I have spent the first half of my life as a physicist. I have a PhD in physics. Physics is a hard science, an exact science. It utilizes a monovalent language known as mathematics, communicable universally and not open to ambiguity and misinterpretation. Granted, there is a metaphysical layer that develops some kind of cancer over physics, but the practitioners of actual physics, experimental physics, theoretical physics, the practitioners are very, very much grounded and down to earth.
And then the second half of my life, starting 26 years ago, I had been introduced to psychology. I now teach psychology and neuroscience because of my medical background. And I am flabbergasted by the hubris of this field, bordering on con artistry. This field is such a scam that it defies belief.
I'm going to discuss today antidepressants and I'm going to discuss today the Diagnostic and Statistical Manual. These are two manifestations, two expressions of the malady, not to say the cancer that had overtaken the field of psychology and its affiliate psychiatry.
Psychology is a crisis owing to the pernicious influences of celebrity and money. There are very worrying trends in psychology and neuroscience and psychiatry. Scientists are claiming expertise when and where they have none. Even online, you have people with PhDs, including PhDs in psychology, who are way outside their field of expertise, if they have any at all. People who talk with confidence and authority about subjects they know nothing about.
Psychology is a huge field that you have a PhD in psychology doesn't automatically qualify you to be an expert on racism or depression or borderline.
And yet numerous scientists are claiming expertise when and where they have none. Scientists are massaging the results of experiments. That's a very fancy and delicate way and politically correct way of saying they are lying. They are lying about experiments, the protocols of the experiment, the progress of the experiment and the outcomes of the experiments.
And this had created something called the replication crisis. We are unable to replicate the results of well over 80%, that's 80% of all experiments in psychology and the number is not much better in other fields of science.
And then you have people who make unfounded claims based on flimsy or non-existent evidence, laymen, but also, shockingly, people with academic degrees, working scientists, alleged or ostensible scholars, they abuse their authority and propagate nonsense, half-baked truths and inflated statements which have very little to do with their state of knowledge.
Sapolsky, in his wonderful book, which by the way I'm reading right now, I hope the camera catches it, it's titled Behave and I'm reading it right now, Robert Sapolsky, great, absolutely great. Sapolsky calls these type of people molecular biology fundamentalists. They're grandiose, they're grossly misleading.
Whenever I read a text put out, promulgated by these people, I cringe. Yes, they have academic degrees in science and academic degrees in biology and molecular biology and psychiatry and so on, but they are way, way over the ethical boundary of science in many of the claims they make.
I have been subjected to rabid, and there's no other word, rabid attacks by molecular biology fundamentalists after I've put out a video about psychedelics and another video about neuroplasticity.
There are some problems, there are some problems in trying to medicalize the human mind and the human condition. Correlation is not causation. If you find two things that happen simultaneously, it doesn't mean they cause each other. And if they do cause each other, you can't be quite sure which of them causes the other.
Reductionism, you can't reduce the human psychodynamics, human mental health disorders, you can't reduce them to molecules.
This is so ridiculous, I don't even understand why I have to defend this thesis that molecules and genes cannot explain an all-pervasive condition with thousands of cognitive emotional parameters.
So for example, changing temporarily one's ability to empathize with people, that's not like curing narcissism. Alcohol does this.
And then there are contradictory results. For every experiment and study published, I can show you another two which contradict the results of the first.
Not enough is known.
Neuroscientists, psychologists and psychiatrists are absolutely grandiose and arrogant. We know close to nothing.
Most of the processes in the human body and in the human mind are triggered by the environment, nurture, not nature. We will be discussing serotonin shortly, see what I mean.
There are replicability issues which I've mentioned. We can't replicate most of these experiments and they're inflated, ill-founded claims.
And today I want to focus on two things, antidepressants and the DSM, Diagnostic and Statistical Manual, whose latest iteration, the text revision of the fifth edition, we published a few weeks ago.
Before we go to antidepressants, I would ask you to watch the video on my channel titled, Is Depression Healthy? It's a video presentation I gave in the second webinar on depression management in May 2021.
Is depression healthy? Why do so many people claim that antidepressants have helped them, have salvaged them, have rescued them from a state of darkness and depression? Why do so many people claim that the antidepressants are efficacious, that they work? I don't know.
