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The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of ...
'', the
taxonomic Taxonomy (general) is the practice and science of classification of things or concepts, including the principles that underlie such classification. The term may also refer to a specific classification scheme. Originally used only about biological ...
and diagnostic tool published by the
American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest Psychiatry, psychiatric organization in the world. Its some 38,800 members are main ...
(APA). In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by
health care providers A health professional (or healthcare professional) may provide health care Healthcare is the maintenance or improvement of health Health, according to the , is "a state of complete physical, and social and not merely the absence of and " ...
, are often determined by DSM classifications, so the appearance of a new version has practical importance. The DSM-5 is the first DSM to use an
Arabic numeral Arabic numerals are the ten digits: 0, 1, 2, 3, 4, 5, 6, 7, 8 and 9. The term often implies a decimal The decimal numeral system A numeral system (or system of numeration) is a writing system ...

Arabic numeral
instead of a
Roman numeral Roman numerals are a numeral system A numeral system (or system of numeration) is a writing system for expressing numbers; that is, a mathematical notation for representing numbers of a given set, using Numerical digit, digits or other s ...
in its title, as well as the first "
living document A living document, also known as an evergreen document or dynamic document, is a document A document is a writing, written, drawing, drawn, presented, or memorialized representation of thought, often the manifestation of nonfiction, non-ficti ...
" version of a DSM. The DSM-5 is not a major revision of the DSM-IV-TR but there are significant differences. Changes in the DSM-5 include the reconceptualization of
Asperger syndrome Asperger syndrome (AS), also known as Asperger's, is a neurodevelopmental disorder Neurodevelopmental disorders are a group of disorders that affect the development of the nervous system, leading to abnormal brain function which may affe ...
from a distinct disorder to an
autism spectrum disorder The autism spectrum encompasses a range of neurodevelopmental conditions, including autism Autism is a developmental disorder Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve ...
; the elimination of subtypes of
schizophrenia Schizophrenia is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may b ...

schizophrenia
; the deletion of the "bereavement exclusion" for
depressive disorders Mood disorder, also known as mood affective disorders, is a group of conditions where a disturbance in the person's mood (psychology), mood is the main underlying feature. The classification is in the ''Diagnostic and Statistical Manual of Mental ...
; the renaming of ''gender identity disorder'' to ''
gender dysphoria Gender dysphoria (GD) is the distress a person feels due to a mismatch between their gender identity Gender identity is the personal sense of one's own gender Gender is the range of characteristics pertaining to, and differentiating bet ...
''; the inclusion of
binge eating disorder Binge eating disorder (BED) is an eating disorder An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's health, physical or mental health, mental health. Only one eating disorder can be ...
as a discrete eating disorder; the renaming and reconceptualization of ''paraphilias'', now called ''paraphilic disorders''; the removal of the five-axis system; and the splitting of ''disorders not otherwise specified'' into ''other specified disorders'' and ''unspecified disorders''. Many authorities criticized the fifth edition both before and after it was published. Critics assert, for example, that many DSM-5 revisions or additions lack empirical support;
inter-rater reliability In statistics, inter-rater reliability (also called by various similar names, such as inter-rater agreement, inter-rater concordance, inter-observer reliability, and so on) is the degree of agreement among independent observers who rate, code, or ...
is low for many disorders; several sections contain poorly written, confusing, or contradictory information; and the psychiatric drug industry may have unduly influenced the manual's content; many DSM-5 workgroup participants had ties to pharmaceutical companies.


Changes from DSM-IV

The DSM-5 is divided into three sections, using
Roman numerals Roman numerals are a that originated in and remained the usual way of writing numbers throughout Europe well into the . Numbers in this system are represented by combinations of letters from the . Modern style uses seven symbols, each with a ...
to designate each section.


Section I

Section I describes DSM-5 chapter organization, its change from the multiaxial system, and Section III's dimensional assessments. The DSM-5 deleted the chapter that includes "disorders usually first diagnosed in infancy, childhood, or adolescence" opting to list them in other chapters. A note under Anxiety Disorders says that the "sequential order" of at least some DSM-5 chapters has significance that reflects the relationships between diagnoses. The introductory section describes the process of DSM revision, including field trials, public and professional review, and expert review. It states its goal is to harmonize with the ICD systems and share organizational structures as much as is feasible. Concern about the categorical system of diagnosis is expressed, but the conclusion is the reality that alternative definitions for most disorders are scientifically premature. DSM-5 replaces the NOS (
Not Otherwise Specified In medicine, Not Otherwise Specified (NOS) is a subcategory in systems of disease/disorder classification such as List of ICD-9 codes, ICD-9, ICD, ICD-10, or DSM-IV. It is generally used to note the presence of an illness where the symptoms present ...
) categories with two options: ''other specified disorder'' and ''unspecified disorder'' to increase the utility to the clinician. The first allows the clinician to specify the reason that the criteria for a specific disorder are not met; the second allows the clinician the option to forgo specification. DSM-5 has discarded the multiaxial system of diagnosis (formerly Axis I, Axis II, Axis III), listing all disorders in Section II. It has replaced Axis IV with significant psychosocial and contextual features and dropped Axis V (Global Assessment of Functioning, known as GAF). The World Health Organization's (WHO) Disability Assessment Schedule is added to Section III (Emerging measures and models) under Assessment Measures, as a suggested, but not required, method to assess functioning.


