The Book of Woe: The DSM and the Unmaking of Psychiatry (42 page)

2.
Biederman thought he detected in these children:
Biederman, “Resolved: Mania Is Mistaken for ADHD.”

3.
a small literature reporting a few cases of “hyperactive children”:
Ibid., 1091.

4.
“the essential feature of Bipolar Disorder”:
DSM-IV-TR, 382.

5.
“a distinct period of abnormally and persistently elevated”:
DSM-IV-TR, 362.

6.
Manic episodes have seven Criterion B symptoms:
Ibid.

7.
So Biederman set out to prove:
Wozniak et al., “Mania-Like Symptoms.” See also Biederman, “Pediatric Bipolar Disorder Coming of Age.”

8.
One in five of those patients:
Wozniak et al., “Mania-Like Symptoms,” 873.

9.
Biederman’s announcement provoked:
See, for instance, Klein, Pine, and Klein, “Resolved: Mania Is Mistaken for ADHD,” and McClellan, “Commentary: Treatment Guidelines for Child and Adolescent Bipolar Disorder.”

10.
“smallpox vaccine was ridiculed”:
Biederman, “Resolved,” 1098.

11.
“disorders with bipolar features”:
DSM-IV-TR, 400.

12.
“thoughtful clinical investigators”:
Papolos and Papolos,
The Bipolar Child
, 32.

13.
“latest research findings” would recognize the symptoms:
Ibid., 55–59.

14.
“You have bipolar disorder”:
Anglada,
Brandon and the Bipolar Bear
, 16.

15.
“can’t do their job right”:
Ibid., 17.

16.
Brandon most likely inherited it:
Ibid., 20.

17.
“Young and Bipolar”:
“Young and Bipolar,”
Time
, August 19, 2002.

18.
6.67 percent of office visits:
Moreno et al., “National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth.”

19.
“The label may or may not reflect reality”:
Benedict Carey, “Bipolar Disorder Cases Rise Sharply in U.S. Children,”
The New York Times
, September 3, 2007.

20.
there is “some medicine that could help”:
Anglada,
Brandon and the Bipolar Bear
, 21.

21.
rebranding
atypical antipsychotics
:
The APA had a hand in this effort. See Hales et al.,
What Your Patients Need to Know About Psychiatric Medications
, 183–85.

22.
devastating side effects:
See, for example, Üçok and Gaebel, “Side Effects of Atypical Antipsychotics: A Brief Overview.”

23.
twelve-to-twenty-year decrease in life expectancy:
See Whitaker,
Anatomy of an Epidemic
, 175–77.

24.
studies indicating that children’s symptoms improved:
For a summary, see Kowatch et al., “Treatment Guidelines for Children and Adolescents with Bipolar Disorder.”

25.
prevalence of BD among children:
Moreno et al., “National Trends.”

26.
antipsychotic use in children and adolescents:
“Antipsychotic Drug Use Among Kids Soars,” Associated Press, May 3, 2006.

27.
Gardiner Harris reported:
Gardiner Harris, “Proof Is Scant on Psychiatric Drug Mix for Young,”
The New York Times
, November 23, 2006.

28.
stories such as that of Rebecca Riley:
David Abel, “Hull Parents Arrested in Girl’s Poisoning Death,”
The Boston Globe
, February 6, 2007.

29.
“In psychiatry
Mr. Grassley has found”:
Benedict Carey and Gardiner Harris, “Psychiatric Group Faces Scrutiny over Drug Industry Ties,”
The New York Times
, July 12, 2008.

30.
what Grassley found when he investigated Joseph Biederman:
Gardiner Harris and Benedict Carey, “Researchers Fail to Reveal Full Drug Pay,”
The New York Times
, June 8, 2008.

31.
“move forward the commercial goals”:
Gardiner Harris, “Research Center Tied to Drug Company,”
The New York Times
, November 25, 2008.

32.
“will support the safety and effectiveness of risperidone”:
Gardiner Harris, “Drug Maker Told Studies Would Aid It,”
The New York Times
, March 20, 2009.

33.
this exchange, which followed his testimony:
Ibid.

34.
“I have never seen someone so angry”:
Harris, “Research Center Tied to Drug Company.”

35.
“violated certain requirements”:
Liz Kowalczyk, “Harvard Doctors Punished Over Pay,”
The Boston Globe
, July 2, 2011.

