The DSM is not the only way to assess patients, and today we speak with Margaret Chisholm

about another model, one that developed at the same time as DSM 3, and takes the famous

manual a few steps further.

Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003. I'm Chris Sagan, the editor-in-chief of the Carlatte Psychiatry podcast, keeping psychiatry honest since 2003.

I'm Chris Hagan, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP, and a dedicated reader of every issue.

Psychiatrists used to pride themselves on rich personal histories, the kind that wove together

a complex pattern of development, life events, inner conflicts, and outer symptoms.

But somewhere along the line, we traded all that for a list of DSM diagnoses.

Maybe it was in the 1980s when insurers threatened to withhold coverage if we didn't submit a medicalized list of diagnoses. Maybe it was in the 1980s when insurers threatened to withhold coverage if we didn't

submit a medicalized list of diagnoses, or the 1990s when industry-sponsored talks started

crowding out the rest of the dialogue with their focus on the diagnoses for which their

drugs were approved.

Or maybe it was when we stopped using psychotherapy as our primary treatment.

But even if you're not practicing psychotherapy, your patients demand a little more.

The psychopharmacology revolution has left many empty-handed.

Only one in three recover fully on an antidepressant. Negative symptoms keep people with schizophrenia from leading full lives, even when they

respond to an antipsychotic. And 30 to 60% of people with bipolar disorder continue to suffer

disabling cognitive problems even after their mood symptoms resolve.

Most patients want us to consider all angles of their problem before jumping to medication,

and they deserve a full account, and taking one builds trust.

Today we're going to introduce you to a method of assessment that does just that.

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