Section II: diagnostic criteria and codes


Neurodevelopmental disorders

* "
Mental retardation Intellectual disability (ID), also known as general learning disability and formerly mental retardation (MR),Rosa's Law Rosa's Law is a United States The United States of America (USA), commonly known as the United States (U.S. or US), o ...
" has a new name: " intellectual disability (intellectual developmental disorder)". * Speech or language disorders are now called
communication disorder A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in discourse effectively with others. The delays and disorders can range from simple sound substitution to ...
s—which include
language disorder Language disorders or language impairments are disorders that involve the processing of linguistic information. Problems that may be experienced can involve grammar In linguistics Linguistics is the scientific study of language, mea ...
(formerly
expressive language disorder Expressive language disorder is a communication disorder A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in discourse effectively with others. The delays a ...
and
mixed receptive-expressive language disorder Mixed is the past tense of ''mix''. Mixed may refer to: * Mixed (United Kingdom ethnicity category) Mixed is an ethnicity category that has been used by the United Kingdom The United Kingdom of Great Britain and Northern Ireland, co ...
),
speech sound disorder A speech sound disorder (SSD) is a speech disorder in which some sounds (phonemes) are not produced or used correctly. The term "protracted phonological development" is sometimes preferred when describing children's speech, to emphasize the contin ...
(formerly
phonological disorder Speech disorders or speech impairments are a type of communication disorder where normal Manner of articulation, speech is disrupted. This can mean stuttering, lisp (speech), lisps, etc. Someone who is unable to speak due to a speech disorder is ...
), childhood-onset fluency disorder (
stuttering Stuttering, also known as stammering, is a speech disorder Speech disorders or speech impairments are a type of communication disorder A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or ...
), and a new condition characterized by impaired social verbal and nonverbal communication called
social (pragmatic) communication disorder Social (pragmatic) communication disorder (SPCD) is a disorder where individuals have difficulties with verbal and nonverbal social communication. As well, SPCD lacks behaviors associated with restrictions and repetition. Relates to Pragmatic Lang ...
. *
Autism spectrum disorder The autism spectrum encompasses a range of neurodevelopmental conditions, including autism Autism is a developmental disorder Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve ...
incorporates
Asperger disorder Asperger syndrome (AS), also known as Asperger's, is a neurodevelopmental disorder characterized by significant difficulties in Interpersonal relationships, social interaction and nonverbal communication, along with restricted and repetitive ...
, childhood disintegrative disorder, and
pervasive developmental disorder not otherwise specified A pervasive developmental disorder not otherwise specified (Including atypical autism) (PDD-NOS) is one of the four autistic disorders (AD) in the DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), i ...
(PDD-NOS)—see . * A new sub-category,
motor disorder Motor disorders are disorders of the nervous system In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, mo ...
s, encompasses
developmental coordination disorder Developmental coordination disorder (DCD), also known as developmental motor coordination disorder, developmental dyspraxia or simply dyspraxia, is a neurodevelopmental disorder characterized by impaired Motor planning, coordination of physical m ...
,
stereotypic movement disorder Stereotypic movement disorder (SMD) is a motor disorder with onset in childhood involving restrictive and/or repetitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results i ...
, and the
tic disorder Tic disorders are defined in the ''Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, ...
s including
Tourette syndrome Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder Neurodevelopmental disorders are a group of disorders that affect the development of the nervous system, leading to abnormal ...
. *
Attention deficit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder Neurodevelopmental disorders are a group of disorders that affect the development of the nervous system, leading to abnormal brain function which may affect ...
(ADHD).


Schizophrenia spectrum and other psychotic disorders

* All subtypes of
schizophrenia Schizophrenia is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may b ...

schizophrenia
were removed from the DSM-5 (
paranoid Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concer ...
,
disorganized Chaos theory is an interdisciplinary scientific theory and branch of mathematics focused on underlying patterns and deterministic Scientific law, laws highly sensitive to initial conditions in dynamical systems that were thought to have complet ...
,
catatonic Catatonia is a neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal. The onset of catatonia can be acute or subtle and symptoms can wax, wane, or change during episode ...
, undifferentiated, and residual). * A major mood episode is required for
schizoaffective disorder Schizoaffective disorder (SZA, SZD or SAD) is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functio ...
(for a majority of the disorder's duration after criterion A elated to delusions, hallucinations, disorganized speech or behavior, and negative symptoms such as avolitionis met). * Criteria for
delusional disorder Delusional disorder is a mental illness A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may ...
changed, and it is no longer separate from shared delusional disorder. *
Catatonia Catatonia is a neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal. The onset of catatonia can be acute or subtle and symptoms can wax, wane, or change during episode ...

Catatonia
in all contexts requires 3 of a total of 12 symptoms. Catatonia may be a specifier for depressive, bipolar, and psychotic disorders; part of another medical condition; or of another specified diagnosis.


Bipolar and related disorders

* New specifier "with mixed features" can be applied to
bipolar I disorder Bipolar I disorder (BD-I; pronounced "type one bipolar disorder") is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode Mania, also known as manic syndrome, is a state of abnormally elevated a ...
,
bipolar II disorder Bipolar II disorder is a bipolar spectrum disorder (see also: Bipolar I disorder) characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for bipolar II disorder requires that the individual mus ...
, bipolar disorder NED (not elsewhere defined, previously called "NOS", not otherwise specified) and MDD. * Allows other specified bipolar and related disorder for particular conditions. *
Anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

Anxiety
symptoms are a specifier (called "anxious distress") added to bipolar disorder and to depressive disorders (but are not part of the bipolar diagnostic criteria).


