Published DSM-5 Field Trial Results Prompt Renewed Criticism

Nov 14, 2012

Publication of the final results of the field trials for the upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has prompted renewed criticism from one of its most vocal critics.

Preliminary results, which were first unveiled last May at the American Psychiatric Association’s (APA’s) 2012 Annual Meeting and were reported by Medscape Medical News at that time, were published online October 30 in 3 separate articles in the American Journal of Psychiatry.

The DSM-5 field trials, which got underway 2 years ago this month, were designed to subject proposed diagnostic criteria for the future DSM-5 to “rigorous, empirically sound evaluation across diverse clinical settings,” David J. Kupfer, MD, chair of the DSM-5 Task Force, and Helena C. Kraemer, PhD, DSM-5 Task Force member and the chief methodologist of the field trials, noted in a joint statement sent to Medscape Medical News.

“And now, as the first comprehensive analyses of that effort are published, what’s clear is just how well the field trials did their job,” they added.

But Allen Frances, MD, former head of the DSM-IV Task Force, who was has been one of the DSM-5’s greatest detractors, has a different view.

The DSM-5 field trials “asked the wrong question and then answered it with a poorly designed and sloppily conducted study. The right question was what would be the impact of DSM-5 on diagnostic inflation and the consequent risk of overtreatment with medication,” Dr. Frances, who is professor emeritus from the Department of Psychiatry at Duke University School of Medicine in Durham, North Carolina, told Medscape Medical News.

–Megan Brooks,

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