March 19, 2010
The American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders (DSM)
is psychiatry’s billing bible of so-called mental disorders.
With the DSM, psychiatry has taken
countless aspects of human behavior and reclassified them as a
mental illness simply by adding the term disorder onto them. While
even key DSM contributors admit that there is no scientific/medical
validity to the disorders, the DSM nonetheless serves as a
diagnostic tool, not only for individual treatment, but also for
child custody disputes, discrimination cases, court testimony,
education and more.
The DSM is driven not by science, but instead caters to the
With its expanding list of “mental
disorders” - voted into existence, not discovered as in real
medicine - for each of these a psychiatric drug can be prescribed
and insurance companies billed. That big formula spells big profits
for psychiatrists and drug companies.
And this has been exposed more recently
with a U.S. Senate Finance Committee investigation into
itself and the fact that about 56% of its $12 million-a-year income
derives from drug makers (more below).
“The way to sell drugs is to sell
psychiatric illness,” says Carl Elliot, a bioethicist at the
University of Minnesota.
Kelly Patricia O’Meara, an award
winning journalist and former Congressional staff points out,
“Drug companies pull a mental
disorder out of the DSM hat and get FDA approval to use an
already existing drug to treat it. Well-known psychiatrists are
enlisted to publicly affirm the disorder as a social
problem… Voila! Confirmed psychiatric ill and magic pill.”
Even within its own ranks there is
disagreement about the drug company influence on the diagnostic
process. An international poll of mental health experts conducted in
DSM-IV one of the 10 worst psychiatric papers of the
Dr. Irwin Savodnik, an assistant clinical professor of psychiatry at
the University of California, Los Angeles, says:
“The very vocabulary of psychiatry
is now defined at all levels by the pharmaceutical industry.”
Conflicts of Interest
That became evident in the landmark study published in the journal
of Psychotherapy and Psychosomatics in 2006 that found that for more
than half of the panel members that reviewed which disorders would
be included in the fourth edition revision of DSM (1994), more than
half had undisclosed financial links to
For the so-called mood disorders
(“depression” and “bipolar”) and “schizophrenia/psychotic disorder,”
100% of the panel members had financial involvements with drug
companies. Sales of the drugs prescribed for these (by virtue of
their inclusion in the DSM) reach more than $80 billion worldwide.
Apparently the APA psychiatrists did not want to give up this
the DSM-V revision, another study
found that 18 of the 20 members overseeing the revision of clinical
guidelines for treating just three “mental disorders” had financial
ties to drug companies, with drug treatment for these disorders
generate some $25 billion a year in pharmaceutical sales (U.S.
Under such public criticism and a year after it had been under
investigation by the Senate Finance Committee for its conflicts of
interest in drug companies, in March 2009, the APA announced that it
would phase out pharmaceutical funding of continuing medical
education seminars and meals at its conventions. However, within two
months, the APA accepted more than $1.7 million in pharmaceutical
company funds for its annual conference, held in San Francisco.
In 2002, the APA’s Anand Pandya said that
without pharmaceutical industry funds, membership dues could
escalate 455% from $540 a year to $3,000.
Pandya is president of the National
Alliance on Mental Illness (NAMI),
which in 2009 as also asked to provide records of its pharmaceutical
company funding to federal investigators.
Psychiatry’s 300% increase of mental disorders in the DSM over five
decades has already generated billions of dollars in government
funding. Since DSM-IV, there has been also been a 256% increase in
psychiatric (antipsychotics and antidepressants) drug sales.
Just how far psychiatrists will go using the DSM to label people
“disordered” is reflected in a recent survey conducted by Ronald
Kessler, professor of health care policy at Harvard Medical School.
He relied upon the DSM to survey Americans and concluded that nearly
every second one (48%) suffers from at least one mental illness
during their lifetime.
A “DSM-IV personality disorders” survey
that he conducted for the World Health Organization (WHO), the results of
which were published in 2009, was heavily funded by,
himself is a consultant for at least seven drug companies.
