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Erin O'Brien

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hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/major-depressive-disorder"> Major Depressive Disorder </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/schizophrenia"> | Schizophrenia/Psychosis </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/mental-health-awareness"> | Mental Health Awareness Month </a><div class="mt-4 max-w-[125px]"></div></div></div></div></div></nav><div id="erin-o-brien" class="container mx-auto flex m-1 min-h-[57vh] px-4"><div class="flex-auto w-[calc(100%-300px)] pr-0 md:pr-6 mt-16 sm:mt-0"><div class="pb-24 my-2"><h1 class="text-3xl">Erin O&#x27;Brien</h1><div class="w-full mb-2 border border-secondary"></div><div class=" flex-1 py-2 text-sm"><a class="text-primary" href="/">home</a><a class="text-primary" href="/authors"> <!-- -->/<!-- --> <span class="">authors</span></a><span class="text-gray-400"> <!-- -->/<!-- --> <span class=" text-gray-400">erin-o-brien</span></span></div><div class="flex justify-end gap-2"></div><div class="flex flex-col sm:flex-row"><div id="description-summary" class="py-2 text-sm text-gray-500 sm:w-[calc(100%-100px)]"><div class="blockText_blockContent__TbCXh"></div></div></div><h3 class="text-xl">Articles</h3><div class="flex flex-wrap w-full"><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/innovations-in-clinical-research"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:41.500332667997334%"></span><img alt="innovations" title="innovations" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="innovations" title="innovations" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbcd6c9945df67a0af40dce3827cbb1f8ccfb349c-6012x2495.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/innovations-in-clinical-research">Innovations in Clinical Research</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/erin-o-brien">Erin O&#x27;Brien</a></div><a href="/view/innovations-in-clinical-research"><span class="text-sm text-gray-500 pl-4">July 8th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The 2024 American Society of Clinical Psychopharmacology Annual Meeting brought together researchers and clinicians to engage in discussion, education, and dissemination of research findings and new methodologies.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/a-look-at-the-comorbidity-of-eating-disorders-and-addiction"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.75531914893617%"></span><img alt="An expert discusses this comorbidity, plus the effects of semaglutide and other GLP-1 agonists on this patient population." title="An expert discusses this comorbidity, plus the effects of semaglutide and other GLP-1 agonists on this patient population." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="An expert discusses this comorbidity, plus the effects of semaglutide and other GLP-1 agonists on this patient population." title="An expert discusses this comorbidity, plus the effects of semaglutide and other GLP-1 agonists on this patient population." sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdc5144168e8249ae53a2067a991cd5dea3c6f2bc-6016x4016.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdc5144168e8249ae53a2067a991cd5dea3c6f2bc-6016x4016.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, 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href="/view/a-look-at-the-comorbidity-of-eating-disorders-and-addiction">A Look at the Comorbidity of Eating Disorders and Addiction</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/erin-o-brien">Erin O&#x27;Brien</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/elizabeth-wassenaar-md-ms-ceds-s-dfapa">Elizabeth Wassenaar, MD, MS, CEDS-S, DFAPA</a></div><a href="/view/a-look-at-the-comorbidity-of-eating-disorders-and-addiction"><span class="text-sm text-gray-500 pl-4">June 24th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">An expert discusses this comorbidity, plus the effects of semaglutide and other GLP-1 agonists on this patient population.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/the-week-in-review-june-17-21"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.625%"></span><img alt="Here are highlights from the week in Psychiatric Times." title="Here are highlights from the week in Psychiatric Times." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Here are highlights from the week in Psychiatric Times." title="Here are highlights from the week in Psychiatric Times." sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5e8798690ca96ea1f5db8838133c1aa80958230f-800x533.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, 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class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/the-week-in-review-june-17-21">The Week in Review: June 17-21</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/erin-o-brien">Erin O&#x27;Brien</a></div><a href="/view/the-week-in-review-june-17-21"><span class="text-sm text-gray-500 pl-4">June 22nd 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Here are highlights from the week in Psychiatric Times.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/apex-labs-files-ind-for-apex-52-study-of-take-home-microdose-psilocybin"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66247800955014%"></span><img alt="The outcomes of this study are expected to inform the development of the upcoming PATHFINDER-52 phase 2b clinical trial." title="The outcomes of this study are expected to inform the development of the upcoming PATHFINDER-52 phase 2b clinical trial." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="The outcomes of this study are expected to inform the development of the upcoming PATHFINDER-52 phase 2b clinical trial." title="The outcomes of this study are expected to inform the development of the upcoming PATHFINDER-52 phase 2b clinical trial." sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1e4c788334af9d6ec3dc360ff97da7e6aeb05c3f-7958x5305.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, 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loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/apex-labs-files-ind-for-apex-52-study-of-take-home-microdose-psilocybin">Apex Labs Files IND Application for APEX-52 Study of Take-Home Microdose Psilocybin</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/erin-o-brien">Erin O&#x27;Brien</a></div><a href="/view/apex-labs-files-ind-for-apex-52-study-of-take-home-microdose-psilocybin"><span class="text-sm text-gray-500 pl-4">June 20th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The outcomes of this study are expected to inform the development of the upcoming PATHFINDER-52 phase 2b clinical trial.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full 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src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="schizophrenia" title="schizophrenia" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F0a9ef5105fc74db5697b1fa463322248ba615dc9-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F0a9ef5105fc74db5697b1fa463322248ba615dc9-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, 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style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/the-week-in-review-june-10-14"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:54.93333333333334%"></span><img alt="Here are highlights from the week in Psychiatric Times." title="Here are highlights from the week in Psychiatric Times." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Here are highlights from the week in Psychiatric Times." title="Here are highlights from the week in Psychiatric Times." sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, 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June 10-14</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/erin-o-brien">Erin O&#x27;Brien</a></div><a href="/view/the-week-in-review-june-10-14"><span class="text-sm text-gray-500 pl-4">June 15th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Here are highlights from the week in Psychiatric Times.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/cdc-issues-han-health-advisory-following-doj-indictment-of-digital-health-provider-of-adderall"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%"></span><img alt="The CDC suggests that disrupted access to ADHD medications may increase risk of overdose and injury." title="The CDC suggests that disrupted access to ADHD medications may increase risk of overdose and injury." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="The CDC suggests that disrupted access to ADHD medications may increase risk of overdose and injury." title="The CDC suggests that disrupted access to ADHD medications may increase risk of overdose and injury." sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F79442aab2ccd8bd4cc32158e7d1857c41100fba3-6600x4400.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F79442aab2ccd8bd4cc32158e7d1857c41100fba3-6600x4400.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, 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srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, 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style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:85.9536082474227%"></span><img alt="The company has announced plans to submit the NDA in the first half of 2025." title="The company has announced plans to submit the NDA in the first half of 2025." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="The company has announced plans to submit the NDA in the first half of 2025." title="The company has announced plans to submit the NDA in the first half of 2025." sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F933ee8a961e284c622675a9671ab5233ad85b4f5-2328x2001.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F933ee8a961e284c622675a9671ab5233ad85b4f5-2328x2001.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F933ee8a961e284c622675a9671ab5233ad85b4f5-2328x2001.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F933ee8a961e284c622675a9671ab5233ad85b4f5-2328x2001.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F933ee8a961e284c622675a9671ab5233ad85b4f5-2328x2001.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, 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gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The company has announced plans to submit the NDA in the first half of 2025.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/psychotropic-polypharmacy-trends-rise-among-child-adolescent-medicaid-beneficiaries"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:39.34942287513116%"></span><img alt="“The findings emphasize the importance of monitoring the use of psychotropic combinations, particularly among vulnerable populations.”" title="“The findings emphasize the importance of monitoring the use of psychotropic combinations, particularly among vulnerable populations.”" