DSM5 Field Trial Proposal—An Expensive Waste of Time
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By Allen Frances, MD
May 7, 2010
Allen Frances, MD, was the chair of the DSM-IV Task Force and of the department of psychiatry at Duke University School of Medicine, Durham, NC. He is currently professor emeritus at Duke.
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Time is running out on DSM5 and the mistakes keep piling up. The latest puzzling misstep is the design for the DSM5 field trials.
The APA will conduct a remarkably complex and expensive reliability study to determine whether 2 raters can agree on a diagnosis. It will devote enormous resources to answer a question that once mattered greatly but is now of quite limited interest. Meanwhile, DSM5 will perversely avoid the one question that does really count: ie, what will be its likely impact on the rates of psychiatric diagnosis?
At least $2.5 million and 1 year later (or possibly 2, if things get delayed as I expect they will), DSM5 will still be flying completely blind on the safety of its proposals. I will list the 6 seriously disabling limitations of the DSM5 field trials—saving the absolutely fatal flaw for last:
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