates the appearance of a united professional consensus.– Herb Kutchins of California State University, Sacramento, and Stuart A. Kirk of the University of California, Los Angeles, authors of Making Us Crazy: The Psychiatric Bible and the Creation of Mental Disorders

The ostensible validity of DSM is reinforced by psychiatry’s claim that mental illnesses are brain diseases—a claim supposedly based on recent discoveries in brain imaging techniques and pharmacological agents for treatment. This is not true.” He also says, “There is no blood or other biological test to ascertain the presence of a mental illness, as there is for most bodily diseases. If such a test were developed, then the condition would cease to be a mental illness and would be classified, instead, as a symptom of a bodily disease.– Thomas Szasz, M.D., Professor of Psychiatry Emeritus

[The DSM] has led to the unnecessary drugging of millions of American children who could be diagnosed, treated, and cured without the use of toxic and potentially lethal medications.”

“The nonscientific approach used to create DSM leads to irrational and constantly changing diagnostic criteria: a patient might be perfectly normal according to one version of DSM and mentally ill by the standards of the next. (For instance, ‘narcissistic personality disorder’—used to describe vain people who are self-centered and frequently take advantage of others—was a DSM ‘diagnosis’ until 1968. It was eliminated from the version used between 1968 and 1980, when it was reinstated. Thus, a self-centered, vain person was ‘mentally ill’ before 1968, normal for the next twelve years, and then ‘mentally ill’ again after 1980.)– Dr. Sydney Walker, III, psychiatrist, neurologist

There has never been any criterion that psychiatric diagnoses require a demonstrated biological etiology (cause).– Dr. Harold Pincus, Vice Chairman of the DSM-IV task force

… In the absence of validating conceptions like the six mechanisms of disease in internal medicine, American psychiatry has turned to “committees of experts” to define mental disorder. Membership on such committees is a mater of one’s reputation in the APA—which means that those chosen can confidently be expected to manifest not only a requisite degree of psychiatric competence but, perhaps more crucially, some talent for diplomacy and self-promotion.

“The new DSM approach of using experts and descriptive criteria in identifying psychiatric diseases has encouraged a productive industry. If you can describe it, you can name it; and if you can name it, then you can claim it exists as a distinct “entity” with, eventually, a direct treatment tied to it. Proposals for new psychiatric disorders have multiplied so feverishly that the DSM itself has grown from a mere 119 pages in 1968 to 886 in the latest edition; a new and enlarged edition, DSM-V, is already in the planning stages. Embedded within these hundreds of pages are some categories…that are dubious, in the sense that they are more like the normal responses of sensitive people than psychiatric “entities”; and some that are purely the inventions of their proponents.– Paul R. McHugh, Professor of Psychiatry at Johns Hopkins University School of Medicine and psychiatrist-in-chief at the Johns Hopkins Hospital in Baltimore

DSM diagnostic system has outlived its usefulness by about two decades. It should be abandoned, not revised.– Paul Genova, M.D., writing in Psychiatric Times

Often tagged “junk science,” according to an international poll of mental health experts conducted in England in 2001, the DSM-IV was voted one of the 10 worst psychiatric papers of the millennium.” and “Widespread professional criticism is leveled against psychiatry’s Diagnostic and Statistical Manual of Mental Disorders (DSM) and its equivalent mental disorders section of the International Classification of Diseases (ICD). Unlike medical diagnosis, psychiatrists categorize symptoms only, not disease.– CCHR Publication, THE DSM HOAX

The humility and the arrogance in the prose are almost indistinguishable, frolicking like puppies at play. They say: ‘…while this manual provides a classification of mental disorder…no definition adequately specifies precise boundaries for the concept…’ [APA, 1987]…They go on to say: ‘…there is no assumption that each mental disorder is a discrete entity with sharp boundaries between it and other mental disorders or between it and no mental disorder’ [APA, 1987]. – Psychiatrist Matthew Dumont