More to the point, as the late Dr. Sydney Walker III, a neurologist
and psychiatrist, wrote:
“Drug company money influences every
aspect of modern-day psychiatry. The American Psychiatric
Association is literally built on a foundation of drug money… In
return, the APA bends over backward to help drug companies
promote their products.” 
“That influence,” he said, “has
focused on expanding the number of ‘psychiatric disorders’
recognized by the APA, and the number of drug treatments
recommended for these disorders. After all, every DSM
‘diagnosis,’ is a potential gold mine for pharmaceutical firms.”
As the diagnoses completely lack scientific criteria, anyone can be
labeled mentally ill, and subjected to dangerous and
life-threatening treatments based solely on opinion.
The scientific validity of the DSM has
come under increasing attack from medical professionals and
scientific experts such as Herb Kutchins of California State
University and Stuart A. Kirk of UCLA, and authors of
Crazy - The Psychiatric Bible and the Creation of Mental Disorders,
“…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
The late Loren Mosher, M.D., a Clinical
Professor of Psychiatry who resigned from the APA because of its
drug company influence, wrote:
“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
“The issue is what do the categories
[in DSM] 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.”
The internationally renowned professor
of psychiatry emeritus Thomas Szasz, supports this point, writing:
“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
So classified, it would make psychiatry
redundant, and general physicians would replace it.
Therein lies the underlying problem of DSM - it isn’t a medical
diagnostic system. Its all based on opinion - and faulty at best.
Psychiatry lacked a system equivalent to that in medicine, and this
contributed greatly to its poor reputation, both among medical
professionals and the population as a whole. Thus it invented DSM to
both convince real medicine of psychiatry’s legitimacy and to
capture a slice of the insurance market.
As Kutchins and Kirk point out, the
evolution of the DSM is a,
“story of the struggles of the
American Psychiatric Association to gain respectability within
medicine and maintain dominance among the many mental health
Further, they assumed 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.” In fact, all
DSM succeeds in doing is “to medicalize too many human troubles.”
Even psychiatrist Al Parides observes:
“what they have done is medicalize many problems that don’t have demonstrable, biological
Quotes Show No Science to DSM
Jeffrey A. Schaler, Ph.D.: says its tantamount to fraud.
“The notion of scientific
validity… 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.”
Psychiatry has been unable to determine
a single cause for a single mental disorder.
Dr. Harold Pincus, Vice Chairman of the DSM-IV task force admitted,
“There has never been any criterion
that psychiatric diagnoses require a demonstrated biological
Psychologist Renee Garfinkel, a staff
member of the American Psychological Association, said of the
DSM-III-R review committee:
“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.”
J. Allan Hobson and Jonathan A. Leonard,
Out of Its Mind, Psychiatry in Crisis, A Call For Reform:
“…DSM-IV’s authoritative status and
detailed nature tends to promote the idea that rote diagnosis
and pill-pushing are acceptable.”
Elliot S. Valenstein, biopsychologist,
Blaming the Brain:
“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
The DSM-V review psychiatrists should
take heed of Paul Genova, M.D., writing in Psychiatric Times, who
“DSM diagnostic system has outlived
its usefulness by about two decades. It should be abandoned, not
 Shankar Vedantam, “Drug Ads
Hyping Anxiety Make Some Uneasy,” The Washington Post, 16 July
 Kelly O’Meara, addressing CCHR 34th Anniversary and Human
Rights Awards, Los Angeles, 2002.
 Sydney Walker, III, M.D., A Dose of Sanity, ( John Wiley &
Sons, Inc, New York, 1996), p. 229.
 Sydney Walker, III, M.D., A Dose of Sanity, ( John Wiley &
Sons, Inc, New York, 1996), p. 230.
 Op. cit., Herb Kutchins, Stuart A. Kirk, Making Us Crazy, p.