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How much is the DSM-5 worth?

The cover of the soon-to-be-released DSM-5.

Controversy has dogged the new DSM-5, what people like to call "the psychiatrist's bible," and it won’t even be officially released until this weekend.

Really, the book is a manual clinicians use to diagnose and classify people with mental illness.

While it sounds pretty dry, there’s a whole lotta drama around this book.

The federal government has questioned its value...some practitioners are boycotting it and there are charges that it’s not ready for prime time.  

Before I say anything more about the DSM-5, here are a couple of facts about the DSM IV.

It's 19 years old and it still brings in about$4-5 million a year.

It appears to meet a need for many, many people,” says Dr. James Scully who is CEO and medical director of the American Psychiatric Association – which publishes the manual.

And he says with 150,000 pre-orders the DSM-5 is a hot seller.

“We may do a second printing more quickly than we originally thought,” says Scully.

At $199 dollars for the hardcover, $149 for paperback — that’s more than $20 million in sales right there.

It cost the APA $25 million to produce the book. The DSM is so popular because it’s widely considered the book for doctors to define and diagnose mental illness in the United States.

“The DSM franchise has become enormously profitable publishing enterprise,” says Dr. Allen Frances who chaired the team that created the DSM-IV.

Frances is now a DSM critic with a book of his own, ‘Saving Normal.’

He’s concerned the latest manual includes new diagnosis that will drive up healthcare costs.  

Frances also charges that financial pressures – like dwindling membership - are forcing the APA to treat the DSM like a cash cow, not a public trust.

“I don’t think they are doing it for their own personal gain. But I think the association placed a lot of pressure working on DSM 5 to get it out before its time,” he says.   

Scully says the APA stands by its book.

“If we were doing this just to make money, we would do it more often than every 19 years,” says Scully.

Some doctors are boycotting the book. Others just don’t see a need to buy it.

Sandra Steingard is the medical director at a community mental health center in Burlington, Vermont.

“My advice to the agency is I don’t think that’s where our resources are best served,” says Steingard.

The APA doesn’t have much reason to worry right now.

The DSM-5 has been on Amazon’s Top 100 best seller list for more than a month. Today, it’s number 8.

About the author

Dan Gorenstein is the senior reporter for Marketplace’s Health Desk. You can follow him on Twitter @dmgorenstein.

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