“The low level of intellectual effort was shocking. Diagnoses were developed by majority vote on the level we would use to choose a restaurant. You feel like Italian, I feel like Chinese, so let’s go to a cafeteria. Then it’s typed into the computer.– Psychologist Renee Garfinkel, a staff member of the American Psychological Association on the DSM-III-R work group

There must inevitably be a struggle, or a dialectical process, to determine the meaning of physical symptoms and where the boundaries of health and disease lie.– David Healy, psychiatrist, director of the North Wales Department of Psychological Medicine and author of The Anti-Depressant Era

…DSM-IV’s authoritative status and detailed nature tends to promote the idea that rote diagnosis and pill-pushing are acceptable.– J. Allan Hobson and Jonathan A. Leonard, authors of Out of Its Mind, Psychiatry in Crisis, A Call For Reform

DSM is “a masterpiece of political maneuvering.” and “what they have done is medicalize many problems that don’t have demonstrable, biological causes.– Al Parides, psychiatrist

DSM-IV is not an exciting document. It is purely descriptive and presents no new scientific insights or any theories about what causes the many mental disorders it lists.– Elliot S. Valenstein, biopsychologist, author of Blaming the Brain

…[The] search for a biological marker is doomed from the outset because of the contradictions and ambiguities of the diagnostic construct of ADHD as defined by the DSM…I liken the efforts to discover a marker…to the search for the Holy Grail.– Lawrence Diller, M.D., author of Running on Ritalin

The DSM-IV has gone too far. There are too many diagnoses without any objective basis or biological support.– Theodore Pearlman, psychiatrist

…[T]he current DSM is a compendium of checklist diagnoses: cursory, superficial menus of symptoms….Any attempt to help patients understand themselves and to effect real change is lost in the rush to diagnose and medicate them.– Joseph Glenmullen, Harvard University Medical School psychiatrist

Despite their lack of scientific veracity, the DSM/ICD feature heavily as diagnostic tools, not only for individual treatment but also for child custody battles, discrimination cases based on alleged psychiatric disability, court testimony, education, and more.

In the absence of objective, scientific evidence, psychiatry has decreed the following to be mental illnesses: Expressive Language Disorder, Phonological Disorder, Sibling Rivalry Disorder, Phase of Life Problem, and Tobacco Use or Withdrawal Disorder. – CCHR Publication, THE DSM HOAX

Disorders come and go. Even Sigmund Freud’s concept of neurosis was dropped in the original DSM-III (1980). And in 1973 APA [American Psychiatric Association] trustees voted to wipe out almost all references to homosexuality as a disorder. Before the vote, being gay was considered a psychiatric problem. After the vote the disorder was relegated to psychiatry’s attic. ‘It’s a matter of fashion,’ says Dr. John Spiegel of Brandeis University, who was president of the APA in 1973, when the debate over homosexuality flared. ‘And fashions keep changing'” – Omni magazine, November 1986 p. 30.

“The public at large may gain false comfort from a diagnostic psychiatric manual that encourages belief in the illusion that the harshness, brutality and pain in their lives and in their communities can be explained by a psychiatric label and eradicated by a pill. Certainly, there are plenty of problems that we all have and a myriad of peculiar ways that we struggle…to cope with them. But could life be any different? Far too often, the psychiatric bible has been making us crazy—when we are just human.” – Professors Herb Kutchins and Stuart A. Kirk, authors of “Making Us Crazy”

“If mental illness were really an illness in the same sense that physical illnesses are illnesses, the idea of deleting homosexuality or anything else from the categories of illness by having a vote would be as absurd as a group of physicians voting to delete cancer or measles from the concept of disease.” – Lawrence Stevens, J.D.

(note: in 1973, American Psychiatric Association members voted by 5,584 to 3,810 to cease calling homosexuality a mental disorder after gay activists picketed the APA conferences.)