Saturday, June 26, 2010

DSM5 Field Trial Proposal—An Expensive Waste of Time

DSM5 Field Trial Proposal—An Expensive Waste of Time

For complete article click on link in Title

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.


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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