Depressive disorders

* The
bereavement Grief is the response to loss, particularly to the loss of someone or some living thing that has died Death is the permanent, Irreversible process, irreversible cessation of all biological process, biological functions that sustain a ...
exclusion in DSM-IV was removed from depressive disorders in DSM-5. * New
disruptive mood dysregulation disorder Disruptive mood dysregulation disorder (DMDD) is a mental disorder in children and adolescents characterized by a persistently irritable or angry mood and frequent temper outbursts that are disproportionate to the situation and significantly more s ...
(DMDD) for children up to age 18 years. *
Premenstrual dysphoric disorder Premenstrual dysphoric disorder (PMDD) is a severe and disabling form of premenstrual syndrome affecting 1.8–5.8% of menstruating women. Code: 625.4 (N94.3) The disorder consists of a variety of affective, behavioral and somatic symptoms that re ...
moved from an appendix for further study, and became a disorder. * Specifiers were added for mixed symptoms and for anxiety, along with guidance to physicians for suicidality. *The term
dysthymia Dysthymia, also known as persistent depressive disorder (PDD), is a mental Mental may refer to: * of or relating to the mind Films * Mental (2012 film), ''Mental'' (2012 film), an Australian comedy-drama * Mental (2016 film), ''Mental'' (2016 ...
now also would be called persistent depressive disorder.


Anxiety disorders

* For the various forms of
phobia A phobia is a type of anxiety disorder Anxiety disorders are a cluster of mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or i ...
s and
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

anxiety
disorders, DSM-5 removes the requirement that the subject (formerly, over 18 years old) "must recognize that their fear and anxiety are excessive or unreasonable". Also, the duration of at least 6 months now applies to everyone (not only to children). *
Panic attack Panic attacks are sudden periods of intense fear Fear is an intensely unpleasant emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feel ...

Panic attack
became a specifier for all DSM-5 disorders. *
Panic disorder Panic disorder is a mental Mental may refer to: * of or relating to the mind Films * Mental (2012 film), ''Mental'' (2012 film), an Australian comedy-drama * Mental (2016 film), ''Mental'' (2016 film), a Bangladeshi romantic-action movie * ''M ...
and
agoraphobia Agoraphobia is an anxiety disorder Anxiety disorders are a cluster of mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impair ...
became two separate disorders. * Specific types of phobias became specifiers but are otherwise unchanged. * The generalized specifier for
social anxiety disorder Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder Anxiety disorders are a cluster of mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental p ...
(formerly, social phobia) changed in favor of a performance only (i.e., public speaking or performance) specifier. *
Separation anxiety disorder Separation anxiety disorder (SAD) is an anxiety disorder Anxiety disorders are a cluster of mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes signi ...
and
selective mutism Selective mutism (SM) is an anxiety disorder in which a person who is otherwise capable of speech becomes unable to speech, speak when exposed to specific situations, specific places, or to specific people, one or multiple of which serving as Trau ...
are now classified as anxiety disorders (rather than disorders of early onset).


Obsessive-compulsive and related disorders

* A new chapter on obsessive-compulsive and related disorders includes four new disorders: excoriation (skin-picking) disorder, hoarding disorder, substance-/medication-induced obsessive-compulsive and related disorder, and obsessive-compulsive and related disorder due to another medical condition. *
Trichotillomania Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significan ...

Trichotillomania
(hair-pulling disorder) moved from "impulse-control disorders not elsewhere classified" in DSM-IV, to an obsessive-compulsive disorder in DSM-5. * A specifier was expanded (and added to
body dysmorphic disorder Body dysmorphic disorder (BDD), occasionally still called dysmorphophobia, is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress o ...
and hoarding disorder) to allow for good or fair insight, poor insight, and "absent insight/delusional" (i.e., complete conviction that obsessive-compulsive disorder beliefs are true). * Criteria were added to body dysmorphic disorder to describe repetitive behaviors or mental acts that may arise with perceived defects or flaws in physical appearance. * The DSM-IV specifier "with obsessive-compulsive symptoms" moved from anxiety disorders to this new category for obsessive-compulsive and related disorders. * There are two new diagnoses: other specified obsessive-compulsive and related disorder, which can include
body-focused repetitive behavior Body-focused repetitive behavior (BFRB) is an umbrella name for Impulse control disorder, impulse control
disorder (behaviors like nail biting, lip biting, and cheek chewing, other than hair pulling and skin picking) or obsessional jealousy; and unspecified obsessive-compulsive and related disorder.


Trauma- and stressor-related disorders

*
Post traumatic stress disorder Post-traumatic stress disorder (PTSD)Acceptable variants of this term exist; see the '' Terminology'' section in this article. is a mental disorder that one can develop after exposure to a traumatic event, such as sexual assault, warfare, ...
(PTSD) is now included in a new section titled "Trauma- and Stressor-Related Disorders." * The PTSD diagnostic clusters were reorganized and expanded from a total of three clusters to four based on the results of confirmatory factor analytic research conducted since the publication of DSM-IV. * Separate criteria were added for children six years old or younger. * For the diagnosis of
acute stress disorder Acute stress disorder (ASD, also known as acute stress reaction, psychological shock, mental shock, or simply shock) is a psychology, psychological response to a terrifying, psychological trauma, traumatic, or surprising experience. Acute stre ...
and PTSD, the stressor criteria (Criterion A1 in DSM-IV) was modified to some extent. The requirement for specific subjective emotional reactions (Criterion A2 in DSM-IV) was eliminated because it lacked empirical support for its utility and predictive validity. Previously certain groups, such as military personnel involved in combat, law enforcement officers and other first responders, did not meet criterion A2 in DSM-IV because their training prepared them to not react emotionally to traumatic events. * Two new disorders that were formerly subtypes were named:
reactive attachment disorder Reactive attachment disorder (RAD) is described in clinical literature as a severe and relatively uncommon disorder that can affect children.DSM-IV-TR (2000) American Psychiatric Association The American Psychiatric Association (APA) is th ...
and
disinhibited social engagement disorder Disinhibited Social Engagement Disorder (DSED), or Disinhibited Attachment Disorder, is an attachment disorder in which a child has little to no fear of unfamiliar adults and may actively approach them. It can significantly impair young children’ ...
. *
Adjustment disorders Adjustment disorder is a maladaptive response to a psychosocial stressor that occurs when an individual has significant difficulty adjusting to or Coping (psychology), coping with a stressful psychosocial event. The maladaptive response usually i ...
were moved to this new section and reconceptualized as stress-response syndromes. DSM-IV subtypes for depressed mood, anxious symptoms, and disturbed conduct are unchanged.


