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A psychiatric split

November 23, 2008

Re "Wrangling over psychiatry's bible," Opinion, Nov. 16

Christopher Lane's Op-Ed article alleges a lack of transparency in the development of the next Diagnostic and Statistical Manual of Mental Disorders, known as the DSM.

The DSM is recognized worldwide as the source of definitive criteria for mental illnesses. The process for the development of the fifth edition of the DSM began in 1999 and will conclude with publication in 2012.

Hundreds of international experts, vetted for conflicts of interest, are involved in researching the scientific literature, discussing all options, assuring that attention is paid to gender, ethnicity, age and other factors and, eventually, testing hypotheses in the field. Comprehensive reports are published several times a year.

The preparation of DSM V is a model of transparency and inclusion.

Nada L. Stotland MD

Darrel A. Regier MD

Arlington, Va.

The writers are, respectively, the president and the director of the division of research of the American Psychiatric Assn.


As a psychiatrist, I was glad to see this article but felt it did not go far enough.

The big issues with the DSM have to do with the politics and economics that drive it. A lot of money is involved in publishing DSM editions and related texts.

The American Psychiatric Assn.'s secrecy regarding the process of preparing the DSM is a form of fascism. Avoiding transparency is a way to evade accountability and maintain political and economic power.

It is crucial that any process that affects the lives of hundreds of millions of people be subject to scrutiny, counterbalance and oversight.

Walter E.

Jacobson MD

Agoura Hills

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