Saving Normal : An Insider's Revolt Against Out-of-control Psychiatric Diagnosis, Dsm-5, Big Pharma, and the Medicalization of Ordinary Life (9780062229274)
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anxiety disorder, 104
Arab (Muslim) world, 49, 50–52
Asclepius, 39–40
Asperger’s disorder, 147–49
assassinations, 110–11
asylum care, 57
attention deficit disorder:
criteria for, 76
false epidemic of, xiv, 26, 75, 85–86, 104, 139, 140–44
see also ADHD
attenuated psychotic symptoms syndrome, 198, 199
autism:
false epidemic of, xiv, 74, 75, 85–86, 104, 139, 147–49
Todd’s Story, 248–50
and vaccination, 81, 147
balance, 30–32, 44, 223
barbiturates, 87
Beard, George Miller, 124, 126–27
beetles, 279
behavioral addiction, 188–92
behavior therapy, 275
bell curve, 6, 7, 12, 13
benzodiazepines, 88
Bill’s Story, mood swings, 265–66
binge eating disorder (BED), xvii, 17, 182–84
bipolar disorder:
adult, 75, 104, 139
Bill’s Story, 265–66
childhood, 104, 144–46, 177, 178
false epidemic of, 74, 75, 104, 139, 144–46
Liz’s story, 253–55
schizophrenia vs., 59, 89, 151
Susan’s story, 250–53
treatment of, 105
bipolar II, 76, 149–52
borderline personality disorder, Brandy’s Story, 275–76
Brahe, Tycho, 54, 55
brain:
complexity of, 10–11
and emotions, 42
and homeostasis, 31
and laboratory tests, 11
and media hype, 225
and neuroscience, 125
and sensory perception, 51
wiring of, 125
Brandy’s Story, borderline personality disorder, 275–76
Breivik, Anders, 110
Breuer, Joseph, 128–29
bromides, 87
Brooks’s Story, schizoaffective disorder, 255–56
Buspar, 101
buyer beware, 228–29
caffeine dependence, 191
Celexa, 88, 156
cells, metabolic balance in, 30
chaos theory, 10
Charcot, Jean-Martin, 53, 124, 127–28, 129, 130
chemical imbalance, 127, 155, 157, 168
childhood bipolar disorder:
false epidemic of, xiv, 104, 144–46, 177, 178
Liz’s Story, 253–55
children:
day care sex abuse scandal, 133–36
excessive diagnosis of, 104
marketing to, 95
and pedophilia, 200–201
tantrums of, 177–79
weight gain in, 146, 177
chloral hydrate, 87
“Choosing Wisely” campaign, 79, 80
chorea, 53
Christian charity hospitals, 48–49
classification, 17, 36, 51, 54–56, 58–59, 60, 68
Cleo’s Story, ADHD, 271–73
clinical observation, 60, 171
clinician, working with, 229–31
cognitive functioning, 185
cognitive therapy, 108
compulsive behavior, 189
Constitution, U.S., and detention of criminals, 165–67
consumer advocacy groups, 223, 224–25, 226
consumer awareness, 228–41
best discipline for diagnosis, 233–34
buyer beware, 228–29
checking the diagnosis, 231–33
diagnosis reevaluation, 235–37
drug companies, 239–40
fad diagnoses, 239
family involvement, 234–35
herbal remedies, 240
natural healing, 240–41
record-keeping, 230–31
second opinion, 232–33, 234
self-reporting, 230, 234, 238–39
working with clinician, 229–31
consumers, direct advertising to, see drug companies
conversion disorder/hysteria, 127–29
Cook, Capt. James, 55
Copernicus, 54
counselors, as diagnosticians, 233
criminals, detention of, 165–67
criteria sets, 23–25, 64–65, 69
dance manias, 120–21
Dark Ages, 46
Darwin, Charles, 55, 281
day care sex abuse scandal, 133–36
dementia, 180–82