Dissociative disorders

*
Depersonalization disorder Depersonalization-derealization disorder (DPDR, DPD) is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of person ...
is now called
depersonalization Depersonalization can consist of a detachment within the self, regarding one's mind or body, or being a detached observer of oneself. Subjects feel they have changed and that the world has become vague, dreamlike, less real, lacking in significanc ...
/
derealization Derealization is an alteration in the perception of the external world, causing sufferers to perceive it as unreal, distant, distorted or falsified. Other symptoms include feeling as if one's environment is lacking in spontaneity, emotional colori ...
disorder. *
Dissociative fugue Dissociative fugue (), formerly called a fugue state or psychogenic fugue, is a mental disorder, mental and Abnormal behavior, behavioral Disorder (medicine), disorderDrs; that is nosology, classified variously as a dissociative disorder,Dissoci ...
became a specifier for
dissociative amnesia Psychogenic amnesia or dissociative amnesia is a memory disorderMemory disorders are the result of damage to neuroanatomical structures that hinders the storage, retention and recollection of Memory, memories. Memory disorders can be progressive ...
. * The criteria for
dissociative identity disorder Dissociative identity disorder (DID), previously known as multiple personality disorder (MPD), is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes sig ...

dissociative identity disorder
were expanded to include "possession-form phenomena and functional neurological symptoms". It is made clear that "transitions in identity may be observable by others or self-reported". Criterion B was also modified for people who experience gaps in recall of everyday events (not only trauma).


Somatic symptom and related disorders

*
Somatoform disorder A somatic symptom disorder, formerly known as a somatoform disorder,(2013) Somatization disorder Somatization disorder is a mental Mental may refer to: * of or relating to the mind Films * Mental (2012 film), ''Mental'' (2012 film), an Australian comedy-drama * Mental (2016 film), ''Mental'' (2016 film), a Bangladeshi romantic-action movie ...
and
undifferentiated somatoform disorder Somatization disorder is a mental disorder, mental and Abnormal behavior, behavioral disease#disorder, disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic nervous system, somatic symptoms. It ...
were combined to become
somatic symptom disorder A somatic symptom disorder, formerly known as a somatoform disorder,(2013) conversion disorder Conversion disorder (CD), or functional neurologic symptom disorder, is a diagnostic category used in some psychiatric classification systems. It is sometimes applied to patients who present with neurological Neurology (from el, νεῦρ ...
and
pseudocyesis False pregnancy (or pseudocyesis, from the Greek "false" and "pregnancy") is the appearance of clinical or subclinical signs and symptoms associated with pregnancy although the individual is not physically carrying a baby. The mistaken impressi ...
(false pregnancy). * A new diagnosis is psychological factors affecting other medical conditions. This was formerly found in the DSM-IV chapter "Other Conditions That May Be a Focus of Clinical Attention". * Criteria for
conversion disorder Conversion disorder (CD), or functional neurologic symptom disorder, is a diagnostic category used in some psychiatric classification systems. It is sometimes applied to patients who present with neurological Neurology (from el, νεῦρ ...
(functional neurological symptom disorder) were changed.


Feeding and eating disorders

* Criteria for pica and
rumination disorder Rumination syndrome, or merycism, is a chronic motility disorder characterized by effortless regurgitation (digestion), regurgitation of most meals following consumption, due to the involuntary contraction of the muscles around the abdomen. There i ...
were changed and can now refer to people of any age. *
Binge eating disorder Binge eating disorder (BED) is an eating disorder An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's health, physical or mental health, mental health. Only one eating disorder can be ...
graduated from DSM-IV's "Appendix B -- Criteria Sets and Axes Provided for Further Study" into a proper diagnosis. * Requirements for
bulimia nervosa Bulimia nervosa, also known as simply bulimia, is an eating disorder An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's health, physical or mental health, mental health. Only one eat ...
and binge eating disorder were changed from "at least twice weekly for 6 months" to "at least once weekly over the last 3 months". * The criteria for
anorexia nervosa Anorexia nervosa, often referred to simply as anorexia, is an eating disorder An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's health, physical or mental health, mental health. On ...
were changed; there is no longer a requirement of
amenorrhea Amenorrhea is the absence of a menstrual period The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cyc ...
. * "Feeding disorder of infancy or early childhood", a rarely used diagnosis in DSM-IV, was renamed to
avoidant/restrictive food intake disorder Avoidant/restrictive food intake disorder (ARFID), previously known as feeding disorder, is a type of eating disorder in which people eat only within an extremely narrow repertoire of foods. It is a serious mental health condition that causes the ...
, and criteria were expanded.


