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Author : Joel Paris Publisher : Oxford University Press, USA Page : 241 pages File Size : 47,5 Mb Release : 2020 Category : Medical ISBN : 9780197504277
"This book, now revised in a section edition, examines the problem of over-diagnosis in psychiatry, focusing on problems with current diagnostic systems. It will show that diagnosis is not always a good guide to treatment selection, and that diagnoses have bee expanded in scope to justify currently popular methods of pharmacotherapy or psychotherapy. The most important categories that are over-diagnosed are bipolar disorders, major depression, attention-deficit hyperactivity disorder, and post-traumatic stress disorder. The boundary of pathology and normality remains unclear. This edition will also discuss dimensional systems that are transdiagnostic, and show how over-diagnosis is linked to the practice of aggressive psychopharmacology"--
As one of the few books to thoroughly examine the critical problem of over-diagnosis in psychiatry today, Dr. Joel Paris - author of The Intelligent Clinician's Guide to the DSM-5RG - shows how over-diagnosis leads to over-treatment in Overdiagnosis in Psychiatry: How Modern Psychiatry Lost ItsWay While Creating a Diagnosis for Almost All of Life's Misfortune.Leaving no stone unturned, Dr. Paris considers the complications of the DSM-5 system with particular reference to major depression, bipolar disorder, PTSD and attention-deficit hyperactivity disorder. While each of these conditions have given rise to diagnostic fads and epidemics, the classificationof mental disorders remains provisional without any biomarkers for mental disorders. Because of this, Dr. Paris makes the case for the importance of conservative diagnoses, recognizing that normal variants are not necessarily disorders.
As one of the few resources to thoroughly examine the critical problem of over-diagnosis in psychiatry today, this title covers how over-diagnosis in psychiatric practice may lead to over-treatment. It considers the complications of the DSM-5 classification system, with particular reference to major depression, bipolar disorder, Post-traumatic Stress Disorder (PTSD), and Attention-Deficit Hyperactivity Disorder (ADHD). While each of these conditions have given rise to diagnostic fads and epidemics, the classification of mental disorders remains provisional without any biomarkers for mental disorders. It then covers the importance of conservative diagnoses, recognizing that normal variants are not necessarily disorder, and that in many cases, under-, rather than over-diagnosing may be best practice.
Vagueness in Psychiatry by Geert Keil,Lara Keuck,Rico Hauswald Pdf
In psychiatry there is no sharp boundary between the normal and the pathological. Although clear cases abound, it is often indeterminate whether a particular condition does or does not qualify as a mental disorder. For example, definitions of subthreshold disorders and of the prodromal stages of diseases are notoriously contentious. Philosophers and linguists call concepts that lack sharp boundaries, and thus admit of borderline cases, 'vague'. Although blurred boundaries between the normal and the pathological are a recurrent theme in many publications concerned with the classification of mental disorders, systematic approaches that take into account philosophical reflections on vagueness are rare. This book provides interdisciplinary discussions about vagueness in psychiatry by bringing together scholars from psychiatry, psychology, philosophy, history, and law. It draws together various lines of inquiry into the nature of gradations between mental health and disease and discusses the individual and societal consequences of dealing with blurred boundaries in medical practice, forensic psychiatry, and beyond. --
“Gary Greenberg has become the Dante of our psychiatric age, and the DSM-5 is his Inferno.” —Errol Morris Since its debut in 1952, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has set down the “official” view on what constitutes mental illness. Homosexuality, for instance, was a mental illness until 1973. Each revision has created controversy, but the DSM-5 has taken fire for encouraging doctors to diagnose more illnesses—and to prescribe sometimes unnecessary or harmful medications. Respected author and practicing psychotherapist Gary Greenberg embedded himself in the war that broke out over the fifth edition, and returned with an unsettling tale. Exposing the deeply flawed process behind the DSM-5’s compilation, The Book of Woe reveals how the manual turns suffering into a commodity—and made the APA its own biggest beneficiary.
