New Framework Proposed for DSM-5

According to a press release today from the The American Psychiatric Association (APA) a new organizational framework has been proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This restructuring of the DSM’s chapters and categories of disorders signals the latest scientific thinking about how various conditions relate to each other and may influence care. The APA is again inviting comment from the public and mental health and other professionals who use the manual for both diagnostic and research purposes.

According to David Kupfer, M.D., chair of the DSM-5 Task Force, “the revisions reflect the knowledge we have gained since the last DSM was published in 1994. They should facilitate more comprehensive diagnosis and treatment approaches for patients and encourage research across diagnostic criteria.”

The changes re-order the existing manual’s 16 chapters based on underlying vulnerabilities as well as symptom characteristics, which currently result in many patients being diagnosed with multiple disorders within and across disorder groups. The chapters are arranged by general categories such as neurodevelopmental, emotional and somatic to reflect the potential commonalities in etiology within larger disorder groups. The manual’s new organization combines certain disorders under more comprehensive chapter headings while breaking others out from their previous categories. One example is obsessive-compulsive disorder (OCD), long considered to be an anxiety-driven disorder. Recent studies have shown that OCD and several related disorders involve distinct neurocircuits, and so they are now listed as a separate grouping—a move that could advance understanding of their root causes.

There are other notable changes. Disorders previously listed under a single rubric of infancy, childhood and adolescence have been integrated into other chapters, in line with the goal of making DSM more developmentally focused. In addition, research findings linking schizophrenia and schizotypal personality disorder into a ―schizophrenia spectrum will be reflected in this next edition.

For more details visit the DSM-5 website
at http://www.dsm5.org