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" 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loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/psychotropic-polypharmacy-trends-rise-among-child-adolescent-medicaid-beneficiaries">Psychotropic Polypharmacy Trends Rise Among Child, Adolescent Medicaid Beneficiaries</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/erin-o-brien">Erin O&#x27;Brien</a></div><a href="/view/psychotropic-polypharmacy-trends-rise-among-child-adolescent-medicaid-beneficiaries"><span class="text-sm text-gray-500 pl-4">May 21st 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">“The findings emphasize the importance of monitoring the use of psychotropic combinations, particularly among vulnerable populations.”</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div 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style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="shrink-0 object-cover" loading="lazy"/></noscript></span></div><div class="jsx-41d2ec0c9882d016 flex flex-col pb-3"><div class="jsx-41d2ec0c9882d016"><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500">Published: <!-- -->March 23rd 2021</span><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500"> | Updated: <!-- -->November 23rd 2024</span></div><div class="jsx-41d2ec0c9882d016 font-bold text-sm pb-1">Poor DSM-5—So Misunderstood!</div></div></a><a class="jsx-41d2ec0c9882d016 recent-article" href="/view/mini-quiz-dsm-5-basics"><div class="jsx-41d2ec0c9882d016 min-h-[65px] min-w-[65px] max-w-[65px] mr-2 lg:mt-1"><span 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style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="shrink-0 object-cover" loading="lazy"/></noscript></span></div><div class="jsx-41d2ec0c9882d016 flex flex-col pb-3"><div class="jsx-41d2ec0c9882d016"><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500">Published: <!-- -->June 6th 2018</span><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500"> | Updated: <!-- -->November 23rd 2024</span></div><div class="jsx-41d2ec0c9882d016 font-bold text-sm pb-1">Mini Quiz: Psychogenic Non-Epileptic Seizures</div></div></a></div></div></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div 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OK, maybe you know most of the criteria for the major categories of serious mental illness. No doubt, you are aware of serious problems with some aspects of DSM-5 (the ","_key":"efdd456407300"},{"text":"Manual)","_key":"efdd456407301","_type":"span","marks":["em"]},{"marks":[],"text":", including the limited reliability and validity of many of its disorder categories.","_key":"efdd456407302","_type":"span"},{"_type":"span","marks":["superscript"],"text":"2","_key":"e9d1ba9a9e8f"},{"_type":"span","marks":[],"text":" But how well do you understand the “deep structure” of DSM-5 as a diagnostic tool?","_key":"0c1e2c424fac"}],"_type":"block","style":"normal","_key":"05e3ad12fa85","upload_doc":null,"medias":null,"uploadAudio":null},{"uploadAudio":null,"markDefs":[],"children":[{"marks":[],"text":"Just to get your adrenaline flowing, try taking this 2-minute quiz:","_key":"77c1d9d6f2a80","_type":"span"}],"_type":"block","style":"normal","_key":"452c258e0dee","upload_doc":null,"medias":null},{"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"fe71f3bdf3f3"}],"_type":"block","style":"normal","_key":"4a81b63a546c","upload_doc":null,"medias":null},{"question":"Which of the following statements regarding DSM-5 is/are true?","response":[{"_type":"block","style":"normal","_key":"5baad7dcaec3","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"If you answered “F,”","_key":"6c5371555ddd"},{"text":" you can stop here. Pat yourself on the back and grab a coffee. Otherwise, you might want to read on.","_key":"be551bf52576","_type":"span","marks":[]}]}],"_type":"poll","_key":"e2ad675ced44","choices":[{"_type":"pollText","choiceCount":108,"_key":"c5266f219d31","choiceText":"A. DSM-5 permits the clinician to make a mental disorder diagnosis simply by checking off the symptoms listed in a disorder’s diagnostic criteria."},{"choiceText":"B. To make a DSM-5 mental disorder diagnosis, the clinician need not assess the social, psychological and biological factors that may have contributed to the patient’s condition.","_type":"pollText","choiceCount":118,"_key":"c8e6c9e8cc01"},{"choiceCount":109,"_key":"ecf97a66f012","choiceText":"C. DSM-5 is an embodiment and expression of the “biomedical” model in psychiatry.","_type":"pollText"},{"_type":"pollText","choiceCount":72,"_key":"a594d0015b49","choiceText":"D. DSM-5 posits that mental disorders are discrete entities sharply distinguished both from “normality” and from each other."},{"choiceText":"E. All of the above","_type":"pollText","choiceCount":307,"_key":"08218d39fb2a"},{"_key":"87973bfd8a46","choiceText":"F. 