Elimination disorders

* No significant changes. * Disorders in this chapter were previously classified under disorders usually first diagnosed in infancy, childhood, or adolescence in DSM-IV. Now it is an independent classification in DSM 5.


Sleep–wake disorders

* "Sleep disorders related to another mental disorder, and sleep disorders related to a general medical condition" were deleted. * Primary insomnia became , and
narcolepsy Narcolepsy is a long-term Long-Term Capital Management L.P. (LTCM) was a hedge fund''A financial History of the United States Volume II: 1970–2001'', Jerry W. Markham, Chapter 5: "Bank Consolidation", M. E. Sharpe, Inc., 2002 based in Green ...
is separate from other hypersomnolence. * There are now three breathing-related sleep disorders: obstructive sleep apnea
hypopnea Hypopnea is overly shallow breathing Breathing (or ventilation) is the process of moving out and in the s to facilitate with the , mostly to flush out and bring in . All aerobic creatures need oxygen for , which uses the oxygen to bre ...
,
central sleep apnea Central sleep apnea (CSA) or central sleep apnea syndrome (CSAS) is a sleep Sleep is a naturally recurring state of mind and body, characterized by altered consciousness Consciousness, at its simplest, is or of internal and exte ...
, and sleep-related
hypoventilation Hypoventilation (also known as respiratory depression) occurs when ventilation (physiology), ventilation is inadequate (''hypo'' meaning "below") to perform needed gas exchange, respiratory gas exchange. By definition it causes an increased conc ...
. * Circadian rhythm sleep–wake disorders were expanded to include
advanced sleep phase syndrome Advanced Sleep Phase Disorder (ASPD), also known as the advanced sleep-phase type (ASPT) of circadian rhythm sleep disorder, is a condition that is characterized by a recurrent pattern of early evening (e.g. 7-9 pm) sleepiness and early morning aw ...
, irregular sleep–wake type, and non-24-hour sleep–wake type.
Jet lag Jet lag is a physiological Physiology (; ) is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is ...
was removed. *
Rapid eye movement sleep behavior disorder Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder A sleep disorder, or somnipathy, is a medical disorder A disease is a particular abnormal condition that negatively affects the structure ...
and
restless legs syndrome Restless legs syndrome (RLS), now known as Willis-Ekbom Disease (WED), is generally a long-term disorder that causes a strong urge to move one's legs. There is often an unpleasant feeling in the legs that improves somewhat by moving them. This i ...
are each a disorder, instead of both being listed under "dyssomnia not otherwise specified" in DSM-IV.


Sexual dysfunctions

* DSM-5 has sex-specific sexual dysfunctions. * For females, sexual desire and arousal disorders are combined into female sexual interest/arousal disorder. * Sexual dysfunctions (except substance-/medication-induced sexual dysfunction) now require a duration of approximately 6 months and more exact severity criteria. * A new diagnosis is genito-pelvic pain/penetration disorder which combines
vaginismus Vaginismus is a condition in which involuntary muscle spasm interferes with vaginal intercourse or other penetration of the vagina. This often results in pain with sex, pain with attempts at sex. Often, it begins when vaginal intercourse is firs ...
and
dyspareunia Dyspareunia ( ) is painful sexual intercourse Sexual intercourse (or coitus or copulation) is a sexual activity Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and expre ...
from DSM-IV. *
Sexual aversion disorder #REDIRECT Hypoactive sexual desire disorder #REDIRECT Hypoactive sexual desire disorder Hypoactive sexual desire disorder (HSDD), hyposexuality or inhibited sexual desire (ISD) is considered a sexual dysfunction and is characterized as a lack or ab ...
was deleted. * Subtypes for all disorders include only "lifelong versus acquired" and "generalized versus situational" (one subtype was deleted from DSM-IV). * Two subtypes were deleted: "sexual dysfunction due to a general medical condition" and "due to psychological versus combined factors".


Gender dysphoria

* DSM-IV
gender identity disorder Gender dysphoria (GD) is the distress a person feels due to a mismatch between their gender identitytheir personal sense of their own genderand their sex assignment, sex assigned at birth.''Sexual Orientation and Gender Expression in Social Work ...
is similar to, but not the same as,
gender dysphoria Gender dysphoria (GD) is the distress a person feels due to a mismatch between their gender identity Gender identity is the personal sense of one's own gender Gender is the range of characteristics pertaining to, and differentiating bet ...
in DSM-5. Separate criteria for children, adolescents and adults that are appropriate for varying developmental states are added. * Subtypes of gender identity disorder based on sexual orientation were deleted. * Among other wording changes, criterion A and criterion B (cross-gender identification, and aversion toward one's gender) were combined. Along with these changes comes the creation of a separate gender dysphoria in children as well as one for adults and adolescents. The grouping has been moved out of the sexual disorders category and into its own. The name change was made in part due to stigmatization of the term "disorder" and the relatively common use of "gender dysphoria" in the GID literature and among specialists in the area. The creation of a specific diagnosis for children reflects the lesser ability of children to have insight into what they are experiencing and ability to express it in the event that they have insight.


