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Undisclosed financial conflicts of interest in DSM-5 (2024)

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Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#31

Post by mapontosevenths »

tomjakubowski wrote: post #22
mapontosevenths wrote: post #20

Earlier quoted context omitted.

I tried to correct myself above, and included the source this time. The actual statistic I was misremembering says that 50.8% of people will meet the requirements for an Axis 1 or higher diagnoses before the age of 75. You're right that it's important to be accurate. Mea Culpa. To the actual point of my wildly incorrect claim: If most people are judged to be mentally ill at some point in their life, and most of the d…

Most mental health diagnoses are transient. If half of people at some point experience diagnosable mental illness in their lives, that doesn't seem all that outlandish to me. Most of us will, at some point, have some kind of non-psychiatric illness, too.

You, and SketchySeaBeast, both make a good point.

I can't reply to Sketchy anymore (throttled maybe?), but I appreciate you both taking the time to have this conversation today. You've made me think a bit harder about something I've believed for 20+ years, and I think I agree now.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#32

Post by [deleted] »

mapontosevenths wrote: post #20
SketchySeaBeast wrote: post #16

Earlier quoted context omitted.

Ok, so we're on the same page as to what we're referring to, but, to be clear, that 50% claim is incorrect[1], it's much lower than that. Who is claiming that more than 50% of people are "less happy than average"? That's not a disorder. I'm fairly certain that the DSM doesn't make a claim like that, does the APA? It feels straw-manish. I know that it's hard to diagnose these more intangible issues, but they are still…

I tried to correct myself above, and included the source this time. The actual statistic I was misremembering says that 50.8% of people will meet the requirements for an Axis 1 or higher diagnoses before the age of 75. You're right that it's important to be accurate. Mea Culpa. To the actual point of my wildly incorrect claim: If most people are judged to be mentally ill at some point in their life, and most of the d…

[deleted]

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#33

Post by worik »

richgroot wrote: post #13

So these folks are implying that the rework of the DSM-4 into DSM-5 was tainted in some way by association of the authors with pharma or other industries? Do I understand that correctly? Is there an example that anyone has pointed to where DSM-5 could have been written differently, to the detriment of a commercial enterprise? (What little I've read in the DSM-5 is enough to leave one with glazed eyes.)

> So these folks are implying that the rework of the DSM-4 into DSM-5 was tainted in some way by association of the authors with pharma or other industries?

Yes

This has been known to economists for a long time

Medicine generally has had its progress (as a general good) held back by misaligned incentives for a long time

See "neglected tropical diseases"

As true in psychiatry as anything else

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#34

Post by beepbooptheory »

dang wrote: post #27
lazide wrote: post #9

Earlier quoted context omitted.

[flagged]

Please keep nationalistic flamebait off this site. It leads to nationalistic flamewars, which we want to avoid here. https://news.ycombinator.com/newsguidelines.html

Surely this is a mistake dang? It's prima facie absurd and if not that unnecessarily stifling. The thread is already talking about the statistics of America, it's not flamebait to bring that up. One may disagree with op, but who would actually complain about it being added to the discussion itself? Doesn't creating a situation where something like this can't even be said more contribute to an atmosphere of passive aggressiveness than not?

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#35

Post by nemomarx »

mapontosevenths wrote: post #6

Sometime in the early 2000's we passed a point where more than 50% of the population had an AXIS 2 or higher chemical disorder[1]. It was around this point that I became skeptical of the DSM. If the majority of people are crazy, it's likely that our definition of "crazy" needs work. That said, the situation isn't as dire as some folks with a vested interest would have you believe... If you're reading this and you're…

It helps to think of these as clusters of symptoms or personality traits anyone might have, which occasionally interfere on your life enough to need treatment. A lot of mental illnesses aren't like a class of person but something that's happening to a person for a while

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#36

Post by hx8 »

brooke2k wrote: post #29
readthenotes1 wrote: post #14

I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research. I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...

The DSM isn't about understanding how the brain works, it's about correlating sets of symptoms to treatments. If your issues are characterized by this broad set of symptoms, then likely you'll benefit from these sorts of treatments, and etc. We don't have a good understanding of how the brain works, but we're pretty confident that people with schizophrenia often benefit from antipsychotic medications.

In some ways the financial conflicts of interest make sense, because the people that best understand a set of symptoms probably also are the ones in the best position to create new treatments. Being undisclosed makes it feel way more scummy than it might actually be.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#37

Post by nullc »

worik wrote: post #33
richgroot wrote: post #13

So these folks are implying that the rework of the DSM-4 into DSM-5 was tainted in some way by association of the authors with pharma or other industries? Do I understand that correctly? Is there an example that anyone has pointed to where DSM-5 could have been written differently, to the detriment of a commercial enterprise? (What little I've read in the DSM-5 is enough to leave one with glazed eyes.)

> So these folks are implying that the rework of the DSM-4 into DSM-5 was tainted in some way by association of the authors with pharma or other industries? Yes This has been known to economists for a long time Medicine generally has had its progress (as a general good) held back by misaligned incentives for a long time See "neglected tropical diseases" As true in psychiatry as anything else

> As true in psychiatry as anything else

Wouldn't we expect it to be more true the fewer objective measures there are? Like if a treatment is supposed to improve blood sugar, and we can measure blood sugar cheaply in real time... we should expect misaligned incentives to have diminished effect compared to something where there is less ability to objectively measure, such as pretty much anything in psychiatry.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#39

Post by yoshuaw »

readthenotes1 wrote: post #14

I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research. I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...

It's hard to tell honestly. I studied psychology for two years in uni, and I dropped out rather disillusioned about the field. Some of my least favorite aspects included:

  - Acknowledgement by our professors that P-hacking (pruning datasets to get the desired results) was not just common, but rampant

  - One of our classes being thrown in limbo for several months after we found out that a bunch of foundational research underpinning it was entirely made up (See: Diederik Stapel).

  - Experiencing first-hand just how unreproducible most research in our faculty was (SPSS was the norm, R was the exception, Python was unused).

  - Learning that most psychology research is conducted on white psychology students in their early/mid-twenties in the EU and US. But the findings are broadly generalized across populations and cultures.

  - Learning that the DSM-IV classified homosexuality as a mental disorder. Though the DSM-V has since dropped this.
The DSM-V is still incredibly hostile towards trans people through a game of internal power politics and cherry-picked research. It's really bad honestly.

Though I do generally hold psychologists in high regard (therapy is good), I'm not particularly impressed by psychology as a science. And in turn don't necessarily trust the DSM all that much.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#40

Post by allemagne »

worik wrote: post #33
richgroot wrote: post #13

So these folks are implying that the rework of the DSM-4 into DSM-5 was tainted in some way by association of the authors with pharma or other industries? Do I understand that correctly? Is there an example that anyone has pointed to where DSM-5 could have been written differently, to the detriment of a commercial enterprise? (What little I've read in the DSM-5 is enough to leave one with glazed eyes.)

> So these folks are implying that the rework of the DSM-4 into DSM-5 was tainted in some way by association of the authors with pharma or other industries? Yes This has been known to economists for a long time Medicine generally has had its progress (as a general good) held back by misaligned incentives for a long time See "neglected tropical diseases" As true in psychiatry as anything else

The OP did ask that first question, but to me it read as being more rhetorical so that we could maybe get specific answers about what in the DSM-5 would have been written differently otherwise.
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