What is the Diagnostic and Statistical Manual of Mental Disorders?

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DSM-5 (previously known as DSM-V) is the planned fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders. It is due for publication in May 2013 and will supersede the DSM-IV which was last revised in 2000.[1] APA has an official development website for posting of draft versions of the DSM-5.[2]

Development of DSM-5

In 1999, a DSM–5 Research Planning Conference; sponsored jointly by APA and the National Institute of Mental Health (NIMH), was held to set the research priorities. Research Planning Work Groups produced “white papers” on the research needed to inform and shape the DSM-V[clarification needed][3] and the resulting work and recommendations were reported in an APA monograph[4] and peer-reviewed literature.[5] There were six workgroups, each focusing on a broad topic: Nomenclature, Neuroscience and Genetics, Developmental Issues and Diagnosis, Personality and Relational Disorders, Mental Disorders and Disability, and Cross-Cultural Issues. Three additional white papers were also due by 2004 concerning gender issues, diagnostic issues in the geriatric population, and mental disorders in infants and young children.[6] The white papers have been followed by a series of conferences to produce recommendations relating to specific disorders and issues, with attendance limited to 25 invited researchers.[6]

On July 23, 2007, the APA announced the task force that will oversee the development of DSM-5. The DSM-5 Task Force consists of 27 members, including a chair and vice chair, who collectively represent research scientists from psychiatry and other disciplines, clinical care providers, and consumer and family advocates. Scientists working on the revision of the DSM have experience in research, clinical care, biology, genetics, statistics, epidemiology, public health, and consumer advocacy. They have interests ranging from cross-cultural medicine and genetics to geriatric issues, ethics and addiction. The APA Board of Trustees required that all task force nominees disclose any competing interests or potentially conflicting relationships with entities that have an interest in psychiatric diagnoses and treatments as a precondition to appointment to the task force. The APA made all task force members’ disclosures available during the announcement of the task force. Several individuals were ruled ineligible for task force appointments due to their competing interests. Future announcements will include naming the workgroups on specific categories of disorders and their research-based recommendations on updating various disorders and definitions.[7]

The DSM-5 field trials included “test-retest reliability” which involved different clinicians doing independent evaluations of the same patient—a new approach to the study of diagnostic reliability.[8]

Owing to criticism over the perceived proliferation of diagnoses in the current edition of the DSM, David Kupfer, M.D., who is the DSM-5 Task Force chair and is shepherding the DSM’s revision, said in an interview: “One of the raps against psychiatry is that you and I are the only two people in the U.S. without a psychiatric diagnosis.”[9]

 

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