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Psychologists now believe fledgling psychopaths can be identified as early as kindergarten. The hope is to teach these children empathy before it’s too late.
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Guideline Revisions May Sharply Increase Addiction Diagnoses
New York Times “The chances of getting a diagnosis are going to be much greater, and this will artificially inflate the statistics considerably,” said Thomas F. Babor, a psychiatric epidemiologist at the University of Connecticut who is an editor of the international ... DSM-5 Field Trials Generate Mixed ResultsMedscape The Gloom-and-Doom Disease: Should Woody Allens Have a Home in the Manual of ...Scientific American (blog) all 92 news articles » |
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Changes to autism manual
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Amid all the Super Bowl-esque hoopla of this year’s annual meeting of the American Psychiatric Association was the final round of a national competition among residency programs to demonstrate superior psychiatric knowledge. The several month competition, MindGames, pitted program against program on timed multiple choice exams on a diverse range of psychiatric topics, including theory, psychopharmacology, psychotherapy, geriatrics, addictions, and forensics.
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It is an honor to be in Philadelphia, the city of “brotherly love”, as one voice among many in this Occupation of the American Psychiatric Association, brilliantly organized by MindFreedom International. It is an honor to be a part ...
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Reports here provided what may be the last public update on DSM-5, the next edition of American psychiatry's diagnostic guide, before it is formally released in May 2013. Many changes have been made since the first draft of ...
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The DSM-V goal to effect a “paradigm shift” in psychiatric diagnosis is absurdly premature. Simply stated, descriptive psychiatric diagnosis does not now need and cannot support a paradigm shift. There can be no dramatic ...
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A shift by the federal government in how it pays for drugs for dialysis patients may have had an unintended and potentially dire consequence, researchers say.
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Government advisers recommended that the F.D.A. approve the weight-loss drug lorcaserin.
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Psychiatrists say diagnosis manual needs overhaul
Chicago Tribune LONDON (Reuters) - Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a year for further revisions, despite some modifications which eliminated two controversial diagnoses. Why Are There No Biological Tests in Psychiatry?Scientific American (blog) Panel suggests DSM-5 psychiatry manual drops two disorders, keeps new autism ...CBS News Psychiatry Manual Drafters Back Down on DiagnosesNew York Times Fox News all 89 news articles » |
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Psychiatrists say diagnosis manual needs overhaul - chicagotribune.com
LONDON (Reuters) - Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a year for further revisions, despite some modifications which eliminated two controversial diagnoses.
The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), a draft of which is open for public consultation this month, will be the first full revision since 1994 of the renowned handbook, which determines how to interpret symptoms in order to diagnose mental illnesses.
But more than 13,000 health professionals from around the world have already signed an open letter petition (at http://dsm5-reform.com) calling for DSM 5 to be halted and re-thought.
"Fundamentally, it remains a bad system," said Peter Kinderman, a professor of clinical psychology at Britain's Liverpool University.
"The very minor revisions...do not constitute the wholesale revision that is called for," he said in an emailed comment.
The American Psychiatric Association (APA), which produces the manual and plans to publish DSM 5 next May, said on Wednesday it had decided to drop two proposed diagnoses, for "attenuated psychosis syndrome" and "mixed anxiety depressive disorder".
The former, intended to help identify people at risk of full-blown psychosis, and the latter, which suggested a blend of anxiety and depression, had been criticized as too ill-defined.
With these and other new diagnoses such as "oppositional defiant disorder" and "apathy syndrome", experts said the draft DSM 5 could define as mentally ill millions of healthy people - ranging from shy or defiant children to grieving relatives, to people with harmless fetishes.
"SIMPLY NOT USABLE"
Robin Murray, a professor of psychiatric research at the Institute of Psychiatry at Kings College London, said it was a great relief to see the changes in the draft, particularly to the attenuated psychosis diagnosis.
"It would have done a lot of harm by diverting doctors into thinking about imagined risk of psychosis (and) it would have led to unnecessary fears among patients that they were about to go mad," he said in a statement.
But Allen Frances, emeritus professor at Duke University in the United States, said it was "only a first small step toward desperately needed DSM 5 reform".