36.
Grassley wasn’t stopping with Biederman:
Gardiner Harris, “Top Psychiatrist Didn’t Report Drug Makers’ Pay,”
The New York Times,
October 3, 2008.

37.
He revealed that Frederick Goodwin:
Gardiner Harris, “Radio Host Has Drug Company Ties,”
The New York Times
, November 21, 2008.

38.
a drug that has been “generic for decades”:
Statement of Frederick K. Goodwin, M.D., http://drgoodwin.com/index.php?page=nyt.

39.
Alan Schatzberg owned nearly $5 million in stock:
Harris, “Top Psychiatrist.”

40. “
I have come to understand”:
Senator Grassley’s letter is available at http://www.finance.senate.gov/newsroom/ranking/release/?id=56860a96-5fba-4fb9-9207-849e796998ad.

41.
nearly one-third of the organization’s $62.5 million annual revenue:
Carey and Harris, “Psychiatric Group Faces Scrutiny over Drug Industry Ties.”

42.
As the
Times
had reported earlier:
Benedict Carey, “Study Finds a Link of Drug Makers to Psychiatrists,”
The New York Times
, April 20, 2006.

43.
the report of a team led by psychologist Lisa Cosgrove:
Cosgrove et al., “Financial Ties Between DSM-IV Panel Members and the Pharmaceutical Industry,” 154–60.

44.
“Pharmaceutical companies have a vested interest”:
Ibid., 159.

45.
Restless legs syndrome:
GlaxoSmithKline, press release, June 10, 2003, www.gsk.com/press_archive/press2003/press_06102003.htm.

46.
“With every new revelation”:
Carey and Harris, “Psychiatric Group Faces Scrutiny.”

47.
the $4 million or so the industry kicked down every year:
See APA Treasurer’s Report, May 2012. Available at https://docs.google.com/file/d/0BzWdENl1wkVSYk5aXzRZelFYUjA/edit?pli=1. This report contains APA financial reports from 2005 to 2011.

48.
“my board thought that through”:
James Scully interview, September 13, 2010.

49.
it took nearly two years:
Regier et al.,
The Conceptual Evolution of DSM-5
, xxv.

50.
“All the people at the top”:
Michael First interview, April 25, 2011.

51.
“a new diagnostic paradigm must be developed”:
Kenneth S. Kendler et al., “Guidelines for Making Changes to DSM-V,” http://www.dsm5.org/ProgressReports/Documents/Guidelines-for-Making-Changes-to-DSM_1.pdf.

Chapter 6

1.
“I was bored stiff”:
Allen Frances e-mail, October 7, 2011.

2.
“Psychiatric classification”:
Allen Frances e-mail, October 11, 2011.

3.
“Perhaps not surprisingly, the diagnosis”:
Allen Frances e-mail, October 7, 2011.

4.
“confidentiality in the development”:
See Hannah Decker, “A Moment of Crisis in American Psychiatry,”
h-madness
(blog), April 27, 2010, http://historypsychiatry.com/2010/04/27/a-moment-of-crisis-in-the-history-of-american-psychiatry/.

5.
the APA had insisted:
On its acceptance form, available at http://www.dsm5.org/about/Documents/DSM%20Member%20Acceptance%20Form.pdf.

6.
“We are rethinking”:
“DSM-V Development Will Be Complex and Open Process,”
Psychiatric News
, June 6, 2008.

7.
“I was dumbfounded”:
Robert Spitzer e-mail, September 24, 2010.

8.
“I found out how transparent”
 . . . “I didn’t know whether”:
Robert Spitzer, “DSM-V: Open and Transparent?”
Psychiatric News
, July 18, 2008.

9.
“I told him I completely agreed”:
Allen Frances interview, August 15, 2010.

10.
new diagnosis to be called Psychosis Risk Syndrome:
For a full description, see Carpenter, “Anticipating DSM-V: Should Psychosis Risk Become a Diagnostic Class?” and Woods et al., “Validity of the Prodromal Risk Syndrome for First Psychosis.”

11.
a
conversion rate
of 25 to 30 percent:
See Cornblatt and Correll, “A New Diagnostic Entity in DSM-5?”

12.
“I had not been closely following”:
Allen Frances interview, August 16, 2010.

13.
Carpenter explained to Pincus:
William Carpenter interview, September 10, 2010.

14.
“I still think it’s a crazy idea”:
Harold Pincus interview, December 9, 2011.