Democritus, 42
demons/demonic possession, 46–50, 57, 118–20, 132
depression:
and bipolar II, 150
criteria set for, 23
major depressive disorder, 154–57, 186–88
mixed anxiety/depression, 200
Peter’s Story, 271
Roberta’s Story, 263–65
diagnosis:
best discipline for, 233–34
checking out, 231–33
checklist as basis of, 67
classic textbook case, 237
collateral damage from errors in, xvi
computer-assisted, 28
criteria-based, 62–65
early, 236–37
fads in, 239
and insurance, 221
“lifetime,” 237
misdiagnosis, xvi, xviii, 238
optimum setting for, 32
as part of overall evaluation, 25–26, 67
reevaluation of, 235–37
required for prescription, 100
research-based, 69, 173
second opinion on, 232–33, 234
self-diagnosis, 234, 238–39
shortcomings of, 61–62
stepped, 221–22
with unsatisfactory results, 236
Diagnostic and Statistical Manual, see DSMs
diagnostic creep, 107
diagnostic inflation, 77–113
causes of, 32, 78–81
consequences of, 103–8
costs of, 111–13
counteracting, 209–27
and disease mongering, 89–95
and drug company profits, 29
DSMs as basis of, xiv-xv, xviii, 25, 67–68, 73, 75, 84–85
and easy-to-use drugs, 87–89
and fads, 83–84
and false epidemics, 104
as hyperinflation, 204–5
and labeling, 109–10
and miscounts, 85–86
and placebo effect, 97–101
by primary care physicians, 101–3
and stress, 81–83
diagnostic testing, 11
dialectic behavior therapy (DBT), 275
diary, keeping notes in, 230
disability benefits, 84–85, 141, 160
disease, environmental causes of, 53, 81
disease mongering, 29, 67, 74, 75, 89–95, 145, 240
Disraeli, Benjamin, 86
disruptive mood dysregulation disorder (DMDD), 177–79
dissociation, 130
distribution, normal, 6–7, 8
diversity, 6, 82, 109, 279–83
doctor creep, 107
doctors:
and drug companies, 29, 93–94
and insurance companies, 102
as pill pushers, 262
prescriptions from, 216–17, 226
primary care, 101–3, 226, 233–34
Dole, Bob, 162
drug companies:
collaboration of doctors and, 29, 93–94
and conflict of interest, 75
controlling the excesses of, 212–13
direct advertising to consumers, 26, 29, 68, 69, 73, 76, 88, 90, 92–93, 105, 107, 142, 143, 168, 211, 227, 240
disease mongering, 29, 67, 74, 75, 89–95, 145, 240
and false epidemics, 26
hall of shame, 96
lobbying by, 92, 226
misinformation spread by, 212, 239–40
monopoly pa
tent protection of, 90, 226
monopoly pricing by, 29
and placebos, 100
profitability of, xv, 29, 77, 80, 89–91, 104, 213, 226
research by, 90, 92
symposia sponsored by, 94
drug overuse, xv, xx, 95
drugs:
addictive, 88, 92, 95, 216
distribution of, 214–15
easy availability of, 107
easy-to-use, 87–89
glut of, 104–6
impact on mental disorder, 81–82, 238
legal, misuse of, 211
Maria’s Story, 260–63
multiple prescriptions of, 106–7
Myra’s Story, 258–60
off-label use of, 95
overdoses of, 211
overprescribing, 214
postapproval surveillance of, 216
self-prescription of, 107
sunsetting, 215–16
teens’ use of, 197
wrong war on, 210–12
DSM-5:
absence of peer review in, 174
absence of quality control in, 172–73, 175, 224
ambition of, xiv, 171
and APA, xvii, 170, 175–76, 219, 224, 227
changes reflected in, 173–74
and conflict of interest, 176
costs of, 175–76
errors seen in, xiv, 173, 217