Disruptive, impulse-control, and conduct disorders

Some of these disorders were formerly part of the chapter on early diagnosis,
oppositional defiant disorder Oppositional defiant disorder (ODD) is listed in the DSM-5 under ''Disruptive, impulse-control, and conduct disorders'' and defined as "a pattern of angry/irritable Mood (psychology), mood, argumentative/defiant behavior, or vindictiveness". Th ...
;
conduct disorder Conduct disorder (CD) is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features ...
; and
disruptive behavior disorder not otherwise specified Disruption, disruptive, or disrupted may refer to: Business *Creative disruption Creative disruption (disruption concept in a creative context) was introduced in 1992 by TBWA's chairman Jean-Marie Dru. It refers to a radical change in a marke ...
became other specified and unspecified disruptive disorder, impulse-control disorder, and
conduct disorder Conduct disorder (CD) is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features ...
s.
Intermittent explosive disorder Intermittent explosive disorder (sometimes abbreviated as IED) is a behavioral disorder Emotional and behavioral disorders (EBD; also known as behavioral and emotional disorders (ICD-10ICD-10 is the 10th revision of the International Statistical ...
,
pyromania Pyromania is an impulse control disorder Impulse-control disorder (ICD) is a class of psychiatric disorders A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significa ...

pyromania
, and
kleptomania Kleptomania is the inability to resist the urge to steal Steal may refer to: * Theft, the illegal act of Borrowing another person's property without giving it back and without them knowing * The gaining of a stolen base in baseball ** the 2004 ...

kleptomania
moved to this chapter from the DSM-IV chapter "Impulse-Control Disorders Not Otherwise Specified". *
Antisocial personality disorder Antisocial personality disorder (ASPD or infrequently APD) is a personality disorder Personality disorders (PD) are a class of mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavior ...
is listed here ''and'' in the chapter on personality disorders (but
ADHD Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder Neurodevelopmental disorders are a group of disorders that affect the development of the nervous system, leading to abnormal brain function which may affect ...
is listed under neurodevelopmental disorders). * Symptoms for
oppositional defiant disorder Oppositional defiant disorder (ODD) is listed in the DSM-5 under ''Disruptive, impulse-control, and conduct disorders'' and defined as "a pattern of angry/irritable Mood (psychology), mood, argumentative/defiant behavior, or vindictiveness". Th ...
are of three types: angry/irritable mood, argumentative/defiant behavior, and vindictiveness. The conduct disorder exclusion is deleted. The criteria were also changed with a note on frequency requirements and a measure of severity. * Criteria for conduct disorder are unchanged for the most part from DSM-IV. A specifier was added for people with limited "prosocial emotion", showing
callous and unemotional traits Callous and unemotional traits (CU) are distinguished by a persistent pattern of behavior that reflects a disregard for others, and also a lack of empathy Empathy is the capacity to understand or feel what another person is experiencing from ...
. * People over the disorder's minimum age of 6 may be diagnosed with
intermittent explosive disorder Intermittent explosive disorder (sometimes abbreviated as IED) is a behavioral disorder Emotional and behavioral disorders (EBD; also known as behavioral and emotional disorders (ICD-10ICD-10 is the 10th revision of the International Statistical ...
without outbursts of physical aggression. Criteria were added for frequency and to specify "impulsive and/or anger based in nature, and must cause marked distress, cause impairment in occupational or interpersonal functioning, or be associated with negative financial or legal consequences".


Substance-related and addictive disorders

* Gambling disorder and
tobacco use disorder Nicotine dependence is a state of dependence upon nicotine Nicotine is a naturally produced alkaloid Alkaloids are a class of basic BASIC (Beginners' All-purpose Symbolic Instruction Code) is a family of general-purpose, high-level ...
are new. *
Substance abuse Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder Substance-related disorders, also known as substance use disord ...
and
substance dependence Substance dependence, also known as drug dependence, is a biopsychological situation where-by an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance, because of an adaptive state that has develo ...
from DSM-IV-TR have been combined into single substance use disorders specific to each substance of abuse within a new "addictions and related disorders" category. "Recurrent legal problems" was deleted and "craving or a strong desire or urge to use a substance" was added to the criteria. The threshold of the number of criteria that must be met was changed and severity from mild to severe is based on the number of criteria endorsed. Criteria for
cannabis ''Cannabis'' () is a genus Genus /ˈdʒiː.nəs/ (plural genera /ˈdʒen.ər.ə/) is a taxonomic rank In biological classification In biology Biology is the natural science that studies life and living organisms, including ...
and
caffeine Caffeine is a central nervous system The central nervous system (CNS) is the part of the nervous system In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structu ...

caffeine
withdrawal were added. New specifiers were added for early and sustained along with new specifiers for "in a controlled environment" and "on maintenance therapy". There are no more polysubstance diagnoses in DSM-5; the substance(s) must be specified.


Neurocognitive disorders

*
Dementia Dementia manifests as a set of related symptoms, which usually surface when the brain is damaged by injury or disease. The symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or ...
and became major or mild neurocognitive disorder (major NCD, or mild NCD). DSM-5 has a new list of neurocognitive domains. "New separate criteria are now presented" for major or mild NCD due to various conditions. Substance/medication-induced NCD and unspecified NCD are new diagnoses.


Personality disorders

* Personality disorder (PD) previously belonged to a different axis than almost all other disorders, but is now in one axis with all mental and other medical diagnoses. However, the same ten types of personality disorder are retained. * There is a call for the DSM-5 to provide relevant clinical information that is empirically based to conceptualize personality as well as psychopathology in personalities. The issue(s) of heterogeneity of a PD is problematic as well. For example, when determining the criteria for a PD it is possible for two individuals with the same diagnosis to have completely different symptoms that would not necessarily overlap. There is also concern as to which model is better for the DSM - the diagnostic model favored by psychiatrists or the dimensional model that is favored by psychologists. The diagnostic approach/model is one that follows the diagnostic approach of traditional medicine, is more convenient to use in clinical settings, however, it does not capture the intricacies of normal or abnormal personality. The dimensional approach/model is better at showing varied degrees of personality; it places emphasis on the continuum between normal and abnormal, and abnormal as something beyond a threshold whether in unipolar or bipolar cases.