"Numerous dangerous suggestions remain, Frances, who chaired a committee overseeing the DSM 4, said, adding that DSM 5 "is simply not usable" and should be delayed for an extra year "to allow for independent review, to clean up its obscure writing, and for retesting".
Diagnosis is always controversial in psychiatry, since it defines how patients will be treated based on a cluster of symptoms, many of which occur in several different types of mental illness.
Peter Jones, a professor of psychiatry at Cambridge University, said DSM 5 should be "underpinned by science" built on an understanding of the biology and functions of the brain and mind - something he said neuroscience was not yet able to do comprehensively enough.
"On this basis DSM 5 is, at best, premature and a waste of time," he said.
Some argue that the whole approach needs to be changed to pay more attention to individual circumstances rather than slotting them into predefined categories.
Lucy Johnstone, a consultant clinical psychologist for the Cwm Taf Health Board in Wales agreed: "(The DSM)is wrong in principle, based as it is on redefining a whole range of understandable reactions to life circumstances as 'illnesses', which then become a target for toxic medications heavily promoted by the pharmaceutical industry," she said.
"The DSM project cannot be justified, in principle or in practice. It must be abandoned so that we can find more humane and effective ways of responding to mental distress."
One of the proposed changes that has survived in the draft DSM 5 - despite fierce public outcry - is in autism. The new edition eliminates the milder diagnosis of Asperger syndrome in favor of the umbrella diagnosis of autism spectrum disorder.
(Editing by Myra MacDonald)
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Psychiatrists say diagnosis manual needs overhaul
A patient looks through a window inside the Larco Herrera psychiatric hospital in Lima (ENRIQUE CASTRO-MENDIVIL, REUTERS / May 10, 2012)
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Kate Kelland Reuters
1:24 p.m. CDT, May 10, 2012
LONDON (Reuters) - Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a year for further revisions, despite some modifications which eliminated two controversial diagnoses.
The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), a draft of which is open for public consultation this month, will be the first full revision since 1994 of the renowned handbook, which determines how to interpret symptoms in order to diagnose mental illnesses.
But more than 13,000 health professionals from around the world have already signed an open letter petition (at http://dsm5-reform.com) calling for DSM 5 to be halted and re-thought.
"Fundamentally, it remains a bad system," said Peter Kinderman, a professor of clinical psychology at Britain's Liverpool University.
"The very minor revisions...do not constitute the wholesale revision that is called for," he said in an emailed comment.
The American Psychiatric Association (APA), which produces the manual and plans to publish DSM 5 next May, said on Wednesday it had decided to drop two proposed diagnoses, for "attenuated psychosis syndrome" and "mixed anxiety depressive disorder".
The former, intended to help identify people at risk of full-blown psychosis, and the latter, which suggested a blend of anxiety and depression, had been criticized as too ill-defined.
With these and other new diagnoses such as "oppositional defiant disorder" and "apathy syndrome", experts said the draft DSM 5 could define as mentally ill millions of healthy people - ranging from shy or defiant children to grieving relatives, to people with harmless fetishes.
"SIMPLY NOT USABLE"
Robin Murray, a professor of psychiatric research at the Institute of Psychiatry at Kings College London, said it was a great relief to see the changes in the draft, particularly to the attenuated psychosis diagnosis.
"It would have done a lot of harm by diverting doctors into thinking about imagined risk of psychosis (and) it would have led to unnecessary fears among patients that they were about to go mad," he said in a statement.
But Allen Frances, emeritus professor at Duke University in the United States, said it was "only a first small step toward desperately needed DSM 5 reform".
"Numerous dangerous suggestions remain, Frances, who chaired a committee overseeing the DSM 4, said, adding that DSM 5 "is simply not usable" and should be delayed for an extra year "to allow for independent review, to clean up its obscure writing, and for retesting".
Diagnosis is always controversial in psychiatry, since it defines how patients will be treated based on a cluster of symptoms, many of which occur in several different types of mental illness.
Peter Jones, a professor of psychiatry at Cambridge University, said DSM 5 should be "underpinned by science" built on an understanding of the biology and functions of the brain and mind - something he said neuroscience was not yet able to do comprehensively enough.