And this is something, this is a sentence no neuroscientist would ever say. I can't remember the last time I've heard a neuroscientist say, I don't know, but I don't know.
I can guess though. I think it's a placebo effect. I think it's mind over matter.
When you take an antidepressant medication, you are told that it should be able to help you. And this claim is backed by decades of science. You succumb to authority. You say, well, they can't all be wrong. So this medication helps you because your mind takes over your body and makes the depression ameliorate or mitigate.
It doesn't mean it's the effect of the medication. The placebo effect is a major problem in experiments in psychology, psychiatry, neuroscience, major problem. We can't disentangle the placebo effect from other effects, real in nature.
And so what we do, we create experiments where there's a control group. The control group is given the placebo and the test group is given the real thing.
Let me try to see what are the effects.
The dirty secret is that in the vast majority of experiments, the placebo group shows much higher improvement than the real group. That's the dirty secret. Placebo effects are much stronger than molecular effects, than pharmaceutical effects, than psychopharmacological effects.
In other words, medications sometimes work, but the placebo effect is stronger, as any yogi in India would tell you.
Okay. What about serotonin? Billions, hundreds of millions of people consume every day medication known as SSRI, serotonin reuptake inhibition medication. And so SSRIs are a class of antidepressants and people consume this medication because allegedly there's a linkage between serotonin and depression. And if you regulate the level of serotonin in the brain, you ought to get rid of depression or at the very least suppress it to levels which render the patient functional.
We do know that serotonin modulates aggression and antisocial behavior. We also know that serotonin is linked to suicidality and it is natural because depression is a form of self-directed aggression and suicidal ideation is very common in major or extreme depression.
So the linkage is there. Serotonin has something to do with all this.
Mind you, studies have shown that for the modulation, fluctuations in serotonin, to encourage aggression and antisocial behavior, there must be a background of abuse in early childhood. In the absence of abuse in early childhood, serotonin has zero impact on anything whatsoever.
So it seems that the environment, especially in early childhood, preconditions serotonin to operate in highly specific pathways and ways.
And so no one is disputing the fact that serotonin plays some role. It is produced in the brain for good reason. It's a neurotransmitter. Mind you, it's produced also in the gut, in the intestines, but okay, it's produced in the brain to some extent. So it must play a role somewhere.
In the early 1990s, a guy by the name of Breggin, B-R-E-G-G-I-N, suggested that there were problems with the methodology in the research of SSRI antidepressants, antidepressants that modulate serotonin in the brain. In 1994, he published a book called Talking Back to Prozac. Breggin warned that Prozac was causing violence, suicide, and mania. Of course, he was immediately demonized, castigated by the pharmaceutical industry. But he persisted. Breggin persisted. And I'm not a fan of Breggin, by the way. He's a conspiracy theorist and not my favorite guy to use a British understatement. Yet on this issue, he had been 100% right. So he continued to plow down. He persisted in the face of enormous adversity and a huge personal cost. And he wrote many subsequent books about SSRIs and newer classes of antidepressants.
And finally, in 2005, that's 11 years later, the FDA, the Food and Drug Administration, introduced black box warnings on SSRI antidepressants. Black box warnings are warnings about side effects. And the black box warnings on SSRIs say that there is an association between the use of SSRI antidepressants, suicidal behavior in children, and also in young adults. So now, it's an established fact.
Breggin had been right all along. Over the years, additional general warnings were added to the black box warning. And the warnings confirmed many of the adverse effects first publicized by Breggin in Toxic Psychiatry, another book of his.
There are specific mentions by the FDA of drug-induced hostility, irritability, mania. I'm not talking about the classic side effects, like a total deterioration in libido and suppression of sex drive.
In 2006, the FDA expanded the warnings to include adults taking Paxil, which is associated with a higher risk of suicidal behavior compared to a placebo.
Okay, sometimes you have to consume medication, and all medication has side effects. There is not a single medicine or drug on earth without side effects. It's a price you pay for healing yourself, for curing yourself. We take antibiotics and they have an effect on the intestinal flora, on the microbiome. You know, everything has an effect on something. And so we take antidepressants, we consume antidepressants in order to reduce potentially life-threatening condition, which is major depression with suicidal ideation. And we pay a price for this, isn't it? Isn't this the truth?
