I have been writing about the DSM process which isn’t always easy to do because the head of DSM-5, David Kupfer, MD, runs a pretty tight ship with his committee members, making them sign confidentiality agreements and not take any notes. Well since he said that there would be a “paradigm shift” and the sky is the limit for coming up with new diagnoses, there has been a lot of interest in the process.

David Kupfer, MD, Head of DSM-5
I recently wrote about the editorial by Allen Frances MD, head of DSM-4, criticizing the current process of DSM-5, and now there is a nasty response from the DSM-5 group, authored by Alan Schatzberg MD, James Scully MD, David Kupfer MD, and David Regier MD, that psychiatry blogger Daniel Carlat MD offered to edit for them to make it more respectful. Lol. A blogger offering to help the leaders of academic psychiatry tone down their language. Lol again.
I mean the damn editorial hasn’t even been published yet.
In their response to Frances Kupfer et al make dubious claims that “attorneys” had advised them to have committee members sign confidentiality agreements to protect “intellectual property”. They also charge Frances (as well as Robert Spitzer MD, who founded DSM and has been making the email rounds with criticism of the current process) with greed in wanting to retain royalties from a book he wrote about DSM-4 which would become outdated after the release of DSM-5. I mean anyone in the business knows that book royalties pale in comparison to the hundreds of thousands of dollars to be had doing pharmaceutical industry consulting and speaking. In fact one could even argue that doing things like editing books (which have essentially no revenue, because hardly anyone buys them) is a feather in the cap that helps you get those more lucrative gigs.
One of the diagnoses on the table is Female Sexual Dysfunction (FSD), a “disease” that if accepted would surely drive the drug companies to “identify and treat” these poor lassies with drugs like the testosterone patch (see “Wow A Drug To Have Sex Once More a Month? Sign Me Up!“) or Viagra or whatever psychotropic they could drug out of the medicine cabinet.
Turns out the medicalizing women’s sexuality may not be such a good idea. There is a long and jaded history of evil meddling by medical doctors in this area. The publication of the book Feminine Forever, whose thesis was that post-menopausal women become shriveled asexual crones due to an estrogen deficiency led doctors to put an entire generation of post-menopausal women on hormone replacement therapy (HRT), which in turn was later found to have caused tens of thousands of deaths from heart attack and other problems.
Then there were Masters & Johnson, the famous sex research team who concluded that women had more frequent orgasms than men.

Masters & Johnson on Meet the Press
This “research” however was based on looking through peep holes at brothels, and later their “research sessions” they conducted with each other. Virginia Johnson was Dr. William Masters secretary, and they “partnered” to have sex on a nightly basis for “research” purposes for years. Their report on 67 patients with unwanted homosexuality showing a 70% conversion to heterosexuality using “conversion therapy” was later disclosed as a fraud when noone could find any evidence of the patients. This bizarre “research team” should hardly be taken seriously about women’s orgasms.
Turns out that the DSM-4 has ‘Female Hypoactive Sexual Desire Disorder’ and ‘Female Hypo Orgasmic Disorder’ (I mean did the guy try going down on her?) as well as Dyspaerunia (painful sex). As a recent editorial pointed out, maybe the 43% of women with some type of so-called sexual dysfunction are acting “appropriately”.
I mean, maybe they’re with jerks and don’t feel like doing it?
The American Journal of Psychiatry has been soliciting editorials on the DSM-5 process. Too bad they rejected the editorial by Robert Spitzer MD who founded the DSM, and for FSD they have only this lame piece by a trio of MDs whose pharma disclosures read like a phone book. Lol. Sort of.
Ray Moynihan had a good piece in bmj on FSD (“FSD: The Making of a Disease”) in which he outlines how industry has moved in a serious way to pour cash in the “research and education” of this newly minted disorder, the rife conflicts of interest in the field, and the attempt by drug companies to medicalize female sexuality.