DSM-5

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
Author	American Psychiatric Association
Language	English
ISBN	978-0-89042-554-1
Pages	947

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, a taxonomic and diagnostic tool published by the American Psychiatric Association (APA). It serves as a key authority for psychiatric diagnoses in the United States, where it influences treatment recommendations and health care provider payments.

History and Development

The DSM-5 was officially published on May 18, 2013, replacing the DSM-IV-TR, which was published in 2000. The process of developing the new edition began with a conference in 1999, followed by the formation of a Task Force in 2007, which developed and field-tested a variety of new classifications.

Notable Changes

While the DSM-5 is not greatly modified from the DSM-IV-TR, there are some significant differences:

• The reconceptualization of Asperger syndrome from a distinct disorder to an autism spectrum disorder.
• The elimination of subtypes of schizophrenia.
• The deletion of the "bereavement exclusion" for depressive disorders.
• The renaming of gender identity disorder to gender dysphoria, along with a revised treatment plan.
• The inclusion of binge eating disorder as a discrete eating disorder.
• The renaming and reconceptualization of paraphilias to paraphilic disorders.
• The removal of the axis system.
• The splitting of disorders not otherwise specified into other specified disorders and unspecified disorders.

Criticism and Controversy

The DSM-5 faced considerable criticism both before and after its formal publication. Critics argued that many DSM-5 revisions or additions lacked empirical support, inter-rater reliability was low for many disorders, and some sections contained poorly written, confusing, or contradictory information. There were also accusations of undue influence from the psychiatric drug industry, and conflicts of interest among work group members, including ties to pharmaceutical companies. A petition signed by numerous mental health organizations called for an external review of the DSM-5.

Impact

The DSM-5's changes had significant implications for diagnosis and treatment, including drug prescriptions and health insurance coverage. For example, the reclassification of Asperger syndrome as part of the autism spectrum could impact service eligibility for individuals previously diagnosed under the separate category.

Future Directions

The APA has described DSM-5 as a "living document" and has established a process for ongoing revision, which will allow for more continuous integration of scientific findings. This marks a departure from the previous static versions and offers an opportunity for more dynamic reflection of the evolving understanding of mental disorders.

See Also

• Diagnostic classification and rating scales used in psychiatry
• ICD-10 Chapter V: Mental and behavioural disorders
• Rosenhan experiment
• The Myth of Mental Illness

References

DSM-5 Resources
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