Paraphilic disorders

* New specifiers "in a controlled environment" and "in remission" were added to criteria for all paraphilic disorders. * A distinction is made between paraphilic behaviors, or paraphilias, and paraphilic disorders. All criteria sets were changed to add the word disorder to all of the paraphilias, for example, pedophilic disorder is listed instead of pedophilia. There is no change in the basic diagnostic structure since DSM-III-R; however, people now must meet both qualitative (criterion A) and negative consequences (criterion B) criteria to be diagnosed with a paraphilic disorder. Otherwise they have a paraphilia (and no diagnosis).


Section III: emerging measures and models


Alternative DSM-5 model for personality disorders

An alternative hybrid ''dimensional''-categorical model for personality disorders is included to stimulate further research on this broader classification system.


Conditions for further study

These conditions and criteria are set forth to encourage future research and are not meant for clinical use. * Attenuated psychosis syndrome * Depressive episodes with short-duration hypomania * Persistent complex bereavement disorder * Caffeine use disorder * Video game addiction, Internet gaming disorder * Neurobehavioral disorder associated with prenatal alcohol exposure * Suicidal behavior disorder * Non-suicidal self-injury


Development

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-5 and the resulting work and recommendations were reported in an APA monograph and peer-reviewed literature. 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. 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. On July 23, 2007, the APA announced the task force that would oversee the development of DSM-5. The DSM-5 Task Force consisted 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 had a broad range of experience and interests. 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. The DSM-5 field trials included test-retest reliability which involved different clinicians doing independent evaluations of the same patient—a common approach to the study of diagnostic reliability. About 68% of DSM-5 task-force members and 56% of panel members reported having ties to the pharmaceutical industry, such as holding stock in pharmaceutical companies, serving as consultants to industry, or serving on company boards.


Revisions and updates

Beginning with the fifth edition, it is intended that diagnostic guideline revisions will be added incrementally. The DSM-5 is identified with Arabic numerals, Arabic rather than
Roman numerals Roman numerals are a that originated in and remained the usual way of writing numbers throughout Europe well into the . Numbers in this system are represented by combinations of letters from the . Modern style uses seven symbols, each with a ...
, marking a change in how future updates will be created. Incremental updates will be identified with decimals (DSM-5.1, DSM-5.2, etc.), until a new edition is written. The change reflects the intent of the APA to respond more quickly when a preponderance of research supports a specific change in the manual. The research base of mental disorders is evolving at different rates for different disorders.


Criticism


General

Robert Spitzer (psychiatrist), Robert Spitzer, the head of the DSM-III task force, publicly criticized the APA for mandating that DSM-5 task force members sign a nondisclosure agreement, effectively conducting the whole process in secret: "When I first heard about this agreement, I just went bonkers. Transparency is necessary if the document is to have credibility, and, in time, you're going to have people complaining all over the place that they didn't have the opportunity to challenge anything." Allen Frances, chair of the DSM-IV task force, expressed a similar concern.Psychiatrists Propose Revisions to Diagnosis Manual.
via PBS Newshour, February 10, 2010 (interviews Frances and Alan Schatzberg on some of the main changes proposed to the DSM-5)
Although the APA has since instituted a disclosure policy for DSM-5 task force members, many still believe the association has not gone far enough in its efforts to be transparent and to protect against industry influence. In a 2009 Point/Counterpoint article, Lisa Cosgrove, PhD and Harold J. Bursztajn, MD noted that "the fact that 70% of the task force members have reported direct industry ties—an increase of almost 14% over the percentage of DSM-IV task force members who had industry ties—shows that disclosure policies alone, especially those that rely on an honor system, are not enough and that more specific safeguards are needed". David Kupfer, chair of the DSM-5 task force, and Darrel A. Regier, MD, MPH, vice chair of the task force, whose industry ties are disclosed with those of the task force, countered that "collaborative relationships among government, academia, and industry are vital to the current and future development of pharmacological treatments for mental disorders". They asserted that the development of DSM-5 is the "most inclusive and transparent developmental process in the 60-year history of DSM". The developments to this new version can be viewed on the APA website. During periods of public comment, members of the public could sign up at the DSM-5 website and provide feedback on the various proposed changes. In June 2009, Allen Frances issued strongly worded criticisms of the processes leading to DSM-5 and the risk of "serious, subtle, (...) ubiquitous" and "dangerous" unintended consequences such as new "false 'epidemics'". He writes that "the work on DSM-V has displayed the most unhappy combination of soaring ambition and weak methodology" and is concerned about the task force's "inexplicably closed and secretive process". His and Spitzer's concerns about the contract that the APA drew up for consultants to sign, agreeing not to discuss drafts of the fifth edition beyond the task force and committees, have also been aired and debated. The appointment, in May 2008, of two of the taskforce members, Kenneth Zucker and Ray Blanchard, led to an internet petition to remove them. According to MSNBC, "The petition accuses Zucker of having engaged in 'junk science' and promoting 'hurtful theories' during his career, especially advocating the idea that children who are unambiguously male or female anatomically, but seem confused about their gender identity, can be treated by encouraging gender expression in line with their anatomy." According to ''The Gay City News'', "Dr. Ray Blanchard, a psychiatry professor at the University of Toronto, is deemed offensive for his theories that some types of transsexuality are paraphilias, or sexual urges. In this model, transsexuality is not an essential aspect of the individual, but a misdirected sexual impulse." Blanchard responded, "Naturally, it's very disappointing to me there seems to be so much misinformation about me on the Internet. [They didn't distort] my views, they completely reversed my views." Zucker "rejects the junk-science charge, saying there 'has to be an empirical basis to modify anything' in the DSM. As for hurting people, 'in my own career, my primary motivation in working with children, adolescents and families is to help them with the distress and suffering they are experiencing, whatever the reasons they are having these struggles. I want to help people feel better about themselves, not hurt them.'" In 2011, psychologist Brent Robbins co-authored a national letter for the Society for Humanistic Psychology that brought thousands into the public debate about the DSM. Approximately 13,000 individuals and mental health professionals signed a petition in support of the letter. Thirteen other American Psychological Association divisions endorsed the petition. In a November 2011 article about the debate in the ''San Francisco Chronicle'', Robbins notes that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences. In 2012, a footnote was added to the draft text which explains the distinction between grief and depression. The DSM-5 has been criticized for purportedly saying nothing about the biological underpinnings of mental disorders. A book-long appraisal of the DSM-5, with contributions from philosophers, historians and anthropologists, was published in 2015. The financial association of DSM-5 panel members with industry continues to be a concern for financial conflict of interest. Of the DSM-5 task force members, 69% report having ties to the pharmaceutical industry, an increase from the 57% of DSM-IV task force members. A 2015 essay from an Australian university criticized the DSM-5 for having poor cultural diversity, stating that recent work done in cognitive sciences and cognitive anthropology is still only accepting western psychology as the norm. DSM-5 includes a section on how to conduct a "cultural formulation interview", which gives information about how a person’s Culture, cultural identity may be affecting expression of signs and symptoms. The goal is to make more reliable and valid diagnoses for Mental disorder, disorders subject to significant cultural variation.