The answer is no.
Antidepressants, especially the serotonin clots, SSRIs, have nothing whatsoever to do with depression. I repeat this, serotonin has nothing whatsoever to do with depression. It's a scam. It's a scam. It's a multi-decade scam by the pharmaceutical industry. They knew that there is no substantiation for the claim that serotonin is associated with depression, directly or indirectly. They knew it. They knew it. The academic community knew it.
And yet, we were all collectively lying to laymen, consumers, and patients through our teeth for decades.
I'm going to read to you an article published in New Scientists on the 20th of July 2022. That's yesterday, 20th of July 2022, the latest word. I'm going to read you the whole article. I don't usually do this, but I think it's so important that I can't miss a single iota and a single word.
Now, the article in New Scientists is based on an academic scholarly article published in Molecular Psychiatry. I'm going to place a link to this article in the description field. I'm going to read to you an article in New Scientists which popularizes an academic scholarly article in Molecular Psychiatry published only recently.
And so, here goes. 20th of July 2022, that's yesterday, and the headline of the article in New Scientist, which is a science journal, the headline is no link.
You heard that? No link between depression and serotonin finds major analysis. The text of the article follows.
A review of 17 previous studies finds no evidence for a link between depression and low serotonin levels, which SSRI antidepressants focus on, though not everyone is convinced by the findings.
And the article continues.
There may be no link between serotonin levels and depression, according to an analysis of 17 studies.
This raises questions about antidepressants that focus on this brain signaling molecule, say the authors of the analysis.
Not everyone is convinced by the findings, though. Of course not. Many, many, many scholars and scientists are on the payroll of the pharmaceutical industry. Why would they ever be convinced? They've invested their entire careers, and they've made a hell of a lot of money in junkets and perks of the pharmaceutical industry.
People have been bribed, and that's the original problem that I mentioned. Celebrity and money have corrupted psychology, to the point that it's no longer trustworthy.
But okay, let's return to the article.
The serotonin hypothesis, which dates from the 1960s, says that a chemical imbalance in the brain, including low levels of serotonin, also known as 5-hydroxy-tritamine or 5-HT, leads to depression.
So I repeat, there's a hypothesis from the 1960s which says that there's a chemical imbalance in the brain, low levels of serotonin, also called 5-HT, and this leads to depression.
Okay?
And I'm continuing to read from the article.
We now think various biological, psychological, and environmental factors play a role.
The most popular antidepressants, known as selective serotonin reuptake inhibitors, SSRIs, increase the availability of serotonin in the brain. They actually prevent the reabsorption of serotonin. It cannot be absorbed by the tissues, and it remains in the brain.
The article continues.
Now Joanna Moncrief, M-O-N-C-R-I-E-F-F, Joanna Moncrief, at University College London, and her colleagues have done an umbrella analysis of 17 systematic reviews and studies, which together included hundreds of thousands of people with and without depression.
By the way, it's by far the largest study ever, ever undertaken, including by the pharmaceutical companies.
It is difficult, I'm continuing from the article, it is difficult to directly measure real-time serotonin levels in the brain.
So the 17 studies looked at depression and proxies for serotonin. So they didn't study serotonin in the brain, that's extremely difficult to do, it's possible, but very difficult, and a bit invasive, and so on.
So instead what they did, they looked at depression and other proxies for serotonin, alleged impacts of serotonin, low or high.
And so the article says they looked at proxies for serotonin, such as the molecules in cerebral fluid that serotonin breaks down into, the levels of serotonin receptors and how active they are, or whether there are more genes for serotonin transporters which remove serotonin in people with depression.
So they tried to find everything on the serotonin pathway, the receptors of serotonin, the byproducts of serotonin when it's metabolized or used, etc. And these were proxies for the levels of serotonin in the brain of depressed people and non-depressed people.
Got it?
Shoshanim, we continue.
Moncrieff's theme, says the article, found that there was no evidence that low serotonin activity or amounts cause depression.
This is such a shocking sentence that I'm going to read it to you again.
Moncrieff's theme, in this largest study ever, found that there was no evidence, read my lips, no evidence that low serotonin activity or low serotonin amounts cause depression, which is the hypothesis on which SSRI antidepressants are based.