15.
pseudoneurotic schizophrenia:
Allen Frances telephone interview, November 23, 2011.

16.
“more kids getting unneeded antipsychotics”:
Allen Frances interview, August 16, 2010.

Chapter 7

1.
“People are going to write dissertations”:
James Scully interview, September 13, 2010.

2.
Zucker was known for research:
See Zucker and Bradley,
Gender Identity Disorder and Psychosexual Problems in Children and Adolescents.

3.
a fetish Blanchard called
autogynephilia
:
Blanchard, “The Concept of Autogynephilia and the Typology of Male Gender Dysphoria.”

4.
“out of step”:
National Gay and Lesbian Task Force, “Task Force Questions Critical Appointments to APA’s Committee on Sexual and Gender Identity Disorders,” news release, May 18, 2008. http://www.thetaskforce.org/press/releases/PR_052808.

5.
“thorough and balanced”:
American Psychiatric Association, “APA Statement on GID and the DSM-V,” news release, May 23, 2008, http://www.dsm5.org/Newsroom/Documents/APAStatementonGIDandTheDSMV.pdf.

6.
“the DSM is a diagnostic manual”:
Ibid.

7.
an immediate rejoinder:
Nada Stotland et al., “DSM-V: Open and Transparent? A Response,”
Psychiatric News
, July 18, 2008.

8.
Regier wanted to know:
Darrel Regier, William Narrow, and David Kupfer interview, September 14, 2010.

9.
“I’m not on the task force”:
Sidney Zisook interview, September 10, 2010.

10.
“We have enemies”:
Stotland, “Presidential Address,” 1102.

11.
“psychiatry is a pseudoscience”:
Tom Cruise, interview by Matt Lauer,
Today
, June 25, 2005, http://msnbc.msn.com/id/8343367/site/todayshow/ns/today-entertainment/t/im-passionate-about-life/.

12.
“Michael First shamed me into it”:
Allen Frances e-mail, December 18, 2011.

13.
“Setting the Record Straight”:
Alan Schatzberg et al., “Setting the Record Straight,”
Psychiatric Times,
July 1, 2008.

14.
“Soaring ambition is another matter”:
William Carpenter, “Criticism vs Fact,”
Psychiatric Times,
July 7, 2008.

15.
“letting nostalgia and passion”:
Alarcon, “DSM-5—The We Know Better/Holier Than Thou Crusade,”
Psychiatric Times
, July 14, 2008.

16.
“You must understand”:
Allen Frances, letter to APA board of trustees, July 6, 2009. http://www.scribd.com/doc/17172432/Letter-to-APA-Board-of-Trustees-July-7-2009-From-Allen-Frances-and-Robert-Spitzer.

17.
The APA’s financial picture:
APA’s Treasurer Report, 2012.

18.
“In reality, clinicians in the United States”:
Michael First interview, August 24, 2010.

19.
the ICD, created by a public agency, is available for download:
You can browse it yourself at http://apps.who.int/classifications/icd10/browse/2010/en.

20.
an unsettling if unsurprising discovery:
Clayton et al., “The Bereavement of the Widowed.”

21.
“a full depressive syndrome”:
DSM-III, 333.

22.
The
bereavement exclusion
:
DSM-III-R, 223.

23.
he tried to define
disease
:
Spitzer and Endicott, “Medical and Mental Disorder: Proposed Definition and Criteria,” in
Critical Issues in Psychiatric Diagnosis.

24.
“present concepts that have influenced the decision”:
DSM-III, 6.

25. Mental disorder,
he argued
: Spitzer and Endicott, “Medical and Mental Disorder,” 30.

26.
“These guys have some chutzpah”:
Kirk and Kutchins,
The Selling of DSM
, 113.

27. “
In DSM-III each of the mental disorders”:
DSM-III, 5–6.

28.
“The syndrome or pattern”:
DSM-III-R, xxii.

29.
DSM-IV devoted seven of its 886 pages:
DSM-IV, 843–49.

Chapter 8

1.
“psychiatric classification is necessarily”:
Frances, “DSM in Philosophyland: Curiouser and Curiouser.”

2.
“recurrent and persistent thoughts”:
DSM-IV-TR, 462–63.

3.
“A diagnosis is a call to action”:
Frances, “DSM in Philosophyland.”