The scientific validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM) has come under increasing attack from medical professionals and scientific experts such as Herb Kutchins of California State University and Stuart A. Kirk of UCLA, who found that there is ample reason to conclude that the latest versions of DSM as a clinical tool are unreliable and therefore of questionable validity as a classification system.

Often tagged junk science, according to an international poll of mental health experts conducted in England in 2001, the DSM-IV was voted one of the 10 worst psychiatric papers of the millennium.

The truth is when we try to fit psychiatry into the definition of a true science, it fails the test. The lack of science behind the DSM gives a clear idea of why it has earned such critics as the following small sample.

Loren Mosher, M.D., Clinical Professor of Psychiatry: DSM-IV is the fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than scientific document... DSM-IV has become a bible and a money making bestsellerits major failings notwithstanding. It confines and defines practice, some take it seriously, others more realistically.

And, It is the way to get paid. Diagnostic reliability is easy to attain for research projects. The issue is what do the categories tell us? Do they in fact accurately represent the person with a problem? They don't, and can't, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder.

Margaret Hagen, author of Whores Of The Court, summarily dismisses the DSM: Given their farcical empirical procedures for arriving at new disorders with their associated symptoms lists, where does the American Psychiatric Association get off claiming a scientific, research-based foundation for its diagnostic manual? This is nothing more than science by decree. They say it is science, so it is. 

Dr. Thomas Dorman, internist and member of the Royal College of Physicians of the United Kingdom: In short, the whole business of creating psychiatric categories of disease, formalizing them with consensus, and subsequently ascribing diagnostic codes to them, which in turn leads to their use for insurance billing, is nothing but an extended racket furnishing psychiatry a pseudo-scientific aura. The perpetrators are, of course, feeding at the public trough.

Jeffrey A. Schaler, Ph.D.: The notion of scientific validity, though not an act, is related to fraud. Validity refers to the extent to which something represents or measures what it purports to represent or measure. When diagnostic measures do not represent what they purport to represent, we say that the measures lack validity. If a business transaction or trade rested on such a lack of validity, we might say that the lack of validity was instrumental in a commitment of fraud. The Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association and used by licensed psychotherapists throughout the country is notorious for low scientific validity. Yet it is instrumental in securing insurance reimbursement for psychotherapy services.... 

Herb Kutchins of California State University, Sacramento, and Stuart A. Kirk of the University of California, Los Angeles, authors of Making Us Crazy: The Psychiatric Bible and the Creation of Mental Disorders:

The developers of DSM assume that if a group of psychiatrists agree on a list of atypical [new] behaviors, the behaviors constitute a valid mental disorder. Using this approach, creating mental disorders can become a parlor game in which clusters of all kinds of behaviors (i.e. syndromes) can be added to the manual.

there is ample reason to conclude that the latest versions of DSM as a clinical tool are unreliable and therefore of questionable validity as a classification system.

There are indeed many illusions about DSM and very strong needs among its developers to believe that their dreams of scientific excellence and utility have come true. The bitter medicine is that DSM has unsuccessfully attempted to medicalize too many human troubles.

[DSM] cannot be used to distinguish mental disorders from other human problems. In practical terms, this means that many people who do not have any mental disorder (although they may have other difficulties) will be inappropriately labeled as mentally ill and those who have a mental disorder will not have it recognizedIf the unreliability of diagnosis were widely recognized and if there were no scientific patina [surface appearance] to it, the use of everyday behaviors as indicators of mental disorder would be more rigorously questioned by the public. The illusion that psychiatrists are in agreement when making diagnoses creates the appearance of a united professional consensus.

Professor Edward Shorter, author of A History of Psychiatry: Rather than heading off into the brave new world of science, DSM-IV-style psychiatry seemed in some ways to be heading out into the desert.

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