They are selling you SSRI antidepressants because they insist that serotonin levels cause depression, serotonin activity causes depression, and they're lying to you. It's not true.
And they have known that it's not true, exactly like the tobacco industry, only much worse because the tobacco industry, you know, screwed up with your lungs. These drugs screw up with your brain and your mind. This is one of the greatest scandals in my view in human medical history.
I'm continuing to read from the article by Sarah Wilde, by the way.
The implication of our paper is that we do not know what SSRI antidepressants are doing, says Moncrieff.
One possibility is that they are working through a placebo effect, she says.
No kidding.
However, Jorgen Lundberg at the Karolinska Institute in Sweden, by the way, as far as I remember, I may be mistaken, a beneficiary of the pharmaceutical industry through collaboration agreements and so on, nevermind.
Jorgen Lundberg says, a limitation of the analysis is that it didn't distinguish between people who had ongoing depression and those who have episodes of depression, whose state at the time they were assessed could affect the functioning of their serotonin system.
Really? Then why do doctors prescribe SSRI antidepressants even for episodic depression, not only for major depression?
Doctors dole out antidepressants like candy. Whenever someone presents with stress or anxiety, they diagnose depression, they over-diagnose depression and they dole out the candy of antidepressants, of course, with very nice commissions in the background.
So this distinction between major depression, ongoing depression and episodic depression is nonsense because the practice is to prescribe antidepressants in all cases of depression.
Lundberg, the aforementioned Lundberg continues, it is key to separately analyze data from studies that examine the same patients when ill and when in remission, to have optimal conditions to examine the hypotheses, he says.
And he is right, had the practice been different, but the practice belies and defies what he says.
Moncrief says, the review was dependent on the studies that had already been done, none of which highlighted any difference between people who were experiencing symptoms of depression or had a history of it.
It must be recognized that 5-HT is likely only one contributor to depression, says Paul Albert at the University of Ottawa in Canada.
Given the large placebo effect in treatment of depression, it is likely that the contribution of other systems, including dopamine that is implicated in the placebo effect, may be greater than that of serotonin 5-HT.
Really? Then why do you prescribe serotonin based antidepressants? If the role of dopamine is greater, if the placebo effect is greater, why do you prescribe very, very dangerous substances to people? Why do you screw up and play with their brains and minds?
Based on flimsy, non-existent, contradicted and counter-indicated science, it's beyond infuriating, it's criminal.
The pharmaceutical industry should be subjected to the same treatment the tobacco industry had received. Nothing short of that, probably much more.
Antidepressants are an effective recommended treatment for depression that can also be prescribed for a range of physical and mental health conditions.
A spokesman for the Royal College of Psychiatrists told the Science Media Centre in the UK, referring to treatment guidelines from the National Institute for Health and Care Excellence, NICE, in England.
Antidepressants, this spokesman says, will vary in effectiveness for different people. And the reasons for this are complex.
We would not recommend for anyone to stop taking the antidepressants based on this review. Of course not, God forbid.
What will happen to the bottom line? And we encourage anyone with concerns about their medication to contact the family doctor, who presumably is more educated about antidepressants than this elite team of scholars.
Okay, the journal reference is Molecular Psychiatry and I will be posting a link to the article in the description.
Depression is a very complex topic. Like narcissism, it is a systemic phenomenon. It affects every field of functioning, every cognitive function, every emotion. It affects everything and it cannot be reduced to a molecule or a neurotransmitter or an area of the brain.
That's utter, unmitigated, counterfactual nonsense propagated and perpetrated by grandiose narcissists who happen to have some training in neuroscience or molecular biology or psychopharmacology.
Narcissists are everywhere and they are not loath to make counterfactual claims if it furthers their career and lines their pockets.
Depression is complex also because the mind has checks and balances against depression.
For example, there's something called hedonic adaptation. Humans have a remarkable ability to get used to or get accustomed to changes in life. And so there could be a spurt, there could be an eruption of elation and euphoria and joy, a boost of happiness, but you will go back to baseline after a while.