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Thus, a professor of history and philosophy—in an article titled, “Forget talking, just fill a script: how modern psychiatry lost its mind”—","_key":"ad3923e532df0","_type":"span"},{"marks":["14d18f83fb1e"],"text":"wrote","_key":"f0928d2e9911","_type":"span"},{"_type":"span","marks":[],"text":"","_key":"a8fcf47fef95"},{"_key":"94bc6be6ea4d","_type":"span","marks":[],"text":":"}],"_type":"block","style":"normal"},{"_key":"0a28fab4df2f","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"text":"In clinical practice, DSM-III led to a “Chinese menu” approach to psychiatric diagnosis: a specific mental illness can be diagnosed if a sufficient number of boxes can be ticked. This is only of limited value in clinical practice.","_key":"5aca93396c100","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"3","_key":"94b44aaa353d"}],"_type":"block","style":"blockquote"},{"children":[{"_key":"dd87609bcfdd0","_type":"span","marks":[],"text":"Indeed, merely checking off boxes of symptoms (and signs) "},{"_type":"span","marks":["em"],"text":"is","_key":"dd87609bcfdd1"},{"_type":"span","marks":[],"text":" of very limited clinical value—","_key":"dd87609bcfdd2"},{"_type":"span","marks":["em"],"text":"but that is not at all what DSM-5 calls for.","_key":"dd87609bcfdd3"},{"_type":"span","marks":[],"text":" As my colleague, Dr Mark Ruffalo, and I ","_key":"dd87609bcfdd4"},{"_type":"span","marks":["7c5dce4cd2ce"],"text":"pointed out","_key":"1343d1c8c660"},{"_type":"span","marks":[],"text":"","_key":"29a9eeaa7daa"},{"_type":"span","marks":[],"text":", the DSM-5 makes it crystal clear: Simply checking off symptoms ","_key":"95714023b2f1"},{"_key":"dd87609bcfdd5","_type":"span","marks":["em"],"text":"cannot and does not constitute a psychiatric diagnosis—"},{"marks":[],"text":"which requires a comprehensive ","_key":"dd87609bcfdd6","_type":"span"},{"_type":"span","marks":["em"],"text":"case formulation.","_key":"dd87609bcfdd7"},{"_key":"7b7908229203","_type":"span","marks":["em","superscript"],"text":"4"},{"_type":"span","marks":["superscript"],"text":" ","_key":"dd87609bcfdd8"},{"_type":"span","marks":[],"text":"As the ","_key":"4981780c6043"},{"_key":"dd87609bcfdd9","_type":"span","marks":["em"],"text":"Manual "},{"marks":[],"text":"itself ","_key":"dd87609bcfdd10","_type":"span"},{"text":"notes","_key":"17931b7ccdaa","_type":"span","marks":["a40e0494c206"]},{"text":"","_key":"52c6816f8f0f","_type":"span","marks":[]},{"_type":"span","marks":[],"text":":","_key":"ae521907939c"}],"_type":"block","style":"normal","_key":"bab7d1828d16","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"href":"https://www.psychologytoday.com/us/blog/freud-fluoxetine/202006/psychiatric-diagnosis-20-the-myth-the-symptom-checklist","_key":"7c5dce4cd2ce","blank":true,"_type":"link"},{"_key":"a40e0494c206","blank":true,"_type":"link","href":"https://dsm.psychiatryonline.org/"}]},{"children":[{"_type":"span","marks":[],"text":"The case formulation for any given patient must involve a careful clinical history and concise summary of the social, psychological and biological factors that may have contributed to developing a given mental disorder. ","_key":"85ab544a4f4a0"},{"_type":"span","marks":["em"],"text":"Hence, it is not sufficient to simply check off the symptoms of the diagnostic criteria to make a mental disorder diagnosis ","_key":"85ab544a4f4a1"},{"_type":"span","marks":[],"text":"(emphasis added).","_key":"85ab544a4f4a2"},{"marks":["superscript"],"text":"5(p19)","_key":"33c92ab96b83","_type":"span"}],"_type":"block","style":"blockquote","_key":"097fbc5bf59d","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[]},{"_type":"sidebar","_key":"bb15b1acef8e","upload_doc":null,"content":[{"_key":"5eeefcbe8854","markDefs":[],"children":[{"_type":"span","marks":["em","strong"],"text":"\"You cannot snag a DSM diagnosis merely by collecting a group of signs and symptoms.\"","_key":"b8e0da0891d1"}],"_type":"block","style":"normal"}],"medias":null,"uploadAudio":null},{"children":[{"_type":"span","marks":[],"text":"As Dr Gary G. Gintner has ","_key":"d92361110e490"},{"text":"explained","_key":"614ec03d46cf","_type":"span","marks":["277f401e0e25"]},{"_type":"span","marks":[],"text":"","_key":"ad0054afc94c"},{"_type":"span","marks":[],"text":", the case formulation “. . . is a core clinical skill that links assessment information and treatment planning. It is a hypothesis about the mechanisms that cause and maintain the problem. It answers the question, ‘Why is this person, having this type of problem, now?’”","_key":"593064299bc4"},{"marks":["superscript"],"text":"6","_key":"ad00fead3832","_type":"span"}],"_type":"block","style":"normal","_key":"568dfef4eabc","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"http://www.lacounseling.org/images/lca/Conference/DSM-5%20LCA%20Case%20Formulation%20Rev.pdf","_key":"277f401e0e25"}]},{"_type":"block","style":"normal","_key":"c33a1708e853","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"_type":"link","href":"https://en.wikipedia.org/wiki/DSM-5","_key":"6730571c1bd0","blank":true}],"children":[{"_type":"span","marks":[],"text":"In principle, the case formulation—and by extension, the final DSM diagnosis—requires medical knowledge, or at least access to medical consultation, in order to assess the “biological factors” that may have contributed to the patient’s problem. Finally, we should note that, in addition to meeting sign/symptom criteria for a mental disorder, virtually all the major ","_key":"90c06147a54a0"},{"_key":"76e7903202a7","_type":"span","marks":["6730571c1bd0"],"text":"DSM-5 categories"},{"_type":"span","marks":[],"text":"","_key":"d887b4f66c33"},{"_type":"span","marks":[],"text":" require evidence of “clinically significant distress or impairment in social, occupational or other important areas of functioning.” You cannot snag a DSM diagnosis merely by collecting a group of signs and symptoms. There must also be adverse consequences in the person’s life.","_key":"aa7780433f3d"}]},{"_type":"block","style":"normal","_key":"7569c721b605","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"The DSM-5 Is “Biomedical”? Not So Much","_key":"13577f2f584d0"}]},{"_type":"block","style":"normal","_key":"aee8b68d7d35","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"It is clear from