If you’ve ever read an article about mental health or looked into the symptoms of a particular mental health condition, you’ve probably come across the DSM.

But what is the DSM exactly, and what does DSM-5 mean?

DSM-5 is short for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

This is a reference handbook that the American Psychiatric Association (APA) publishes. It gathers the input and expertise of more than 160 mental health clinicians and researchers from all over the world.

The DSM-5 is a tool and reference guide for mental health clinicians to diagnose, classify, and identify mental health conditions.

It now lists 157 mental disorders with symptoms, criteria, risk factors, culture and gender-related features, and other important diagnostic information.

The DSM does not include treatment guidelines.

The DSM also includes “specifiers.” These are extensions to the formal diagnoses that specify one or more particular features like onset or severity. A diagnosis can have one or more specifiers to make it more precise.

In other words, because a mental health condition doesn’t always present itself in the same way, a DSM specifier can better describe particular scenarios.

For example, a person may receive a diagnosis of bipolar disorder. If they also experience catatonia during mood episodes, their diagnosis would read “bipolar disorder, recurrent with catatonic features.”

Work began on the DSM-5 around the year 2000 and it was released in 2013.

The DSM-5 is 947 pages and costs about $210 for a hardcover copy.

It took more than 13 years to update and finalize the book’s fifth edition. There likely won’t be a DSM-6 before a lot of work goes into identifying and reframing some of the conditions still being studied.

The DSM-5 is organized into three sections and an appendix.

Section II of the DSM is the lengthiest because it lists all of the mental health conditions.

Here are the DSM sections:

Section I: DSM-5 Basics

This section includes an “Introduction” and “Use of the Manual” chapters, as well as a “Cautionary Statement for Forensic Use of DSM-5” chapter.

Section II: Diagnostic Criteria and Codes

This section includes classifications and definitions of mental health disorders.

These conditions are organized alphabetically and developmentally, with all childhood conditions listed before adult on-set conditions.

Section III: Emerging Measures and Models

This section comprises chapters that discuss applying the newest mental health information — for example, assessment measures and how to account for cultural influences.

It also includes newer conditions that require further study before entering the general diagnostic classification — for example, persistent complex bereavement disorder, caffeine use disorder, and internet gaming disorder.

Appendix

The final section contains supplemental information such as a list of changes from the DSM-4 to the DSM-5, a glossary of technical terms, and a list of DSM-5 advisors.

The first edition of the DSM was published in 1952 following an increased need to classify and define mental conditions, especially in veterans returning home after World War II.

The DSM was created to catalog mental health conditions similar to its counterpart, the International Classification of Disease (ICD).

The ICD is published by the World Health Organization (WHO) and catalogs both physical and mental conditions.

The DSM-II was released in 1968 and focused on broadening terms and definitions from the original DSM to diagnose mental health conditions better.

The biggest shift in the history of the DSM came as a result of the DSM-III, published in 1980.

This edition listed 265 categories — a big increase from 182 in the previous edition. This jump was due to an expansion of disorder subtypes, which allowed for more accurate classifications and options for a diagnosis.

The DSM-III also saw the removal of “homosexualityas a mental condition category.

The DSM-III would later receive an update and be revised and renamed in 1987 as the DSM-III-R.

The next edition, the DSM-IV, was published in 1994 and was created alongside the WHO’s International Classification of Disease, 10th edition. This aimed to decrease inconsistencies in terminology between the two manuals.

The DSM-IV would see one final revision in 2000, named the DSM-IV-TR before the DSM-5 was released in 2013.

One of the biggest changes in the DSM-5 is the removal of the multiaxial assessment system to categorize diagnoses.

This evaluation method was based on multiple factors, specifically five “axes”:

  • clinical disorders
  • personality disorders
  • general medical disorders
  • psychosocial and environmental factors
  • global assessment of functioning

The system was removed and replaced with a streamlined diagnostic method that combines axes I, II, and III into 1.

Additional changes in the DSM-5 include broadening the definitions to clarify certain conditions.

For example, the diagnostic label autism spectrum disorder now comprises four previously separate conditions:

  • autistic disorder
  • Asperger’s disorder
  • childhood disintegrative disorder
  • pervasive developmental disorder

Major changes in the DSM-5

Below are links to explore additional updates and changes to the DSM-5:

The DSM-5 offers an extensive list of conditions and symptoms that can aid mental health professionals in reaching accurate diagnoses.

The manual has come a long way since its first edition and now provides diagnostic criteria for 192 mental health conditions.

The fifth edition will surely not be the last. The DSM is a living document that continues to change over time as we learn more about the human brain.