field trials for, 174–75
and future fads, xv-xviii, 170, 176–205
and leadership style, 71
literature reviews for, 172
and media, 225, 226–27
negative impact of, 195–96
preparation of, xii-xiii, xvii
as protected intellectual property, xvii
secrecy in, xvii, 73, 174
DSM-I, 61
DSM-II, 61
DSM-III, 61–68, 218
creation of, xvii, 63–66, 172
criteria sets in, 23–25, 64–65, 69
impact of, xii, 67–68
limitations of, 66–67, 68
multiaxial system in, 65
revisions of, xii, 22
sexual disorders, 161
surface symptom method in, 65
DSM-IIIR, 68–69, 71, 172
DSM-IV, 69–76
cost of, 175–76
data reanalyses in, 72
diagnostic thresholds in, 73–74
and drug companies, 75–76
false epidemics stemming from, xiv, 74, 75, 139–69
field trials for, 72, 174
goals for, 70–71
Guidebook, 73
and leadership style, 71
literature review in, 72
misuse of, xiv, 73, 75, 76, 77, 139, 168–69, 173
negative impact of, 75
Options Book, 73
positive results from, 74–75
quality control in, 72
revisions to the series in, xiii-xiv
on sexual disorders, 166
Sourcebook, 73
standard operating procedures for, 72, 172
DSMs:
basis of, 59
criteria for changes in, 71–72, 74, 217–18
criteria sets in, 23–26, 64–65, 69
diagnosis required for prescription, 100
diagnostic inflation based on, xiv-xv, xviii, 25, 67–68, 73, 75, 84–85
editions and revisions of, xii-xiii
inconsistencies within, 17
influence of, 218
and insurance, 221
misuse of, 173
mixed record of, 76
as powerful tool, xiv, xviii, 26, 83, 84–85
profitability of, 176, 219, 226
and research, 71, 173
sensitivity as goal in, 24–25, 68
Durkheim, Emile, 14
eccentricity, 281
Eisenhower, Dwight D., 80
Elavil, 87
elderly:
marketing to, 95
memory loss in, 179–82
electrotherapy, 126
emotions, 42
adaptive, 31
Enlightenment, 5, 53–54, 56, 119, 121
environmental causes of disease, 53, 81
epidemiology, 53
equilibrium, 30–31
erectile dysfunction (ED), 162–63
evolution, 55
exorcism, 46, 49–50, 119
expectation, 98
fads, see psychiatric fads
faith healing, 49
family involvement, 234–35
field trials:
control in, 26
fallibility of, 27, 174–75
and generalizability, 26–27
names vs. numbers in, 27–28
patient selection in, 27
peer-reviewed, 72, 174
in university research clinics, 27
First Do No Harm, 242, 243
Food and Drug Administration (FDA), 95, 215–16, 220
forgetting, 17, 179–82
French Revolution, 54
Freud, Sigmund, 15–16, 53, 59–60, 125, 126, 128, 129
frontal lobe, 51
Galen, 44–46, 49, 51
Galileo Galilei, 54
gambling, addictive, 189
Garfield, James, 110
gender norms, 15
generalizability, 26–27
genetic code, 10
gluttony, 182–84
gods/goddesses, 38–41
golden mean, 7, 13
Greeks, medicine invented by, 42–43, 46
grief, 186–88
Paul and Janet, 268–69
Sarah’s Story, 257–58
guilds, 223
Guiteau, Charles, 110
Haldane, J.B.S., 279
harmony, 35, 44
healing, 42
faith, 49
natural, 32, 58, 240–41
health vs. illness, 9, 28
hebephilia, 200–203
hedonism, 204
Henry’s Story, schizophrenia, 273–74
herbal remedies, 240
Hippocrates, 26, 41–43, 44, 52–53, 242, 243, 263
Hitler, Adolf, 5
homeostasis, 30–32
hope, power of, 98
hospitalization, involuntary, 75
hospitals:
asylum care in, 57
charity, 48–49
humoral theory, 8–9, 42, 44–46, 49