the aforementioned description of the case formulation that the DSM-5 explicitly uses a “biopsychosocial” approach to diagnosis. In addition, DSM-5 has extensive coverage of cultural issues, as they impinge on differential diagnosis. Excellent examples of the “case conceptualization” using a bio-psychosocial-cultural approach may be found in the text by Sperry and Sperry.","_key":"4cbb04c594a80"},{"_type":"span","marks":["superscript"],"text":"7","_key":"c4eb4d2cae95"}]},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"_key":"2cad2965cdb7","blank":true,"_type":"link","href":"https://journals.sagepub.com/doi/abs/10.1177/0959353512467974"}],"children":[{"text":"Nonetheless, some commentators—mainly critics of psychiatric nosology—have asserted that DSM-5 represents the “biomedical” model. For example, 1 paper ","_key":"31f81735a0bf0","_type":"span","marks":[]},{"_type":"span","marks":["2cad2965cdb7"],"text":"argues","_key":"ad2720f585c5"},{"text":"","_key":"c28d62decd5d","_type":"span","marks":[]},{"marks":[],"text":" that,","_key":"c07307108016","_type":"span"}],"_type":"block","style":"normal","_key":"a89b1bf1dc19"},{"_type":"block","style":"blockquote","_key":"40c18087430d","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"marks":[],"text":"The ","_key":"4d7d5c8398940","_type":"span"},{"marks":["em"],"text":"Diagnostic and Statistical Manual of Mental Disorders","_key":"4d7d5c8398941","_type":"span"},{"_key":"4d7d5c8398942","_type":"span","marks":[],"text":" . . . offers a biomedical framing of people’s experiences of distress and impairment, and despite decades of criticism, it remains the dominant approach."},{"_key":"7ad7cb0112b3","_type":"span","marks":["superscript"],"text":"8"}]},{"_key":"deba9e3ad206","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"_type":"link","href":"https://journals.sagepub.com/doi/abs/10.1177/0959353512467974","_key":"bcea9ca8aa06","blank":true}],"children":[{"marks":[],"text":"These authors go on to argue that, “. . . a biomedical construction of ‘mental illness’ all too frequently fails to protect individuals from delegitimation and stigma.” That is a provocative claim worth examining but is beyond the scope of this essay. 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The authors do ","_key":"462ecf099e420","_type":"span"},{"_type":"span","marks":["bcea9ca8aa06"],"text":"note","_key":"6bc99380248b"},{"_type":"span","marks":[],"text":"","_key":"0f6884a260d0"},{"_key":"21a8318dcccb","_type":"span","marks":[],"text":" the biomedical model is oriented “around the problems of the body . . . such as genetics or neurochemistry.”"},{"_type":"span","marks":["superscript"],"text":"8","_key":"c89e7cb62697"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"If we take that rough formulation as a guide, it can be readily seen that—with a few exceptions—there is very little in DSM-5 that invokes “genetics” or “neurochemistry.” True, DSM-5’s discussion of ","_key":"dce356c6a1660"},{"_type":"span","marks":["0de6f0e3140c"],"text":"Huntington disease","_key":"998e080ba613"},{"_type":"span","marks":[],"text":"","_key":"b0108c3ca6e7"},{"_key":"c3733e7056ec","_type":"span","marks":[],"text":" does reference abnormalities on chromosome 4; and other neurocognitive disorders, such as Lewy body disease, are linked to genetic abnormalities. 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What DSM-5 Is and What It Is Not","_key":"65990a6ffa25","_type":"span"}]}],"link":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/34def3064505b4e400fdc8147dc7123c929c23f4-992x776.jpg?auto=format"},{"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"What About “Neurochemistry”?","_key":"9977b2841c2e0"}],"_type":"block","style":"normal","_key":"a16c790a0e87","upload_doc":null},{"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://dsm.psychiatryonline.org/","_key":"a0aeb0d0ce16"}],"children":[{"_type":"span","marks":[],"text":"As far as I know, discussion of “neurochemistry” as a ","_key":"4558c0fb942f0"},{"_type":"span","marks":["em"],"text":"causal or etiological factor","_key":"4558c0fb942f1"},{"marks":[],"text":" in any of the common psychiatric disorders is entirely lacking in DSM-5. (So much for “chemical imbalances”). With only a few exceptions, DSM-5 avoids commitments regarding etiology. Indeed, the ","_key":"4558c0fb942f2","_type":"span"},{"marks":["em"],"text":"Manual ","_key":"4558c0fb942f3","_type":"span"},{"_type":"span","marks":[],"text":"explicitly ","_key":"4558c0fb942f4"},{"marks":["a0aeb0d0ce16"],"text":"notes","_key":"4854258bf606","_type":"span"},{"text":"","_key":"42e91efbcfe0","_type":"span","marks":[]},{"text":", “a diagnosis does not carry any necessary implications regarding the etiology or causes of the individual’s mental disorder. . .”","_key":"dd9ac997a7f8","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"5(p25)","_key":"08a9a0df8f98"},{"_type":"span","marks":[],"text":" One can see this as a serious deficiency in the DSM-5—but one cannot claim the ","_key":"b4306e79b14a"},{"text":"Manual ","_key":"4558c0fb942f5","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":"endorses anything resembling neurochemical etiologies or “chemical imbalances” for the major mental disorders.","_key":"4558c0fb942f6"}],"_type":"block","style":"normal","_key":"ba2aa9da3917","upload_doc":null,"medias":null},{"markDefs":[{"_key":"4a6c213a1875","blank":true,"_type":"link","href":"https://journals.sagepub.com/doi/abs/10.1177/0959353512467974"}],"children":[{"_type":"span","marks":[],"text":"In sum, there is no credible basis