Diagnosis in psychiatry -- DSM and its discontents -- Over-diagnosis and overtreatment -- Science, philosophy and diagnosis -- How "major" is major depression? -- The boundaries of bipolarity -- PTSD and trauma -- ADHD and attention -- Personality and personality disorder -- Other disorders in which over-diagnosis is a risk -- Transdiagnostic approaches -- The rise of aggressive psychopharmacology -- How do we know what is normal? -- Where do we go from here?

“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.

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.

A practical guide translating clinical trials findings, across major psychiatric disorders, to devise tailored, evidence-based treatments.

Health at a Glance: Europe 2018 presents comparative analyses of the health status of EU citizens and the performance of the health systems of the 28 EU Member States, 5 candidate countries and 3 EFTA countries.

Thirty years ago, it was estimated that less than five percent of the population had an anxiety disorder. Today, some estimates are over fifty percent, a tenfold increase. Is this dramatic rise evidence of a real medical epidemic?In All We Have to Fear, Allan Horwitz and Jerome Wakefield argue that psychiatry itself has largely generated this "epidemic" by inflating many natural fears into psychiatric disorders, leading to the over-diagnosis of anxiety disorders and the over-prescription of anxiety-reducing drugs. American psychiatry currently identifies disordered anxiety as irrational anxiety disproportionate to a real threat. Horwitz and Wakefield argue, to the contrary, that it can be a perfectly normal part of our nature to fear things that are not at all dangerous--from heights to negative judgments by others to scenes that remind us of past threats (as in some forms of PTSD). Indeed, this book argues strongly against the tendency to call any distressing condition a "mental disorder." To counter this trend, the authors provide an innovative and nuanced way to distinguish between anxiety conditions that are psychiatric disorders and likely require medical treatment and those that are not--the latter including anxieties that seem irrational but are the natural products of evolution. The authors show that many commonly diagnosed "irrational" fears--such as a fear of snakes, strangers, or social evaluation--have evolved over time in response to situations that posed serious risks to humans in the past, but are no longer dangerous today.Drawing on a wide range of disciplines including psychiatry, evolutionary psychology, sociology, anthropology, and history, the book illuminates the nature of anxiety in America, making a major contribution to our understanding of mental health.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Many people consider stopping their psychiatric medications, but prescribers may not know how to do this in a collaborative, systematic way. This book describes the ins and outs of how clinicians can work closely with their patients to consider whether or not to try decreasing medications. It outlines the how and when, and gives recommendations on what the prescriber and patient may encounter along the way.