The New Crisis of Confidence in Psychiatric Diagnosis

Abstract

Ideas and OpinionsAugust 6, 2013The New Crisis of Confidence in Psychiatric DiagnosisFREEAllen Frances, MDAllen Frances, MDFrom Duke University, Durham, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-3-201308060-00655 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the early 1970s, 2 highly publicized studies showed that psychiatric diagnosis, as it was then conducted, was unreliable and inaccurate. The first found that British and U.S. psychiatrists came to different diagnostic conclusions when viewing the same patients on videotape (1). The second found that healthy volunteers claiming to hear voices were admitted to psychiatric hospitals for extended stays despite subsequently acting normally (2). Was psychiatry entitled to a place among the other medical specialties when its diagnoses were so random? The response was quick and effective. The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), published in 1980, featured definitions of mental disorders that, when properly used, achieved reliability equivalent to that of most medical diagnosis. The DSM-III stimulated an outpouring of psychiatric research. In most medical schools, mental health research now ranks behind only internal medicine in National Institutes of Health funding.Unfortunately, the extensive research h…