for ","_key":"dec98c7ab62f0"},{"_type":"span","marks":["4a6c213a1875"],"text":"arguing","_key":"f761fd457434"},{"_type":"span","marks":[],"text":"","_key":"075f6897ed7b"},{"_type":"span","marks":[],"text":" that the DSM-5 “offers a biomedical framing of people’s experiences of distress and impairment.”","_key":"dd0a65d63a6e"},{"_type":"span","marks":["superscript"],"text":"8","_key":"1a8d78fa18fb"},{"_type":"span","marks":[],"text":" Deacon, in a detailed review and critique, argues that “The biomedical model posits that mental disorders are brain diseases and emphasizes pharmacological treatment to target presumed biological abnormalities.”","_key":"fb4909ed388e"},{"_type":"span","marks":["superscript"],"text":"9","_key":"6f09945f91c8"},{"_type":"span","marks":[],"text":" I do not contest that description, but nothing in Deacon’s analysis shows that DSM-5 is essentially “biomedical” in the sense he explicates.","_key":"e23a3f8136b2"}],"_type":"block","style":"normal","_key":"63200e276463","upload_doc":null,"medias":null,"uploadAudio":null},{"children":[{"_type":"span","marks":["strong"],"text":"Fuzzy Boundaries, Overlapping Symptoms, and Dimensions of Pathology","_key":"e6f630d9933d0"}],"_type":"block","style":"normal","_key":"61ff117070c1","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"Another common claim is that DSM-5 is a strictly “categorical” framework that conceptualizes mental illness as a collection of discrete, diagnostically separable entities. As one paper puts it, “. . . the DSM-5 is a categorical system. Thus, individual disorders are regarded as discrete units—“you either have it, or you don't.”","_key":"e04600f374050"},{"_type":"span","marks":["superscript"],"text":"10","_key":"70938dab549b"},{"_key":"0edae070055e","_type":"span","marks":[],"text":" A related claim is that DSM-5 posits a clear and distinct separation between mental abnormality and “normal” mental or psychological states. "}],"_type":"block","style":"normal","_key":"4f560435e5e8","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[]},{"_type":"block","style":"normal","_key":"4d793f1845fb","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/34def3064505b4e400fdc8147dc7123c929c23f4-992x776.jpg?auto=format","_key":"24338a1fb671"}],"children":[{"_key":"5c60fad957dd0","_type":"span","marks":[],"text":"In truth, neither claim is supported in the DSM-5 ("},{"text":"Table 1","_key":"5c60fad957dd1","_type":"span","marks":["strong","24338a1fb671"]},{"_type":"span","marks":[],"text":"","_key":"279eb87df95b"},{"text":"). On the contrary, the Introduction to the ","_key":"5c60fad957dd2","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"Manual ","_key":"56b2b05c3e89"},{"_key":"691b4ad75a36","_type":"span","marks":[],"text":"clearly states,"}]},{"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"text":"The results of numerous studies of comorbidity and disease transmission . . . make strong arguments for what many astute clinicians have long observed: the boundaries between many disorder “categories” are more fluid over the life course than DSM-IV recognized, and many symptoms assigned to a single disorder may occur, at varying levels of severity, in many other disorders. These findings mean that DSM . . . should accommodate ways to introduce dimensional approaches to mental disorders, including dimensions that cut across categories . . . Although some mental disorders may have well-defined boundaries around symptom clusters, scientific evidence now places many, if not most, disorders on a spectrum with closely related disorders that have shared symptoms, shared genetic and environmental risk factors, and possibly shared neural substates . . . ","_key":"78107f484f400","_type":"span","marks":[]},{"marks":["em"],"text":"In short, we have come to recognize that the boundaries between disorders are more porous than originally believed.","_key":"2d61b5d3ba19","_type":"span"},{"marks":[],"text":"” (Italics added)","_key":"19facd202b8c","_type":"span"},{"text":"5(pp5-6)","_key":"3fb484507689","_type":"span","marks":["superscript"]},{"_type":"span","marks":[],"text":"","_key":"365491a27bc70"}],"_type":"block","style":"blockquote","_key":"57dc0cc46007","upload_doc":null},{"_type":"block","style":"normal","_key":"8d71057879ae","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Furthermore, the DSM-5 does not argue for a hard and fast boundary between “normal” and “abnormal” states and conditions. On the contrary, it states:","_key":"f299962ef90a0"}]},{"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The boundaries between normality and pathology vary across cultures for specific types of behaviors…Hence, the level at which an experience becomes problematic or pathological will differ. The judgment that a given behavior is abnormal and requires clinical attention depends on cultural norms that are internalized by the individual and applied by others around them, including family members and clinicians.","_key":"875cbfd1866e0"},{"_key":"431cbcbebb25","_type":"span","marks":["superscript"],"text":"5"}],"_type":"block","style":"blockquote","_key":"dba9a96d6508","upload_doc":null},{"imgcaption":[{"children":[{"_type":"span","marks":["strong"],"text":"Table 2. 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and it is very doubtful that we can “carve Nature at its joints.”","_key":"032c01fe1432","_type":"span","marks":[]},{"_key":"81bea0aa38c3","_type":"span","marks":["superscript"],"text":"12"}],"_type":"block"},{"uploadAudio":null,"markDefs":[],"children":[{"_key":"d59c26b22d2d0","_type":"span","marks":["strong"],"text":"The Worst Diagnostic System?"