The much-anticipated 5th edition of the reference manual mental health professionals use to classify and diagnose mental disorders — called the Diagnostic and Statistical Manual of Mental Disorders — was officially released today. The DSM-5, as it’s called, was published today after a 14 year revision process.
The manual is published by the American Psychiatric Association (APA).
The process included the analysis of hundreds of research studies published in the past two decades by multi-disciplinary, disorder-based workgroups. Then drafts of the proposed manual were published three times, resulting in over 13,000 comments, emails and letters from other researchers, clinicians and the public.
James Scully, Jr., MD, CEO of the APA, suggested that the DSM-5 will be a “critical guidebook for clinicians.”
“The manual is first and foremost a guidebook for clinicians,” reiterated David Kupfer, M.D., DSM-5 task force chair, who noted that the overall number of disorders remains largely the same as what appeared in the DSM-IV, the prior edition of the book. The number has stayed largely the same because new disorders have been offset by the combining or removing old, outdated disorders.
Details of the biggest changes made in the DSM-5 were first reported by us earlier today in a blog entry.
New disorders added since the publication of the DSM-IV nearly 19 years ago include Disruptive Mood Dysregulation Disorder (formerly known by clinicians as childhood bipolar disorder), mild neurocognitive disorder, binge eating disorder and premenstrual dysphoric disorder. The latter two were first suggested in the DSM-IV, and were formally recognized as disorders by the DSM-5.
Childhood bipolar disorder has been recognized by some pediatric clinicians and researchers for over a decade. The DSM workgroup, however, decided that using a new term to describe this cluster of symptoms was more appropriate. Disruptive mood dysregulation is characterized by a child or teen under age 18 who exhibits persistent irritability and frequent episodes of extreme, out-of-control behaviors that cause significant distress in the child or teen.
Mild neurocognitive disorder was added to recognize the neurodegenerative decline witnessed by many clinicians who wanted to help their patients, but had no diagnosis to give people who were beginning to experience out-of-the-ordinary memory problems associated with aging. Since normal aging is not associated with memory or cognition problems, the new diagnosis appears to fill the gap between such problems and full-blown dementia (now called Major Neurocognitive Disorder).
Other changes include a difference in how attention deficit hyperactivity disorder (ADHD) is diagnosed in adults, and the merging of four disorders into the single label, Autism Spectrum Disorder. This last change was a significant re-labeling of well-known disorders such as Asperger’s syndrome, and lesser-known disorders: childhood disintegrative disorder and pervasive developmental disorder not otherwise specified.
Last, the multi-axial system of the DSM-IV was jettisoned due to a lack of research demonstrating any meaningful diagnostic distinctions between Axis I and Axis II disorders.
While some critics contend the new edition of the DSM will result in significant changes in how mental disorders are diagnosed in the U.S., they have failed to produce much research data to support their contentions.
With little research producing reliable biomarkers or laboratory tests for mental disorders, the DSM-5 remains the most reliable diagnostic system that is empirically-based.
Source: American Psychiatric Association