What is the DSM, and what changes have recently occurred to it?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals as the authoritative guide to the diagnosis of mental disorders.

The American Psychiatric Association announced that this updated edition of the Diagnostic and Statistical Manual of Mental Disorders incorporates significant scientific advances in more precisely identifying and diagnosing mental disorders.

What was the reason behind changing the DSM from the IV-RT to the DSM-5?

DSM-5 represents an opportunity to better integrate neuroscience and the wealth of findings from neuroimaging, genetics, and cognitive research that have emerged over the past several decades, all of which are vital to diagnosis and treatment.

DSM-5 criteria are intended to facilitate an objective assessment of symptom presentations in a variety of clinical settings, including inpatient, outpatient, partial hospital, consultation-liaison, clinical, private practice, and primary care.

How is the DSM-5 thought to be better than the DSM-IV (1994) and DSM-IV-TR (2000)?

DSM-5 has better reliability. In addition, the DSM-5 accommodates a dimensional approach to mental disorders, recognizing that many mental disorders are on a spectrum with related disorders that have shared symptoms. Disorders are organized on a developmental and lifespan basis. There is a chapter on cultural formation which shapes the experience and expression of symptoms.

How will the DSM-5 be helpful to clinicians?

The DSM-5 provides a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the research of mental disorders. In addition, it establishes a common language for researchers to study the criteria for potential future revisions and to aid in the development of medications and other interventions.

DSM-5 will also be helpful in measuring the effectiveness of treatment, as dimensional assessments will assist clinicians in assessing changes in severity levels as a response to treatment.

The DSM-5 changes should also assist researchers in their work and clinicians in their daily practice, not only mental health professionals, but primary care physicians and the medical specialists who commonly assess depression and other problems following events such as heart attacks, trauma or childbirth.

How will the DSM-5 assist clinicians with diagnosing?

DSM-5 is the most comprehensive, current, and critical resource for clinical practice available to today’s mental health clinicians and researchers of all orientations.

Many of the changes in DSM-5 were made to better characterize symptoms and behaviors of groups of people who are currently seeking clinical help but whose symptoms were not well defined by DSM-IV-TR.

The hope is that by more accurately defining disorders, diagnosis and clinical care will be improved and new research will be facilitated to further our understanding of mental disorders.

What are some of the changes represented in the DSM-5?

One of the significant changes in the DSM-5 is the developmental approach and examination of disorders across the lifespan, including children and older adults.

Though the DSM-5 has approximately the same number of conditions as the DSM-IV-TR, some conditions are now grouped together as syndromes because the symptoms are not sufficiently distinct to separate the disorders. Others have been split apart into distinct groups.

The multiaxial system is no longer required to make a mental disorder diagnosis.  The DSM-5 has incorporated a nonaxial documentation of diagnosis, previously listed as Axes I, II, & III, and utilizes separate notations form important psychosocial and contextual factors, previously listed as Axis IV, and disability, which were listed previously in Axis V.

Are the chapters organized in a specific manner?

Yes, DSM-5 has 20 chapters that are structured based on the disorder’s relatedness to one another, as reflected by the similarities in the disorders’ underlying vulnerability and symptom characteristics.

Why was the traditional Roman numeral dropped from DSM?

This change reflects APA’s intention to make future revision processes more responsive to breakthroughs in research with incremental updates until a new edition is required. Since the research base of mental disorders is evolving at different rates for different disorders, diagnostic guidelines will not be tied to a static publication date but rather to scientific advances. These incremental updates will be identified with decimals, i.e. DSM-5.1, DSM-5.2, etc., until a new edition is required.

What is the relationship between DSM and the World Health Organization’s International Classification of Disease?

DSM-5 and the ICD should be thought of as companion publications. DSM-5 contains the most up-to-date criteria for diagnosing mental disorders, along with extensive descriptive text, providing a common language for clinicians to communicate about their patients. The ICD contains the code numbers used in DSM-5 and all of medicine, needed for insurance reimbursement and for monitoring of morbidity and mortality statistics by national and international health agencies.

Where can I learn More About DSM-5 and the Impact it Will Have on the EPPP?

There are a number of places where you can read more about the DSM-5 and its impact on the EPPP. The American Psychiatric Association has a page of resources about the DSM-5, including a PDF outlining the primary changes from DSM-IV. We also have a number of resources on this blog detailing the impact that the changes in DSM-5 will have on the EPPP. These resources include the following:


Leave a comment