}],"_type":"block","style":"normal","_key":"1e7ed27d434d","upload_doc":null,"medias":null},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-7-9","_key":"f7f35df24f73"},{"blank":true,"_type":"link","href":"https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-7-9","_key":"f99e57bd700a"},{"blank":true,"_type":"link","href":"https://winstonchurchill.org/resources/quotes/the-worst-form-of-government/","_key":"741692f703e2"}],"children":[{"_type":"span","marks":[],"text":"Winston Churchill once ","_key":"fe1ed015da420"},{"_type":"span","marks":["741692f703e2"],"text":"quipped","_key":"d9f7db6da36c"},{"_type":"span","marks":[],"text":"","_key":"ef65e7b23603"},{"_type":"span","marks":[],"text":" that democracy is the very worst form of government, except for all the others that have been tried.","_key":"101278a71639"},{"_type":"span","marks":["superscript"],"text":"13","_key":"055de1553aae"},{"text":" It is tempting to suggest, tongue slightly in cheek, that DSM-5 is by far the worst diagnostic framework psychiatry could have chosen—except for all the rest. To be sure, many different approaches to psychiatric diagnosis have been ","_key":"5a6089611570","_type":"span","marks":[]},{"marks":["f99e57bd700a"],"text":"proposed and debated","_key":"e59dbb7f245b","_type":"span"},{"_type":"span","marks":[],"text":"","_key":"4ead56afdde0"},{"marks":[],"text":"—each with its pros and cons.","_key":"f49e75a15fe0","_type":"span"},{"text":"14","_key":"942f805d585e","_type":"span","marks":["superscript"]},{"_type":"span","marks":[],"text":" ","_key":"0dfaf38aca8e"}],"_type":"block","style":"normal","_key":"b7e4837fc372"},{"_type":"block","style":"normal","_key":"4c6d89dae9a4","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"_key":"f7f35df24f73","blank":true,"_type":"link","href":"https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-7-9"},{"_key":"0f1c047ee704","blank":true,"_type":"link","href":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/609ade8b5182635e0794137012407eede1478403-979x861.jpg?auto=format"}],"children":[{"_type":"span","marks":[],"text":"Personally, I favor a prototype-based diagnostic approach for every-day clinical work; and a parallel set of “research diagnostic criteria” for investigative purposes (","_key":"8e8f2ea67577"},{"text":"Table 2","_key":"fe1ed015da421","_type":"span","marks":["strong","0f1c047ee704"]},{"_type":"span","marks":[],"text":"","_key":"c5cb85b9d6c1"},{"_type":"span","marks":[],"text":"). “Prototype” diagnosis refers to the use of idealized models or archetypes of disease, rather than either “categorical” or “dimensional” methods of classification. ","_key":"fe1ed015da422"},{"_key":"fe1ed015da423","_type":"span","marks":["f7f35df24f73"],"text":"Phillips and colleagues"},{"_type":"span","marks":["superscript"],"text":"14","_key":"fe1ed015da424"},{"_type":"span","marks":[],"text":" discuss and debate various diagnostic models in a wide-ranging colloquium.","_key":"5edeba76678b"}]},{"style":"normal","_key":"e9bf0e5cde7c","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_key":"ecc53e65abd80","_type":"span","marks":[],"text":"It seems very clear that diagnosis is, and will always remain, a necessary part of clinical care, both in general medicine and psychiatry. When a patient presents with the complaint, “I hear threatening voices in my head,” we simply must"},{"_type":"span","marks":["em"],"text":" diagnose","_key":"ecc53e65abd81"},{"marks":[],"text":"—a word whose etymology means, “knowing the difference between.” For example, we must know the difference between “threatening voices” stemming from combat-related trauma, on the one hand, versus schizophrenia or anti-NMDA receptor encephalitis","_key":"ecc53e65abd82","_type":"span"},{"_type":"span","marks":["superscript"],"text":"15","_key":"06256ee9df73"},{"_type":"span","marks":[],"text":" on the other. Otherwise, our treatment is likely to be misguided.","_key":"85a9f0b3a9f8"}],"_type":"block"},{"medias":null,"uploadAudio":null,"markDefs":[{"_type":"link","href":"https://www.medscape.com/viewarticle/942694#vp_1","_key":"f5e26e0eaf4d","blank":true},{"_type":"link","href":"https://www.psychiatry.org/","_key":"bd7fde28952e"}],"children":[{"text":"No, whatever the lay press claims, DSM-5 is not “The Bible of psychiatry.’ It is not a sacred, eternal, and inviolable text, or even a very sophisticated diagnostic tool. John Talbott, MD, professor emeritus of psychiatry and former president of the ","_key":"d8395e013a6d0","_type":"span","marks":[]},{"_type":"span","marks":["bd7fde28952e"],"text":"American Psychiatric Association","_key":"e732678bba48"},{"_type":"span","marks":[],"text":"","_key":"f3bf0e86f5d9"},{"marks":[],"text":", has ","_key":"39f0b7ec5add","_type":"span"},{"_type":"span","marks":["f5e26e0eaf4d"],"text":"cautioned","_key":"6c71f4e342d6"},{"_key":"01ac73fba028","_type":"span","marks":[],"text":""},{"_type":"span","marks":[],"text":", “If you let the specifics of the DSM tie you down, it prevents you from practicing the art of medicine. So, I would hope people would not be bound by it, but be flexible and use their clinical judgment instead.”","_key":"6d51fa25d22c"},{"_type":"span","marks":["superscript"],"text":"16","_key":"e10d99057a89"}],"_type":"block","style":"normal","_key":"f20428555e02","upload_doc":null},{"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"I agree. But before we use the DSM-5’s text to line our bird cages—as a renowned British psychiatrist I once met described the utility of the DSM-III—we should at least understand what DSM-5 does, and does not, represent.","_key":"85ae6926e9850"}],"_type":"block","style":"normal","_key":"7e515a3586b6","upload_doc":null,"medias":null},{"style":"normal","_key":"353d669181c3","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Pies","_key":"1494743e6aec0"},{"_type":"span","marks":["em"],"text":" is professor emeritus of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University; clinical professor of psychiatry, Tufts University School of Medicine; and editor in chief emeritus of ","_key":"1494743e6aec1"},{"_type":"span","marks":[],"text":"Psychiatric Times","_key":"1494743e6aec2"},{"text":"TM","_key":"1494743e6aec3","_type":"span","marks":["em","superscript"]},{"_key":"81cc63a101b8","_type":"span","marks":["em"],"text":" (2007-2010)."