Borderline personality disorder controversy

In 2003, the Treatment and Research Advancements National Association for Personality Disorders (TARA-APD) campaigned to change the name and designation of borderline personality disorder in DSM-5. The paper ''How Advocacy is Bringing BPD into the Light'' reported that "the name BPD is confusing, imparts no relevant or descriptive information, and reinforces existing Social stigma, stigma." Instead, it proposed the name "emotional regulation disorder" or "emotional dysregulation disorder." There was also discussion about changing borderline personality disorder, an Axis II diagnosis (personality disorders and mental retardation), to an Axis I diagnosis (clinical disorders). The TARA-APD recommendations do not appear to have affected the American Psychiatric Association, the publisher of the DSM. As noted above, the DSM-5 does not employ a multi-axial diagnostic scheme, therefore the distinction between Axis I and II disorders no longer exists in the DSM nosology. The name, the diagnostic criteria for, and description of, borderline personality disorder remain largely unchanged from DSM-IV-TR.


British Psychological Society response

The British Psychological Society stated in its June 2011 response to DSM-5 draft versions, that it had "more concerns than plaudits". It criticized proposed diagnoses as "clearly based largely on social norms, with 'symptoms' that all rely on subjective judgements... not value-free, but rather reflect[ing] current normative social expectations", noting doubts over the reliability, validity, and value of existing criteria, that personality disorders were not normed on the general population, and that "not otherwise specified" categories covered a "huge" 30% of all personality disorders. It also expressed a major concern that "clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences... which demand helping responses, but which do not reflect illnesses so much as normal individual variation". The Society suggested as its primary specific recommendation, a change from using "diagnostic frameworks" to a description based on an individual's specific experienced problems, and that mental disorders are better explored as part of a spectrum shared with normality (behavior), normality: Many of the same criticisms also led to the development of the Hierarchical Taxonomy of Psychopathology, an alternative, dimensional framework for classifying mental disorders.


National Institute of Mental Health

National Institute of Mental Health director Thomas R. Insel, MD, wrote in an April 29, 2013 blog post about the DSM-5: Insel also discussed an NIMH effort to develop a new classification system, Research Domain Criteria (RDoC), currently for research purposes only. Insel's post sparked a flurry of reaction, some of which might be termed sensationalism, sensationalistic, with headlines such as "Goodbye to the DSM-V", "Federal institute for mental health abandons controversial 'bible' of psychiatry", "National Institute of Mental Health abandoning the DSM", and "Psychiatry divided as mental health 'bible' denounced". Other responses provided a more nuanced analysis of the NIMH Director's post. In May 2013, Insel, on behalf of NIMH, issued a joint statement with Jeffrey Lieberman, Jeffrey A. Lieberman, MD, president of the American Psychiatric Association, that emphasized that DSM-5 "... represents the best information currently available for clinical diagnosis of mental disorders. Patients, families, and insurers can be confident that effective treatments are available and that the DSM is the key resource for delivering the best available care. The National Institute of Mental Health (NIMH) has not changed its position on DSM-5." Insel and Lieberman say that DSM-5 and RDoC "represent complementary, not competing, frameworks" for characterizing diseases and disorders. However, epistemologists of psychiatry tend to see the RDoC project as a putative revolutionary system that in the long run will try to replace the DSM, its expected early effect being a liberalization of the research criteria, with an increasing number of research centers adopting the RDoC definitions.Aragona M. (2014
Epistemological reflections about the crisis of the DSM-5 and the revolutionary potential of the RDoC project
Dialogues in Philosophy, Mental and Neuro Sciences 7: 11-20


See also

* ''
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of ...
'' *ICD-10


References


External links

* * {{DEFAULTSORT:Diagnostic And Statistical Manual Of Mental Disorders Diagnostic and Statistical Manual of Mental Disorders it:Manuale diagnostico e statistico dei disturbi mentali#DSM-5