It's often called the psychiatrist's bible. Now changes to the diagnostic and statistical manual are causing controversy. Critics say we are already over-diagnosing psychiatric patients.
Among those worried is the co-author of the last version of the manual, Dr. Alan Francis is his name. His new book is called Saving Normal. Dr. Francis, I like the title. Good to see you.
Good to have you here. Thank you for having me. What are you most concerned about?
We have a terrible paradox in our country. We're over-treating people who are basically well, the word well. At the same time, we're shamefully neglecting psychiatric patients who are really well.
sick. We have 1 million psychiatric patients in prisons. The prison system now is the biggest caregiver for psychiatric patients. At the same time people are basically normal, are getting all kinds of medicine.
that they don't need, that makes them worse, and it's a terrible drain on the economy. Give specific examples. How are we over-diagnosing and what kind of drugs are we giving that you say we shouldn't be?
Well, what's really terrible is attention deficit disorder. 20% of high school boys in America would get this diagnosis. 10% would be on medication. And it turns out, an amazing Canadian study, the best predictor of attention deficit disorder is when you're born.
If you're born in December as opposed to January, it doubles. the risk. The youngest kids in the class, the youngest kids in the class are being diagnosed with ADD and given medicine.
We should be spending the money on the school systems, we should have smaller classes, phys ed. Are the diagnosis being done too quickly in your opinion? Oh wow.
What do you mean? The average diagnosis now is being given by a primary care doctor, not by a psychiatrist. The average visit, seven minutes. Seven?
Yeah. A diagnosis can change your whole life. It can be a wonderful moment for the future or a terrible moment you wouldn't buy a house you wouldn't buy a car after the cursory why is it happening a lot of it's the drug companies that the diagnostic systems way too loose and at the same time the drug companies are able to exploit it and with advertising to people which can't be done anywhere else in the world except the United States and New Zealand direct advertising to consumers has convinced people that many problems in life are really mental disorders. They're caused by chemical imbalances and the solutions of pill.
And that's really nonsense. Most problems that people present with to a primary care doctor will get better on their own. Yeah. With time, resilience, and support.
So we shouldn't be making diagnoses real fast. We should be doing this in a thoughtful way. It's a life-changing decision. Thank you, Dr. Francis.
The name of the book is called Saving Normal. It's on sale where you like to buy your books.