Dr. Frances is an American psychiatrist best known for chairing the task force that produced the fourth revision of Diagnostic and Statistical Manual (DSM-IV), that was published in 1994, and for his critique of the current version, DSM-5. He warns that the expanding boundary of psychiatry is causing a diagnostic inflation that is swallowing up normality and that the over-treatment of the “worried well” is distracting attention from the core mission of treating the more severely ill. DSM-5 takes a strong step towards biomedical model in defining disease in psychiatry. However, Frances has said that “psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests”.
Q: What did you want to be when you grew up?
A: Beach bum.
Q: Who is/was your role model?
A: Hundreds of people and none. I most liked people who quietly do their jobs and wanted to be like them.
Q: Tell us about a meaningful moment in your career
A: Seeing my first patients during psychiatric residency. I am still in contact with several of them 50 years later.
Q: If someone asked you to suggest a book to read, what would you recommend?
A: ULYSSES James Joyce
Q: What do you like to do in your down time?
A: Beach bum, read, play with wife and grandkids, reunions with ok friends.
Q: What is your favourite cuisine?
A: Junk food
Q: What is your favourite place in the world?
A: Wherever I am.
Q: Who would you most like to thank, and why?
A: My father- he was very patient, loving, and much wiset than I realized at the time.
Q: What are three things you would change in medicine?
A” Treat people, not tests
Less is more
Reduce medical mistakes
Cut obscene prices in US
Emphasize primary care
Q: How do you want people to remember you?
A: Since it won’t matter to me, whatever memories serve them best. Or none.
Selected (representative) publications
- Frances A. A report card on the utility of psychiatric diagnosis. World Psychiatry. 2016 Feb;15(1):32-3.
- Frances A. Resuscitating the biopsychosocial model. Lancet Psychiatry. 2014 Dec;1(7):496-7.
- Frances A. The new crisis of confidence in psychiatric diagnosis. Ann Intern Med. 2013 Nov 19;159(10):720.
- Schooler NR, Keith SJ, Severe JB, Matthews SM, Bellack AS, Glick ID, et al. Relapse and rehospitalization during maintenance treatment of schizophrenia – The effects of dose reduction and family treatment. Arch Gen Psychiatry 1997; MAY 1997;54(5):453-63.
- Simeon D, Stanley B, Frances A, Mann JJ, Winchel R, Stanley M. Self-Mutilation in Personality-Disorders – Psychological and Biological Correlates. Am J Psychiatry 1992; FEB 1992;149(2):221-6.
- Frances A. The Dsm-Iii Personality-Disorders Section – a Commentary. Am J Psychiatry 1980;137(9):1050-4. (185 citations)