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Proposed DSM-5: Food for Thought
by Monique Johnson, MD, CCMEP
Indeed, it is true. The “bible” used by mental health professionals to diagnose mental illness has reached a new milestone in its evolution. This month, the American Psychiatric Association (APA) announced proposed changes to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and issued a call for public comment on its official DSM-5 website (www.dsm5.org).
Since it was first published in 1952, there have been 5 revisions; the current DSM-IV-TR was published in 2000. DSM-5 is slated for publication in 2013.
| Version |
Year Published |
DSM-I |
1952 |
DSM-II |
1968 |
DSM-III |
1980 |
DSM-IIIR |
1987 |
DSM-IV |
1994 |
DSM-IV-TR |
2000 |
DSM-5 |
2013 (planned) |
Because the goal of the DSM is to offer common language and standard criteria for the classification of mental disorders, the APA estimates that more than 600 global mental health experts and over a decade of revision activities have been devoted to this revision. This has been accomplished through the work of numerous task force members and working group participants who have spent countless hours reviewing epidemiologic data and published literature.
Summary of all proposed revisions for all Axis I disorders is beyond the scope of this article. However, some of the consideration from the working groups for Mood Disorders is outlined below.
The Mood Disorders Working Group
- Recommends that Depressive Disorder Not Otherwise Specified be subdivided and relabeled as Depressive Conditions Not Elsewhere Classified.
- Recommends that certain severity dimensions related to factors that determine treatment outcome be included with each categorical mood diagnosis. At present, an anxiety dimension and a suicide assessment dimension is proposed.
- Is still reviewing whether to propose that Premenstrual Dysphoric Disorder (PMDD) be classified as a separate and distinct disorder from mood disorders or a specifier for mood disorders.
The proposed DSM-5 draft will be available for public comment until April 20th, after which time working group members will incorporate changes based on public comment. Also planned are three phases of field trials that will test some of the proposed diagnostic criteria in real-world clinical settings. The final DSM-5
is slated for publication in 2013.
It is important that mental health professionals recognize that current clinical trials and treatment guidelines have been based on the current DSM-IV. Thus, until the completion of DSM-5, mental health professionals are cautioned regarding changing current practice based on the proposed revision.
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Reference
American Psychiatric Association. APA Announces Draft Diagnostic Criteria for DSM-5 New Proposed Changes Posted for Leading Manual of Mental Disorders. February 10, 2010. [press release]. http://www.dsm5.org/Newsroom/Pages/PressReleases.aspx
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