Letter to the Wall Street Journal in Response to Sally Satel’s Op-Ed piece by Zvi Lothane.

Sally Satel’s caveats concerning the forthcoming DSM-V, a child of  the current DSM-IV, are well taken. I would like to suggest  further clarifications. Unlike medicine, a clinical discipline  that deals with medical conditions, psychiatry is a hybrid  discipline, not just a cultural institution but a social and  political one as well, dealing with a person’s conduct in society.

Social misconduct has been variously categorized as vice by  philosophers, sin by priests, crime by policemen, and disease by  psychiatrists. Diagnosing social misconduct as psychosis has  serious social consequences: involuntary commitment, involuntary drug treatments, and stigmatization. Psychiatric diagnoses are  also powerful political and economic tools in the marketplace, serving the pharmaceutical and insurance industries. Follow the money: witness the intensity of the current political storm about  the future of the entire health care system.