"On this basis DSM 5 is, at best, premature and a waste of time," he said.
Some argue that the whole approach needs to be changed to pay more attention to individual circumstances rather than slotting them into predefined categories.
Lucy Johnstone, a consultant clinical psychologist for the Cwm Taf Health Board in Wales agreed: "(The DSM)is wrong in principle, based as it is on redefining a whole range of understandable reactions to life circumstances as 'illnesses', which then become a target for toxic medications heavily promoted by the pharmaceutical industry," she said.
"The DSM project cannot be justified, in principle or in practice. It must be abandoned so that we can find more humane and effective ways of responding to mental distress."
One of the proposed changes that has survived in the draft DSM 5 - despite fierce public outcry - is in autism. The new edition eliminates the milder diagnosis of Asperger syndrome in favor of the umbrella diagnosis of autism spectrum disorder.
(Editing by Myra MacDonald)
Copyright © 2012, Reuters
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Psychiatrists say diagnosis manual needs overhaul
Ottawa Citizen - 13 seconds ago
By Kate Kelland, Reuters May 11, 2012 9:13 AM Experts say the draft DSM 5 could define as mentally ill millions of healthy people - ranging from shy or defiant children to grieving relatives, to people with harmless fetishes.
Reuters Health News Summary
Chicago Tribune - 1 hour ago
Following is a summary of current health news briefs. Psychiatrists say diagnosis manual needs overhaul LONDON (Reuters) - Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a ...
Battle looms in psychiatry world over controversial manual update
Montreal Gazette - 4 hours ago
'Numerous dangerous suggestions remain'despite revisions LONDON – Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a year for further revisions, despite some modifications ...
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Will help define was is, and isn't, covered by insurance.
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He said he hopes the document, which is due to be published in May 2013, will lead to greater innovation in psychiatric research and practice. “We need find ways of unshackling science that will encourage scientists to ...
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I had the chance to speak with him recently to discuss how there's such a broad disconnect between psychiatric research and the common perception of how psychiatric issues are solved. Motherboard: You wrote in your introduction to ...
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Psychiatrists say diagnosis manual needs overhaul
Montreal Gazette Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a year for further revisions, despite some modifications which eliminated two controversial diagnoses. Why Are There No Biological Tests in Psychiatry?Scientific American (blog) Two Disputed Psychiatric Diagnoses Dropped From Revised DSMHuffington Post Panel suggests DSM-5 psychiatry manual drops two disorders, keeps new autism ...CBS News New York Times all 88 news articles » |
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Alzheimer's research fraud case set for trial
Chicago Tribune The lawsuit accuses Marilyn Albert, a former professor of psychiatry at Harvard Medical School, and Massachusetts General Hospital (MGH), where she was conducting research, of submitting a grant application based on manipulated data. and more » |
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Alzheimer's research fraud case set for trial
Chicago Tribune The lawsuit accuses Marilyn Albert, a former professor of psychiatry at Harvard Medical School, and Massachusetts General Hospital (MGH), where she was conducting research, of submitting a grant application based on manipulated data. and more » |
Alzheimer's research fraud case set for trial - chicagotribune.com
www.chicagotribune.com/news/sns-rt-us-science-fraudbre8491n5-20120510,0,2693773.story
chicagotribune.com
Alzheimer's research fraud case set for trial
Toni Clarke
Reuters
6:34 PM CDT, May 10, 2012
BOSTON (Reuters) - Two Harvard teaching hospitals and a prominent Alzheimer's disease researcher accused of using falsified data to obtain a government research grant are set to stand trial after a federal appeals court said this week that a lower court erred when it dismissed the case.
The lawsuit accuses Marilyn Albert, a former professor of psychiatry at Harvard Medical School, and Massachusetts General Hospital (MGH), where she was conducting research, of submitting a grant application based on manipulated data.
The data showed results from a trial were scientifically significant when in fact they were not, according to the lawsuit.
Brigham and Women's Hospital, which collaborated on the research, is also a defendant in the case. The lawsuit was brought in 2006 under the False Claims Act, a 150-year-old federal law designed to recover government funds appropriated through fraud.
