Are We Thinking Ourselves Sick? (River Page, August 7, 2024, Free Press)
This problem was only made worse in 1980 with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, a sort of psychiatrists’ bible. Before then, psychiatrists had only a paragraph of descriptions of mental illnesses to rely on. In the DSM-III, more detailed criteria were listed. Dr. Edward Shorter, who studies the history of medicine, and appears in the film, says the thinking went something like this: “Well, we’re going to have a set of operational criteria in order to qualify, for example, depression. There are plenty of symptoms you could have. If you can check five boxes and you’ve had these symptoms for two weeks, then you qualify for the diagnosis of depression.”
“This sounds like science,” Shorter says. “In fact, it’s not really.”
Then, in the early ’90s, the DSM-IV updated its autism criteria, allowing, for the first time, individuals without significant language or intellectual incapacities to be diagnosed. Additionally, it lowered the number of traits required for a diagnosis from eight to six.
Last year, Dr. Allen Frances, a world-renowned-psychiatrist who helped loosen the definition of autism for the DSM-IV, told the New York Post he regretted his decision: “More clinicians began labeling both normal diversity and a variety of other psychological problems as autistic.” Dr. Frances estimated that his changes would triple the rate of autism. According to the CDC, it has more than quadrupled since 2000.
It drives business.