Allen Frances, MD

Allen Frances is a psychiatrist who blogs at the Huffington Post.

We will never really understand the motivations of mass murderers

Physician

May 2, 2014

After every mass murder, the question everyone asks is why it happened. How could anyone possibly be so violent, or so evil, or so out of control, or so crazy as to engage in the wholesale and indiscriminate killing of a bunch of people who are usually complete strangers?

In some cases, there are longstanding preexisting warning signs: a history of mental illness, substance use, isolation and/or estrangement; the repeated experience …

Sluggish cognitive tempo is a dangerous diagnostic idea

Allen Frances, MD

Conditions

April 23, 2014

Sluggish cognitive tempo may possibly be the very dumbest and most dangerous diagnostic idea I have ever encountered.

And I have seen some beauts during my forty years of shooting down crazy new diagnostic dream lists. The wild suggestions are usually created by “experts” brim full with diagnostic exuberance — sometimes well meaning, sometimes influenced by extensive drug company affiliations — and always ungoverned by simple common sense, a respect for …

We are turning childhood into an illness

Allen Frances, MD

Meds

April 10, 2014

The statistics tell us that our children are getting sicker and sicker. Attention deficit hyperactivity disorder (ADHD) has more than tripled in just 20 years: It is now diagnosed in 11 percent of all kids, and in an astounding 20 percent of teenage boys. Autism is also on a rapid rise. The latest reported rate suggests that it occurs in one in every 68 kids — 20 years ago it …

It is time to re-evaluate ADHD and return to safe practice habits

Allen Frances, MD

Meds

January 13, 2014

Every once in a while a brilliant investigative journalist can get us back on track when we have been led badly astray. I hope that a recent New York Times front page story, “The Selling of Attention Deficit Disorder,” by Alan Schwarz will have that kind of special societal impact.

Schwartz has previously written a series of accurate and hard-hitting articles exposing the over-diagnosis of ADHD and the consequent careless and excessive …

Why psychiatry is handicapped today

Allen Frances, MD

Physician

November 5, 2013

Pinel, the father of modern psychiatry, is famous for liberating his patients from their chains. But he did a whole lot more. Pinel spent long hours listening attentively to each patient’s life story so that he could correlate their life experiences with the onset and course of symptoms.

Pinel got to know his patients well enough to like them as people. When given the choice of joining Napoleon as personal physician …

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Why psychiatry is handicapped today

The degradation prison life can hold for psychiatric patients

Allen Frances, MD

Physician

October 24, 2013

Sexual abuse is shockingly common in the U.S. prison system. A recent survey conducted by the Bureau of Justice Statistics concluded that each year about 200,000 prisoners are victims of coercive sex.

Most of the those abused are psychiatric patients misplaced in prison. They make vulnerable targets — less able to defend themselves and less likely to be believed if they report infractions.

Prisons are clearly not an appropriate or safe place …

The conundrum of forcing treatment on psychiatric patients

Allen Frances, MD

Conditions

October 9, 2013

When is it justified to force treatment on someone?

Some would shout a resounding,impassioned, all inclusive, “Never!” No psychiatric coercion, not ever, not even under the most seemingly urgent of circumstances.

I once put the question to its supreme test — 35 years ago while having dinner with Tom Szasz. Tom was the probably the greatest defender of patient rights since Pinel (the father of modern psychiatry who, two centuries ago, started …

Defeating overtesting: Right sometimes does bring might

Allen Frances, MD

Policy

September 19, 2013

Medical science is making such remarkable progress that soon none of us will be well.
-Aldous Huxley

The recently completed conference, “Preventing Over Diagnosis,” was easily the most important meeting I ever attended. Sponsored by the British Medical Journal, Consumer’s Reports, and Dartmouth and Bond Universities, the goal was to identify the excesses in medical care and to figure out how to correct them.

The evidence is compelling that we in the developed countries …

Use the Internet to create a competitive medical marketplace

Allen Frances, MD

Policy

September 9, 2013

An enemy intent on ruining the U.S. economy and sabotaging our public health could do no better than burden us with our current system of health care. The crushing costs of our health expenditures almost double per person those of other developed countries, with health outcomes that fall somewhere between mediocre and lousy.

There is no single cause for our medical fiasco and no single cure — especially since all solutions …

The voices of schizophrenia: Treatment still has a long ways to go

Allen Frances, MD

Conditions

September 3, 2013

Read the original op-ed from the TED speaker who inspired this post: “Why I Thank the Voices in My Head.”

Eleanor Langdon is an extraordinary woman who has shown remarkable grit and creativity in transforming her disturbing symptoms into useful tools. Hats off to her for finding such a fruitful path to personal recovery and for sharing her techniques and inspiring story so that others may benefit from what she has learned.

There are …

The decision to end a treatment is as important as the one to start it

Allen Frances, MD

Meds

August 22, 2013

We have become a pill popping society. It makes absolutely no sense that 20 percent of our population regularly uses a psychotropic medicine and that the United States has more deaths each year from overdose with prescription drugs than from street drugs.

The causes of excessive medication use are numerous — the diagnostic system is too loose; some doctors are trigger happy in. their prescribing habits; the drug companies have sold …

Why Congress should be responsible to fix mental health

Allen Frances, MD

Physician

July 25, 2013

The past months have been disastrous for mental health. One embarrassment has followed another — leading to a crisis of confidence that is potentially dangerous for those who rely on psychiatric care.

Most damaging were the negative reviews of DSM-5, the new diagnostic manual. It was justly panned for introducing many unsafe and scientifically unsound diagnoses that will worsen the already existing over-treatment of the worried well and the shameful neglect …

Confronting the reality of uncertainty in medicine

Allen Frances, MD

Physician

June 30, 2013

Medical care in the U.S. over-promises and under delivers. It costs about twice as much as in most other developed countries, but compared to them manages to produce only mediocre health outcomes. The profit motive has resulted in badly misallocated resources — too much testing and treatment for people who don’t need it and lousy access for many who do.

The impact of advances in medical science on the delivery of …