This is the first time a lawsuit dealing with alleged scientific fraud has been allowed to progress to trial under the False Claims Act, according to Michael Kohn, a lawyer with Kohn, Kohn & Colapinto in Washington, D.C.
Kohn represents the whistle-blower in the case, Kenneth Jones, a former statistician at Massachusetts General Hospital, who filed suit in 2006 claiming the defendants violated the act by including false statements in a $15 million grant application to the National Institutes of Health (NIH).
The case was dismissed in the lower court three days before it was due to go to trial. Barring settlement, a new trial could begin later this year in U.S. District Court in Boston, Kohn said.
If the defendants are found guilty, they could pay as much as $45 million to the U.S. government. By law, whistle-blowers in such cases receive 15 percent to 30 percent of funds recovered.
Albert, who is now director of the Division of Cognitive Neuroscience at Johns Hopkins University School of Medicine, declined to comment except to say in an email: "I am confident that there was no misconduct involved."
Both hospitals said they are confident the researchers acted appropriately and according to the highest standards of scientific integrity.
"While it is disappointing that additional time and resources will have to be devoted to defending the institution and its investigators, the MGH remains confident that the resolution of the case will show that the allegations are without merit," Massachusetts General said in a statement.
Brigham and Women's responded with an identical statement.
INFLUENTIAL RESEARCH
Albert's research was part of an ongoing investigation into the structure of the brain as it progresses toward Alzheimer's disease. She specifically hoped to show that it might be possible to predict, years in advance, who might be destined to develop the disease, based on measurements taken over time of certain regions of the brain.
The results of the trial were published in the scientific journal Annals of Neurology in April 2000 and, according to Jones, proved extremely influential.
"The data appeared to confirm what had been suspected by some very prominent scientists, which is that Alzheimer's disease is associated with decreased blood flow to the brain," Jones said in an interview on Thursday. "The MRIs showed the volume of certain parts of the brain was decreasing in the people who were sick."
There are multiple theories about the cause of Alzheimer's disease.
In March 2001, Jones discovered what he believed to be anomalies in the research, specifically in data produced by one of the researchers, Ronald Killiany. The lawsuit alleges that Killiany revised his initial MRI measurements to prove the hypothesis of the trial.
Killiany, now an associate professor at Boston University School of Medicine, did not return a phone call or email seeking comment. Kohn said he was not named as a defendant. In retrospect, Kohn said, "He probably should have been."
Jones took his concerns to Albert, who authorized an investigation into the matter by Killiany's boss, Mark Moss. She declined to appoint an independent investigator, as requested by Jones, according to the lawsuit.
Moss concluded that Killiany's second set of measurements was more accurate than the initial set. Albert accepted Moss's conclusion and proceeded to apply for an NIH grant in November 2001, according to the lawsuit.
The defense argued before the appeals court that it would not have been unusual or inappropriate for Killiany to re-measure patient brain scans as long as he remained blind to the clinical status of the participants, and that this was a matter for scientific debate.
This argument was accepted when the case was initially heard by the lower court in the United States District Court for the District of Massachusetts. On that basis, it dismissed the case in October 2010. Kohn said
the court ruled that scientific fraud could not be brought under the False Claims Act, since the case related to a scientific dispute, not fraud.
The appeals court, however, rejected the argument, saying, "We disagree that the creation of the data in question was necessarily a matter of scientific judgment."
The court noted that the lower court's determination "misses the point that the various results produced in this case were obtained by one scientist purportedly using the same protocol."
The government's Office of Research Integrity declined to say whether it is investigating the case.
Jones said he hopes the trial will shed light on the issue of scientific misconduct.
"My interest is in correcting the science and bringing this academic cheating to light," he said, "and maybe sending a message saying, 'You're being watched, and you shouldn't do it.'"
The case is: U.S. ex rel. Jones v. Brigham and Women's Hospital, et al, 1st U.S. Circuit Court of Appeals, No: 10-2301.
(Editing by Michele Gershberg and Douglas Royalty)
Copyright © 2012, Reuters
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