From "the most powerful psychiatrist in America" (New York Times) and "the man who wrote the book on mental illness" (Wired), a deeply fascinating and urgently important critique of the widespread medicalization of normality Anyone living a full, rich life experiences ups and downs, stresses, disappointments, sorrows, and setbacks. These challenges are a normal part of being human, and they should not be treated as psychiatric disease. However, today millions of people who are really no more than "worried well" are being diagnosed as having a mental disorder and are receiving unnecessary treatment. In Saving Normal, Allen Frances, one of the world's most influential psychiatrists, warns that mislabeling everyday problems as mental illness has shocking implications for individuals and society: stigmatizing a healthy person as mentally ill leads to unnecessary, harmful medications, the narrowing of horizons, misallocation of medical resources, and draining of the budgets of families and the nation. We also shift responsibility for our mental well-being away from our own naturally resilient and self-healing brains, which have kept us sane for hundreds of thousands of years, and into the hands of "Big Pharma," who are reaping multi-billion-dollar profits. Frances cautions that the new edition of the "bible of psychiatry," the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), will turn our current diagnostic inflation into hyperinflation by converting millions of "normal" people into "mental patients." Alarmingly, in DSM-5, normal grief will become "Major Depressive Disorder"; the forgetting seen in old age is "Mild Neurocognitive Disorder"; temper tantrums are "Disruptive Mood Dysregulation Disorder"; worrying about a medical illness is "Somatic Symptom Disorder"; gluttony is "Binge Eating Disorder"; and most of us will qualify for adult "Attention Deficit Disorder." What's more, all of these newly invented conditions will worsen the cruel paradox of the mental health industry: those who desperately need psychiatric help are left shamefully neglected, while the "worried well" are given the bulk of the treatment, often at their own detriment. Masterfully charting the history of psychiatric fads throughout history, Frances argues that whenever we arbitrarily label another aspect of the human condition a "disease," we further chip away at our human adaptability and diversity, dulling the full palette of what is normal and losing something fundamental of ourselves in the process. Saving Normal is a call to all of us to reclaim the full measure of our humanity.
Author : Joel Paris Publisher : Oxford University Press, USA Page : 305 pages File Size : 51,5 Mb Release : 2015 Category : Medical ISBN : 9780199395095
All We Have to Fear by Allan V. Horwitz, PhD,Jerome C. Wakefield Pdf
Argues that anxiety and fear are a part of everyone's life, and that the medical industry has created an epidemic out of over-diagnosing these conditions.
This book is a guide for psychiatrists struggling to incorporate transformational strategies into their clinical work. The book begins with an overview of the concept of critical psychiatry before focusing its analytic lens on the DSM diagnostic system, the influence of the pharmaceutical industry, the crucial distinction between drug-centered and disease-centered approaches to pharmacotherapy, the concept of “de-prescribing,” coercion in psychiatric practice, and a range of other issues that constitute the targets of contemporary critiques of psychiatric theory and practice. Written by experts in each topic, this is the first book to explicate what has come to be called critical psychiatry from an unbiased and clinically relevant perspective. Critical Psychiatry is an excellent, practical resource for clinicians seeking a solid foundation in the contemporary controversies within the field. General and forensic psychiatrists; family physicians, internists, and pediatricians who treat psychiatric patients; and mental health clinicians outside of medicine will all benefit from its conceptual insights and concrete advice.
In the 1970s, author Joel Paris was one of the first doctors in his hospital to prescribe lithium to a psychiatric patient. In the wake of the drug’s success, both in that case and countless others, why this book? As Dr. Paris’ historical examination of bipolar diagnosis and critique of the spectrum demonstrates, medicine has often been prone to fads that are assumed correct until proven wrong by science. This book opens discussion about the overdiagnosis of bipolar disorder and the negative impact of this development on clinical care. Dr. Paris explores why patients are being classified as bipolar on dubious grounds and are being prescribed drugs they do not need. He explains the differences between bipolar disorder and depression without mania, personality disorders characterized by unstable mood, and impulsive disorders. A separate chapter discusses the unique issues present in the field of child psychiatry. Fads remain popular as long as they answer elusive and complex questions. Unfortunately, the bipolar spectrum being used to explain a wide variety of psychopathological phenomena has caused classic bipolar disorder to become almost lost in the shuffle. Combining research findings and personal experiences, Dr. Paris documents the damage of overdiagnosis and explores alternative treatments patients could benefit from.