}],"_type":"block"},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"href":"mailto:PTEditor@mmhgroup.com","_key":"b931db2d80b6","blank":true,"_type":"link"}],"children":[{"text":"Let us hear from you!","_key":"f34aa6cd02f60","_type":"span","marks":["strong","em"]},{"_type":"span","marks":["em"],"text":" Share comments with your colleagues by emailing ","_key":"f34aa6cd02f61"},{"_type":"span","marks":["b931db2d80b6","em"],"text":"PTEditor@mmhgroup.com","_key":"f34aa6cd02f62"},{"_type":"span","marks":["em"],"text":". 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","_key":"5248ab0cc9fd0","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"Am J Psychiatry.","_key":"5248ab0cc9fd1"},{"_type":"span","marks":[],"text":" 2013;170(1):59-70.","_key":"5248ab0cc9fd2"}]},{"medias":null,"uploadAudio":null,"markDefs":[{"_type":"link","href":"https://theconversation.com/forget-talking-just-fill-a-script-how-modern-psychiatry-lost-its-mind-9569","_key":"e024b1ca6628","blank":true}],"children":[{"_type":"span","marks":[],"text":"3. Pols H: Forget talking, just fill a script: how modern psychiatry lost its mind. ","_key":"f168f272ee680"},{"_type":"span","marks":["em"],"text":"The Conversation.","_key":"f168f272ee681"},{"_type":"span","marks":[],"text":" October 21, 2012. Accessed March 17, 2021. 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Pies, MD","url":"ronald-w-pies-md"}],"_type":"article","is_visible":true,"summary":"A DSM-5 diagnosis requires a biopsychosocial case formulation—not just a symptom checklist.","timeAgo":115881141.934,"updatedOn":null,"url":"poor-dsm5-so-misunderstood","taxonomyMapping":[{"_rev":"BmvClBuXMtNlljYu6nhdr9","_type":"taxonomy","name":"Couch in Crisis","_id":"pst_taxonomy_55_couchincrisis","_updatedAt":"2020-06-10T19:45:36Z","identifier":"commentary/couch-in-crisis","parent":{"_rev":"CT8kz40NBv9JvHKzAk1arA","_type":"taxonomy","name":"Commentary","_id":"pst_taxonomy_54_commentary","_updatedAt":"2021-10-07T14:44:33Z","parent":null,"identifier":"commentary","_createdAt":"2020-03-26T06:11:21Z"},"_createdAt":"2020-03-26T06:11:21Z"},{"_rev":"IakUcQKwj7kr3xQjaaWRSw","_createdAt":"2020-03-26T06:11:21Z","_type":"taxonomy","identifier":"topics/dsm","perKeywordMapping":["Psychiatry","Neurology"],"parent":null,"_updatedAt":"2024-02-21T20:43:43Z","cmeType":"per","name":"DSM","_id":"pst_taxonomy_58_dsm"},{"_rev":"77mZ7PORfofI3dBGfWfij5","name":"Schizophrenia/Psychosis","_id":"pst_taxonomy_362_schizophreniapsychosis","cmeType":"per","_type":"taxonomy","_updatedAt":"2023-03-31T19:32:05Z","parent":{"identifier":"topics","_createdAt":"2020-03-26T06:11:21Z","parent":null,"_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_rev":"uvXJooXtzvjNOyx50HTt8m","_updatedAt":"2023-03-31T19:15:59Z","isMainTopic":true},"identifier":"topics/schizophrenia","perKeywordMapping":["Psychiatry","Neurology"],"_createdAt":"2020-03-26T06:11:21Z"}],"_rev":"LMsvoO9kT4cTyaW2IgSLub","gptTakeaways":"• DSM-5 requires comprehensive case formulation, integrating social, psychological, and biological factors, beyond mere symptom checklists.\n• Critics' claims of DSM-5's biomedical focus are unfounded; it lacks emphasis on genetics or neurochemistry.\n• DSM-5 acknowledges fluid boundaries between disorders and the influence of cultural norms on defining pathology.\n• Despite its limitations, DSM-5 remains a crucial diagnostic tool, advocating for clinical judgment over strict adherence to its criteria.","published":"2021-03-23T16:00:10.066Z","factCheckAuthors":null,"gptSummary":"The DSM-5 is often misunderstood as a simplistic checklist for psychiatric diagnosis, but it requires a comprehensive case formulation considering biopsychosocial factors. 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Take the quiz and learn more.","seoTag":["Anxiety","Quizzes"],"published":"2018-06-06T22:00:00Z","authorMapping":[{"_ref":"pst_author_329418","_type":"reference","_key":"d977c7c9498ba0a64febeb21472812da"}],"thumbnail":{"_type":"mainImage","asset":{"_type":"reference","_ref":"image-541c2e28bec71c472da7129bd782878350a7c5aa-1080x811-jpg"}},"_rev":"TeM23AriO5FesfXinM3bDx","nodeId":"613686","is_visible":true,"gptSummary":"I'm sorry, but it seems there is no article provided for me to summarize and extract key takeaways from. Could you please provide the text of the article","_id":"pst_poll_613686","factCheckAuthors":null,"updatedOn":null}],"videoData":{}},"queryString":{"slug":["authors","erin-o-brien"]}},"host":"www.psychiatrictimes.com"},"__N_SSP":true},"page":"/[...slug]","query":{"slug":["authors","erin-o-brien"]},"buildId":"9NxASLqZOtjGmsCDs4KHX","isFallback":false,"gssp":true,"appGip":true,"scriptLoader":[]}</script></body></html>

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