Authors of Bogus Letter Asking for Removal of Dissociative Disorders from DSM Dance Together Around a Maypole

Recently a bogus letter was written to the head of the DSM V Committee, David Kupfer MD, by several psychiatrists, arguing that Dissociative Identity Disorder (DID) should be removed from the DSM. Here is the letter:

Letter asking for removal of DID from DSM

They didn’t have any solid reason to ask for this, other than the fact that they thought it was an “embarassment to psychiatry.” Here is their argument:

Due to the assumption that trauma is a primary etiological factor, the DID diagnosis has resulted in wrongful accusations of sexual abuse on the basis of recovered memories, not only in North America but throughout the developed world (references). DID has caused mockery of psychiatry, and, for patients, has led to misdiagnosis (13) and inadequate treatment of depression (14) [not only depression, but other disorders that it’s distracted attention away from; also, this reference seems rather thin to make a strong statement on. Perhaps it would be better not to reference this, but simply assert that treatable causes of problems are missed when the DID diagnosis is applied].

They conclude

There are overwhelming reasons to question the validity of Dissociative Identity Disorder. We respectfully urge you as members of the Work Group and the Task Force to drop the category of dissociative disorders from the upcoming DSM-V because it is scientifically unjustified, clinically harmful to patients and their families, and it undermines the credibility of psychiatry.

 

Signed:

1.     Paul R. McHugh, M.D. Distinguished Service Professor of Psychiatry at Johns Hopkins University.

2.     Harrison Pope, Jr., MD, MPH, Professor of Psychiatry, Harvard Medical School, Boston, Massachusetts; Director, Biological Psychiatry Laboratory, McLean Hospital, Belmont Massachusetts 

3.     James Hudson, MD, ScD, Professor of Psychiatry, Harvard Medical School, Boston, Massachusetts; Director, Biological Psychiatry Laboratory, McLean Hospital, Belmont Massachusetts 

4.     Elizabeth Loftus, PhD, Distinguished Professor, University of California-Irvine.

5.     Richard J. McNally, Ph.D., Professor and Director of Clinical Training, Department of Psychology, Harvard University, Cambridge, MA.

6.     Harold Merskey, DM, FRCP, FRCPC, FRCPsych., Professor Emeritus of Psychiatry.

7.     Joel Paris, M.D. (M.B., B.Ch.)

8.     August Piper, M.D., independent practice of psychiatry, Seattle, WA.

9.     Numan Gharaibeh, MD (MB, BCh), Principal Psychiatrist, Western Connecticut Mental Health Network, Danbury, CT.

10. Pamela Freyd, Ph.D.

11. Brian Boffi, MD, Principal Psychiatrist, Western Connecticut Mental Health Network, Torrington, Torrington, CT.

12. Alexander Miano, M.D.

13. Joanne Iurato, PhD, Clinical Director, Western Connecticut Mental Health Network, Danbury, CT.

14. Donna Pellerin, M.D., Medical Director of Inpatient Services, Danbury Hospital, Danbury, CT.

15.  Jennifer Ballew, DO, Principal Psychiatrist, Western Connecticut Mental Health Network, Waterbury, CT

The letter includes references to papers written by themselves which are mere opinion pieces, with no reference to actual research studies, such as our paper showing smaller amygdala volume and hippocampal volume on MRI in women with childhood sexual abuse and the diagnosis of DID. They make silly references to popular movies about DID and claim that embarrassment about over dramatization of the disorder should be the basis for changing psychiatric nosology.

The leader of their merry band is Paul McHugh, MD, former Chair of Psychiatry at Johns Hopkins Medical School, who got the job because they hate all things behavioral there, and would hire only someone who would trash his own, and who was once described as an “evil leprechaun”.

Dr Paul McHugh debates lolcat.

The letter is a shoddy piece that says “we think this is so, therefore make these changes,” exactly the kind of thing that irks me about the whole DSM process, and led us to form the Shadow Team and to square off against the authors of a special issue of Journal of Anxiety questioning the validity of the PTSD diagnosis.

We’re not gonna take it.

The group that wrote the letter includes people who have profited by working as expert witnesses on behalf of parents accused in courts of childhood abuse, but make no disclosure of that fact. I am not sure who they think they are protecting, but I surely wouldn’t want to have one of them as my psychiatrist or psychologist. This anti-trauma bias of the DSM is why we formed the DSM Shadow Team in the first place. Head of the DSM committee, David Kupfer MD, has said that he wants to cut down on the number of psychiatric diagnoses in DSM V. He also simply skipped forming a committee to review the Dissociative Disorders. So which of the diagnoses is he going to drop? It certainly isn’t going to be any of the one generating billions of dollars for the pharmaceutical industry, like major depression.

Since they don’t seem to have anything better to do, and it is a spring day, I thought I would let them dance around the Maypole together for a while.

From L to R: Numan Gharaibeh MD, August Piper MD, Pamela Freyd PhD, Joel Paris MD, Joanne Iurato PhD, Elizabeth Loftus PhD, Donna Pellerin MD (in front), Harold Merskey MD, Richard McNally PhD, James Hudson MD, Harrison Pope MD (in front), Paul McHugh MD (green hat) (not included in picture) Brian Boffi MD, Alexander Miano MD, Jennifer Ballew DO