Humpty Dumpty (fict.), 138
Huxley, Aldous, 77, 155, 281
hyperactivity, xvii
hyperinflation, 204–5
hypersexuality, 203–4
hypnosis, 128, 130–31
hypochondriasis, 53, 239
hypomanic episodes, 150
hysteria, 53, 124–25
and conversion disorder, 127–29
vampire hysteria, 121–23
iatrogenic deaths, 106–7
Icarus, 171
ICD-10, 22
ICD-11, 22
incubation, 40
Industrial Revolution, 56
inquisition, 46, 47
instinct, 15
insurance, 85, 102, 112, 132, 221
Internet:
addiction to, 189, 191–92
double-checking information from, 240
drugs marketed on, 211
influence of, 83–84, 131, 148–49
IQ tests, 12–13
iron, 53
Janet, Pierre-Marie-Félix, 128
Kaplan, Helen Singer, 161
Kepler, Johannes, 54, 55
Koran, 50
Kraepelin, Emil, 59
labeling, 35–36, 109–10, 118, 141, 199
law of averages, xii
Lewis, Mindy, 244–47
libido, 126–27
Librium, 88, 92, 156
life expectancy, 199, 201–2
lifestyle choices, and addiction, 189
“lifetime diagnosis,” 237
Lincoln, Abraham, 213
&nbs
p; Linnaeus, Carl, 54–55, 58
lithium, 87, 91
Liz’s Story, childhood bipolar disorder, 253–55
Locke, John, 52
lust, normal male, 201
MacArthur Foundation, 72
major depressive disorder (MDD), xvii, 154–57, 186–88
male hard wiring, 201
Malleus Maleficarum, 47
Mania (demon), 38–39
mania (disease), 42, 91
MAO inhibitors, 91
Maria’s Story, drug abuse, 260–63
Maria Theresa, queen of Austria, 123
masochistic personality disorder, 66
media:
advertising in, 92
and day care scandal, 134
and DSM-5, 225, 226–27
and false epidemics, 141, 148
influence of, 83–84
investigative journalism, 223, 225–26
medications, records of, 230
medicine:
evidence-based, 172
Greek invention of, 42–43, 46
learning at bedside, 43
in Muslim world, 49
“normal” defined in, 8–9
plant-based, 54
and psychiatry, 193–96
rule of thirds in, 43
see also drugs
medicine man (shaman), 36–37, 38, 119
medieval guilds, 223
melancholia, 42, 186–88
Peter’s Story, 270–71
memory loss, 17, 179–82
Mencken, H. L., 209
Mendeleyev, Dmitry, 56
mental disorders:
causes of, 58–59
chemical imbalance in, 93, 108
classification of, 69
and criminals, 110–11
criteria sets of, 23–25
impact of alcohol and drugs on, 81–82, 238
and the Koran, 50
labeling of, 36
medical illness mislabeled as, 193–96
misidentification of, 198–99
nature of, 18–21, 32
normal vs., 5, 16, 18
optimum diagnosis of, 32
stigma of, 109
and unemployment, 84
mild neurocognitive disorder (MND), xvii, 180–82
Miltown, 87
Mindy’s Story, schizophrenia, 244–47
miracles of faith, 49
misdiagnosis, collateral damage from, xvi, xviii, 238
mixed anxiety/depression (MAD), xvii, 200
mood disorder, 104
mood swings, 145–46, 149–52
Bill’s Story, 265–66
mourning, 186–88
Moynihan, Ray, 163
multiple personality disorder, 124–25, 130–33
Musil, Robert, 167
Muslim world:
medicine in, 49
psychiatry in, 50–52
Myra’s Story, prescription drugs, 258–60
myths, 18, 20, 38
naming, 35–36
Napoleonic wars, 54
Nardil, 87
National Institute of Mental Health, 86, 174, 219
natural healing, 32, 58, 240–41
natural philosophy, 41–42, 43, 52–53
natural world, classification of, 55–56
neurasthenia, 124–25, 126–27
neurology, 59, 60, 125
neurons, 125
neuroscience, 124–25, 171
neuroses, 60