Similarly, you can get stressed and anxious and depressed. You experience disappointment. Your expectations are not made. Something horrible has happened in your life. You have hit rock bottom, negative changes, but eventually you become used to these changes and you feel as happy as you have ever felt.
It's called the baseline.
Dr. Sonia Lubomirsky is a professor of psychology at the University of California, Riverside. She studies happiness and she says, with most negative changes, we are able to get used to them and revert back to a previous happiness baseline.
Dr. Lubomirsky should suggest to keep the company of others and to be grateful for what we have. She does not suggest antidepressants.
Now, I'm not disputing the fact that some people, myself included, go through hell and cope with a black dog of depression, major depression. It's real. Depression is real firsthand. This is firsthand experience. Depression is very real. It can put you down. It makes you think of the alternative to life very often, but is it merely molecular? Can it be reduced to chemistry? Can it be tackled with a pill?
Even on the face of it, this is utter nonsense. I again recommend to you to adopt a more holistic view of the human complex machinery.
This machinery is not amenable to reduction. It cannot be dismantled and put together like some spoiled brat would do with his toys.
We need to see the individual from all aspects. Of course, the brain is crucial. Of course, what happens in the brain is paramount and very important.
There's also the environment. There's also personal history. There's also psychology. There's also other people, object relations. There's so many other considerations.
When you talk today to neuroscientists and psychiatrists, they put and dismiss the enormous wealth of observations of generations of psychologists and psychiatrists that came before them because now they have a pill. Now they know everything there is to know about the brain. Now they can manipulate this machinery with confidence and ease.
This is not true. To say this is criminal and yet numerous scholars are saying exactly this. They find a gene and it's a warrior gene. They find a chemical and it's the magic chemical like oxytocin. They find mechanism or a process in the brain. It can negate depression like the serotonin reuptake process or the dopaminergic pathway. They call it fancy names and they think by doing so they have captured the essence of what's going on.
We are centuries, if not millennia, from understanding the brain, from knowing the first thing about the brain. We are discovering new shocking things by the year.
Sapolsky, this guy, this wonderful book, he has made a list of what we used to know about the brain only six or seven years ago. You would be shocked, close to nothing.
So a little humility in the face of this magnificent of creations.
The human brain is infinitely more complex than the universe. And I know because I deal with both. I'm an astrophysicist. That's my field in physics.
And on the other hand, I deal with the brain. I teach neuroscience and I can tell you the universe is a child's play compared to the most rudimentary aspects of the brain.
Brain is amazing. If I had to put a number on it, I think we know one millionth, one millionth of what is the brain and what it does.
And no, I'm not exaggerating. Okay.
The serotonin conundrum, not to say scam, is an example of how psychology and psychiatry and neuroscience have been compromised by money. Money comes from the government and money comes from pharmaceutical industries. There is no other source of money. These are the two sources.
The government, naturally as it should be, is biased towards public policy, health policies, and so on. They have their own agenda, governments, and they are not at the cutting edge of science. The pharmaceutical industry is about profits on the bottom line. They want to sell drugs. They are drug pushers. They're drug pushers and they want all of us to be junkies.
It's extremely as simple as that. See what happened during the pandemic.
So these are the two sources of money and they corrupt the science.
An excellent example of this is the Diagnostic and Statistical Manual. I would ask you to watch my video titled Future of Personality Disorders, ICD Revolutionary DSM Craven, Future of Personality Disorders, ICD Revolutionary DSM Craven.
The Diagnostic and Statistical Manual is 70 years old. That's seven zero. The first edition or first draft in a way was published in 1952.
The classification model in the DSM, the taxonomic model in the DSM has been the same since 1952. And from its very inception, already in the early sixties, there has been harsh criticism of this classification model, of this taxonomy as inadequate. Many scholars and many practitioners have written extensively of how the way the DSM is organized is counterproductive and doesn't afford patients the best service.
The DSM has been originally considered as a list of lists. It was dictated literally by the insurance industry because the insurance industry wanted to homogenize mental illness and to reduce it to paragraphs and clauses and numbers so that doctors, psychiatrists and psychologists and psychotherapists could make insurance claims based on an agreed upon manual, manual that is shared with the insurance industry.
Of course, the interest of the insurance industry is to minimize payouts and the interest of psychologists or alleged interests of psychology, psychiatrists and therapists is to help people, to cure them, to heal them, or at the very least to allow them to cope better with adversity.
