Note to our followers: Our nearly 13-year run of daily publication of new content on comes to a close at the end of 2018. Publisher Gary Schwitzer and other contributors may post new articles periodically. But all of the 6,000+ articles we have published contain lessons to help you improve your critical thinking about health care interventions. And those will be still be alive on the site for a couple of years.

Podcast: Allen Frances, MD – A psychiatrist’s take on the DSM, Pharma, and Donald Trump

Michael Joyce produces multimedia for and tweets as @mlmjoyce

Is President Donald Trump mentally ill?

Do we really need over 500 psychiatric diagnoses?

What do the changes in the Diagnostic and Statistical Manual of Mental Disorders (or ‘DSM’ for short) over the past 60+ years say about psychiatry? The influence of industry? Us?

This conversation with renowned psychiatrist, Allen Frances MD — although just over 10 minutes long — touches on all of the above and much more. Trust me, he’s not shy.

A central theme in my conversation with Dr. Frances is the DSM. This diagnostic guide — published by the American Psychiatric Association — lists standardized criteria that psychiatrists use in making diagnoses. Frances chaired the revision of the 4th edition, and was an outspoken critic of the 5th edition.

In many ways the DSM is not just a barometer of psychiatry, but a litmus test of many of the issues we feel quite strongly about, including: over-diagnosis and over-treatment, as well as the minefield of conflicts of interest to be found at the intersection of industry and academic medicine. Here is some of our previous writing on these topics:

We’ve also written on whether it’s appropriate for the media to speculate on whether or not Donald Trump has a psychiatric illness.

Finally, if you are someone who is concerned that our medical culture is becoming too closely aligned with the notion of ‘a disease for every drug, and a drug for every disease,’ then you might enjoy our publisher Gary Schwitzer’s take on a New York Times op-ed entitled: ‘Diagnosis: Human.’

You can find all the Watchdog Podcasts HERE


We Welcome Comments. But please note: We will delete comments left by anyone who doesn’t leave an actual first and last name and an actual email address.

We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity. We will also end any thread of repetitive comments. Comments should primarily discuss the quality (or lack thereof) in journalism or other media messages about health and medicine. This is not intended to be a forum for definitive discussions about medicine or science. Nor is it a forum to share your personal story about a disease or treatment -- your comment must relate to media messages about health care. If your comment doesn't adhere to these policies, we won't post it. Questions? Please see more on our comments policy.