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APA Announces Draft Diagnostic Criteria for DSM-5 ARLINGTON, Va -- February 10, 2010 -- The American Psychiatric Association (APA) today released the proposed draft diagnostic criteria for the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM). “These draft criteria represent a decade of work by the APA in reviewing and revising DSM,” said APA President Alan Schatzberg, MD. “But it is important to note that DSM-5 is still very much a work in progress -- and these proposed revisions are by no means final.” The proposed diagnostic criteria will be available for public comment until April 20, and will be reviewed and refined over the next 2 years. During this time, the APA will conduct 3 phases of field trials to test some of the proposed diagnostic criteria in real-world clinical settings. Members of 13 work groups, representing different categories of psychiatric diagnoses, have reviewed a wide body of scientific research in the field and consulted with a number of expert advisors to arrive at their proposed revisions to DSM. Among the draft revisions are the following: · The recommendation of new categories for learning disorders and a single diagnostic category, “autism spectrum disorders” that will incorporate the current diagnoses of autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder (not otherwise specified). Work group members have also recommended that the diagnostic term “mental retardation” be changed to “intellectual disability,” bringing the DSM criteria into alignment with terminology used by other disciplines. · Eliminating the current categories substance abuse and dependence, replacing them with the new category “addiction and related disorders.” This will include substance use disorders, with each drug identified in its own category. · Eliminating the category of dependence will better differentiate between the compulsive drug-seeking behaviour of addiction and normal responses of tolerance and withdrawal that some patients experience when using prescribed medications that affect the central nervous system. · Creating a new category of “behavioural addictions,” in which gambling will be the sole disorder. · New suicide scales for adults and adolescents to help clinicians identify those individuals most at risk, with a goal of enhancing interventions across a broad range of mental disorders; the scales include research-based criteria such as impulsive behavior and heavy drinking in teens. · Consideration of a new “risk syndromes” category, with information to help clinicians identify earlier stages of some serious mental disorders, such as neurocognitive disorder and psychosis. · A proposed new diagnostic category, temper dysregulation with dysphoria (TDD), within the Mood Disorders section of the manual. · New recognition of binge eating disorder and improved criteria for anorexia nervosa and bulimia nervosa, as well as recommended changes in the definitions of some eating disorders now described as beginning in infancy and childhood to emphasise that they may also develop in older individuals. In addition to proposed changes to specific diagnostic criteria, the APA is proposing that “dimensional assessments” be added to diagnostic evaluations of mental disorders. These would permit clinicians to evaluate the severity of symptoms, as well as take into account “cross-cutting” symptoms that exist across a number of different diagnoses (such as insomnia or anxiety). “We know that anxiety is often associated with depression, for example, but the current DSM doesn’t have a good system for capturing symptoms that don’t fit neatly into a single diagnosis, said David Kupfer, MD, chair of the DSM-5 Task Force. “Dimensional assessments represent an important benefit for clinicians evaluating and treating patients with mental illness. It may help them better evaluate how a patient is improving with treatment, help them address symptoms that affect a patient’s quality of life and better assess patients whose symptoms may not yet be severe -- leading to earlier effective treatment.” Based on the upcoming comments to the draft criteria and findings of the field trials, the work groups will propose final revisions to the diagnostic criteria in 2012. The final draft of DSM-5 will be submitted to the APA’s Assembly and Board of Trustees for their review and approval. A release of the final, approved DSM-5 is expected in May 2013. SOURCE: American Psychiatric Association E-mail this page to a friend or colleague! To print, use this version