Getting ready for DSM-5: Part 1
The process, challenges, and status of constructing the next diagnostic manual
Initial hopes that DSM-5 could represent a paradigm shift toward an etiopathophysiological classification of psychiatric disorders have been tempered by recognition of the limitations of our current neurobiologic understanding of psychiatric disorders. Therefore, the focus for DSM-5 has shifted from validity enhancements to improved clinical utility while building a framework that better lends itself to a future etiopathophysiological nosology.13-18 Whereas dimensional assessments are likely to be added across various diagnostic categories, a primarily categorical nosology will be retained and the proposed criterion changes are relatively modest. The results of our enhanced knowledge about the neurobiologic underpinnings of psychiatric disorders will not be reflected in diagnostic criteria, but in the significant revisions to the DSM text.
Our DSM-5 series
Subsequent articles in this series—which will be published here, at CurrentPsychiatry.com—will discuss specific proposed DSM-5 changes in 13 groups of disorders (Table 2) and their clinical implications. These articles also will address the relationship of DSM to ICD, issues with dimensional classification, and the importance of and challenges in precise diagnostic measurement.
Table 2
DSM-5 Work Groups
| Attention-deficit/hyperactivity disorder and disruptive behaviors |
| Anxiety, obsessive-compulsive, posttraumatic, and dissociative disorders |
| Disorders in childhood and adolescence |
| Eating disorders |
| Mood disorders |
| Neurocognitive disorders |
| Neurodevelopmental disorders |
| Personality and personality disorders |
| Psychotic disorders |
| Sexual and gender identity disorders |
| Sleep-wake disorders |
| Somatic distress disorders |
| Substance-related disorders |
Related Resources
- American Psychiatric Association. DSM-5 Development. www.dsm5.org.
- Black DW, Zimmerman M. Redefining personality disorders: Proposed revisions for DSM-5. Current Psychiatry. 2011;10(9):26-38.
Disclosure
Dr. Tandon is a member of the DSM-5 Psychotic Disorders Work Group. He reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