These are incompatible goals.
And from its very, very first day, the DSM reflects this dichotomy, this abyss between money and help.
Help costs money. Help costs money.
And those who dole out the money would like to minimize the help.
So the DSM adopted a categorical model. DSM states that personality disorders are qualitatively distinct clinical syndromes.
But this is by no means widely accepted. I, for example, strongly contest this ridiculous claim. I don't think personality disorders are clinical entities and they are definitely not qualitatively distinct clinical syndromes.
That's wishful thinking. That's pathological fantasy and that's a bit of grandiosity.
The professionals cannot even agree on what constitutes normal and how to distinguish normal from disordered and abnormal. The DSM does not provide a clear threshold or a critical mass beyond which a subject should be considered mentally ill.
How can you have a clinical entity with no boundaries, with no clear thresholds, you know?
The DSM's diagnostic criteria are what we call polythetic. In other words, it is sufficient to satisfy only a subset of the criteria in order to diagnose a personality disorder.
For example, to diagnose narcissistic personality disorder, you need to meet five of the nine criteria. You need to satisfy five of the nine diagnostic criteria.
And so people diagnosed with the same personality disorder may share only one criterion. For example, I can satisfy criteria one to five. You can satisfy criteria five to nine. We will both be diagnosed with narcissistic personality disorder, but the only thing common to both of us would be criterion five.
It's utterly ridiculous. This diagnostic heterogeneity, what we call the variance, the great variance, is unacceptable and defies the scientific method. It's non-scientific.
The five diagnostic axes employed by the DSM to capture the way clinical syndromes, such as anxiety, mood, and eating disorders, general medical conditions, psychosocial and environmental problems, chronic childhood and developmental problems, and functional issues interact with personality disorders. They are all organized in the form of lists.
The DSM's laundry lists obscure, rather than clarify, the interactions between the various axes.
As a result, the differential diagnosis that are supposed to help us to distinguish one personality disorder from all the others, the differential diagnosis are exceedingly vague and open to interpretation, arbitrary interpretation.
The personality disorders are insufficiently demarcated, and this is a very unfortunate state of affairs. It leads to excessive comorbidity, diagnosing multiple personality disorders in the same subject.
Psychopaths, for example, people with extreme antisocial personality disorder are often also diagnosed as narcissists, people with narcissistic personality disorder, and borderline personality disorder. Not all psychopaths are narcissists, but some of them are diagnosed also with narcissism. Narcissism and psychopathy are contradictions. Narcissism and borderline are contradictions.
The psychopath doesn't need anyone. The narcissist relies on other people for self-regulation. The borderline has too many emotions. She is overwhelmed by emotions. She is dysregulated. The psychopath has no emotions. The narcissist has no access to positive emotions.
And yet, sometimes, all three are diagnosed in the same person because the definitions are very vague and ambiguous and equivocal.
And the reason is the categorical attitude deletes the bullet points.
The DSM also fails to distinguish between personality, personality traits, personality style, character, temperament, Theodore Millen's work, Lee Sperry's work.
Full-fledged personality disorders are none of the above. The DSM doesn't accommodate personality disorders induced by circumstances.
For example, reactive personality disorders.
Millen proposed acquired situational narcissism, late onset narcissism. There's no hint of this in the DSM.
The DSM doesn't efficaciously cope with personality disorders as a result of medical conditions, such as brain injuries, metabolic conditions, or protracted poisoning.
The DSM had to resort to classifying some personality disorders and other mental health disorders as NOS not otherwise specified. It's a catch-all. Meaningless, unhelpful, and dangerously vague diagnostic category.
Everyone knew all this. Everyone realized the DSM was fatally flawed, fatally flawed.
One of the reasons for this dismal taxonomy is the dearth.
How little research we have. Nothing is rigorously documented.
Clinical experience is rarely as rigorously documented as, for example, in physics or even in biology.
Various disorders, various treatment modalities, the whole thing is anecdotal.
And so many, many personality disorders are actually culture-bound. They reflect social and contemporary biases, values, and prejudices rather than authentic and invariable psychological constructs and entities.
