"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"--

“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.

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.

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.

Blurred boundaries between the normal and the pathological are a recurrent theme in almost every publication concerned with the classification of mental disorders. Yet, systematic approaches that take into account discussions about vagueness are rare. This volume is the first in the psychiatry/philosophy literature to tackle this problem.

The registered trademark symbol appears after the word DSM-5 in title.

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.