Extraordinary Science and Psychiatry by Jeffrey Poland,Serife Tekin Pdf
Leading scholars offer perspectives from the philosophy of science on the crisis in psychiatric research that exploded after the publication of DSM-5. Psychiatry and mental health research is in crisis, with tensions between psychiatry's clinical and research aims and controversies over diagnosis, treatment, and scientific constructs for studying mental disorders. At the center of these controversies is the Diagnostic and Statistical Manual of Mental Disorders (DSM), which—especially after the publication of DSM-5—many have found seriously flawed as a guide for research. This book addresses the crisis and the associated “extraordinary science” (Thomas Kuhn's term for scientific research during a state of crisis) from the perspective of philosophy of science. The goal is to help reconcile the competing claims of science and phenomenology within psychiatry and to offer new insights for the philosophy of science. The contributors discuss the epistemological origins of the current crisis, the nature of evidence in psychiatric research, and the National Institute for Mental Health's Research Domain Criteria project. They consider particular research practices in psychiatry—computational, personalized, mechanistic, and user-led—and the specific categories of schizophrenia, depressive disorder, and bipolar disorder. Finally, they examine the DSM's dubious practice of pathologizing normality. Contributors Richard P. Bentall, John Bickle, Robyn Bluhm, Rachel Cooper, Kelso Cratsley, Owen Flanagan, Michael Frank, George Graham, Ginger A. Hoffman, Harold Kincaid, Aaron Kostko, Edouard Machery, Jeffrey Poland, Claire Pouncey, Şerife Tekin, Peter Zachar
Overdiagnosed by H. Gilbert Welch,Lisa Schwartz,Steve Woloshin Pdf
An exposé on Big Pharma and the American healthcare system’s zeal for excessive medical testing, from a nationally recognized expert More screening doesn’t lead to better health—but can turn healthy people into patients. Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesses of American medical practice that labels far too many of us as sick, Welch examines the social, ethical, and economic ramifications of a health-care system that unnecessarily diagnoses and treats patients, most of whom will not benefit from treatment, might be harmed by it, and would arguably be better off without screening. Drawing on 25 years of medical practice and research on the effects of medical testing, Welch explains in a straightforward, jargon-free style how the cutoffs for treating a person with “abnormal” test results have been drastically lowered just when technological advances have allowed us to see more and more “abnormalities,” many of which will pose fewer health complications than the procedures that ostensibly cure them. Citing studies that show that 10% of 2,000 healthy people were found to have had silent strokes, and that well over half of men over age sixty have traces of prostate cancer but no impairment, Welch reveals overdiagnosis to be rampant for numerous conditions and diseases, including diabetes, high cholesterol, osteoporosis, gallstones, abdominal aortic aneuryisms, blood clots, as well as skin, prostate, breast, and lung cancers. With genetic and prenatal screening now common, patients are being diagnosed not with disease but with “pre-disease” or for being at “high risk” of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care.
Discusses the effects of expanding the Diagnostic and Statistical Manual of Mental Disorders (DSM)'s fourth edition on the psychiatric community, pharmaceutical companies, and the nation.
Essentials of Psychiatric Diagnosis, Revised Edition by Allen Frances Pdf
Grounded in author Allen Frances's extensive clinical experience, this comprehensive yet concise guide helps the busy clinician find the right psychiatric diagnosis and avoid the many pitfalls that lead to errors. Covering every disorder routinely encountered in clinical practice, Frances provides the ICD-9-CM and ICD-10-CM (where feasible) codes required for billing, a useful screening question, a colorful descriptive prototype, lucid diagnostic tips, and a discussion of other disorders that must be ruled out. The book closes with an index of the most common presenting symptoms, listing possible diagnoses that must be considered for each. Frances was instrumental in the development of past editions of the DSM and provides helpful cautions on questionable aspects of DSM-5. The revised edition features ICD-10-CM codes where feasible throughout the chapters, plus a Crosswalk to ICD-10-CM Codes in the Appendix. The Appendix, links to further coding resources, and periodic updates can also be accessed online (www.guilford.com/frances_updates).