Even the Diagnostic and Statistical Manual Steering Committee, even the committee itself, has been distancing itself from the DSM.
I'm going to repeat this mind-boggling sentence.
Even the people who offered, who composed, who put together the DSM have been trying to put distance between themselves and the DSM because they consider the DSM flawed, problematic, partial, and in many cases, wrong and unhelpful.
So we read, for example, in the text revision of DSM-IV, which was published 22 years ago, we read what the committee has to say.
They distance themselves from the categorical model. They hint at the emergence of an alternative, the dimensional approach.
They say, and that's 22 years ago, they said, an alternative to the categorical approach is a dimensional perspective that personality disorders represent maladaptive variants of personality traits that merge imperceptibly into normality and into one another.
Much later in 2009, again in New Scientist, there was an article, Psychiatry's Civil War, December 2009. And there was this paragraph in the article.
One aim of the workgroups compiling the DSM-V is to cut through this chaos. They are streamlining diagnoses by removing various subtypes of schizophrenia, for example, and they intend to address a confusion created by the fact that many people with one condition meet criteria for other disorders as well.
The DSM-5 task force is expected to propose a series of dimensions to be considered with a patient's main diagnosis.
So as well as deciding whether someone has, for example, bipolar disorder, doctors would determine whether they are suffering from problems such as anxiety and sleeping disturbances and assess them on a simple scale of severity.
Diagnostic and Statistical Manual Committee for Edition 5 promise to tackle these neglected issues.
They actually came with a manifesto and they said we're going to tackle the longitudinal course of the disorders and their temporal stability from early childhood onwards, the genetic and biological underpinnings of personality disorders, the development of personality psychopathology during childhood and its emergence in adolescence, the interactions between physical health and disease and personality disorders, the effectiveness of various treatments, top therapies, as well as psychopharmacology.
They chickened out in the last minute. In 2013, the fifth edition was published and with the exception of an appendix with alternative models at the very, very end of this hefty one thousand page tome with this single exception, it was a carbon copy of the DSM-IV.
Okay, so we waited another nine years from 2013 to 2022 and there's been a tax revision published a few weeks ago and it is minor changes aside. It's a carbon copy of the DSM-V, which is a carbon copy of the DSM-IV.
The insurance industry and the pharmaceutical industry prevailed on the committee to not change a word or not change any meaningful word. The committee had not transitioned from the categorical model to the dimensional model. The committee had not resolved the comorbidity problem.
The new DSM doesn't tackle well differential diagnosis. It is still polythetic. All the problems are still there. Adversely impacting treatment. That's the key problem.
People are suffering because of this god-awful mess. They're suffering. They're misdiagnosed. They're given wrong medication. They deteriorate. Doctors are ruined. This is not just a text. It dictates and determines treatment not to mention expenditure.
And so not revising the DSM according to current knowledge or actually not so current, not revising the DSM according to what we have known for the past 70 years, that is 70 years, not taking into account all this, ignoring all this, just to cater to the bottom lines of the insurance industry and the pharmaceutical industry is, ladies and gentlemen, criminal.
The DSM-5 is a crime scene and should be cordoned off. It's very heartbreaking and very disappointing because a lot of progress has been made outside North America, outside the United States.
The international classification of disorders, the 11th edition is a masterpiece, state of the art, delineation, depiction and capture of the human condition and psychopathology. The DSM could have done better a long time ago, had the committee not been in thrall to special interests. It's very reminiscent of the gun lobby.
We need to take on the pharmaceutical industry and the insurance industry, the medical insurance industry. They are corrupting science. They're damaging people. They're hurting and harming people. Sometimes, very often actually, to the point of suicide, this is untenable. This is criminal. They are lying through the teeth about the effects of medication. They're pretending to have science when they have none and they're preventing real science from emerging in critical texts like the DSM just because it is inconvenient and would reduce profits.
This is where we are at. This is where we are now, psychology and psychiatry, corrupted on the one hand by money and on the other hand by the insatiable wish to be noticed. Scholars and scientists constitute themselves online and in the mainstream media and everywhere just to gain 15 minutes of fame.
And on the other hand, there is no lobby for real science. There's no lobby for true reform because a lot of money is sloshing around. There's only one constituency who suffer – you, the patient.