DSM-5

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DSM-5 is the abbreviation for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM ; English for "Diagnostic and Statistical Guide to Mental Disorders"). The DSM is the dominant psychiatric classification system in the USA and plays a central role in the definition of mental illness . The DSM-5 is published by the American Psychiatric Society (APA) and has been the currently valid edition that is binding for psychiatric diagnostics since May 2013.

For a disorder to be classified as a mental disorder according to DSM-5 , it must be permanent or recurring . The symptoms must also not be related to a drug or medication and must be clinically meaningful to cause suffering or impairment in social, professional, or other important functional areas. Normal grief and socially deviant behavior (in the political, sexual or religious sense) are not to be rated as psychological disorders (see also the basics of the DSM ).

development

Work on the DSM-5 began in 1999. From 2000, Darrel Regier was the APA's Research Director, responsible for coordinating the preparatory work. It has had its own website since 2004. The DSM-5 working group has been headed by David Kupfer since 2006; Darrel Regier is his deputy. Since 2007, working groups (so-called task forces ) have met regularly on the various diagnostic categories. In addition, the research results of numerous conferences and congresses were incorporated.

Close coordination with the ICD-11 was also planned from the start of development . The final version was finally published in May 2013, replacing the DSM-IV from 1994.

construction

The current DSM-5 is divided into the following categories:

  1. Disorders of neural and mental development
  2. Schizophrenia Spectrum and Other Psychotic Disorders
  3. Bipolar and Allied Disorders
  4. Depressive disorders
  5. Anxiety disorders
  6. Obsessive-Compulsive Disorder and Related Disorders
  7. Trauma and stress related disorders
  8. Dissociative disorders
  9. Somatic stress disorder and related disorders
  10. Feeding and eating disorders
  11. Elimination disorders
  12. Sleep-wake disorders
  13. Sexual dysfunction
  14. Gender dysphoria
  15. Disruptive, impulse control, and behavioral disorders
  16. Disorders related to psychotropic substances and dependent behaviors
  17. Neurocognitive Disorders (NCD)
  18. Personality disorders
  19. Paraphilic disorders
  20. Other mental disorders
  21. Drug-Induced Movement Disorders and Other Unwanted Drug Effects
  22. Other clinically relevant problems

Changes

Changes in the DSM-5 affect e.g. B .:

  • Abandonment of the old multiaxial system
  • stricter criteria for an ADHD diagnosis
  • Introducing a new dimensional alternative model for personality disorders
  • Deletion of the division of schizophrenia into various sub-forms that has been common for decades
  • Asperger's Syndrome is deleted as a standalone diagnosis and now falls under Autism Spectrum Disorders
  • Reshaping the classification of depressive and bipolar disorders
  • Revision of the addiction chapter (integration of addictions under the addiction disorders) and a classification of the diagnoses as "mild", "medium" or "severe"
  • New diagnoses such as binge eating , premenstrual dysphoric disorder, disruptive mood dysregulation disorder, and compulsive hoarding .
  • However, number of diagnostic categories reduced from 172 (DSM-IV) to 157 (DSM-5)

The following are still no diagnoses: burnout syndrome , complex post-traumatic stress disorder and internet addiction .

criticism

The number of diseases and disorders listed in the DSM has increased steadily from 106 (DSM-I) to 374 (DSM-5).

This could u. a. This is because many of the diagnoses newly included in the DSM-5 may not have been scientifically verified enough and the threshold values ​​for older diagnoses have been lowered. A study by the University of Massachusetts Boston found that 69% of DSM-5 employees had links to the pharmaceutical industry; in the working group on mood disorders it was 83% and in the authors responsible for sleep disorders it was 100%.

Due to the possibility of diagnosing any behavioral problem as a “mild” disorder, critics fear an inflation of diagnoses, which those affected could then stick to for life. The most prominent critic is the American psychiatrist Allen Frances , the former chairman of the DSM-IV commission. The National Institute of Mental Health (NIMH), headed by Thomas Insel, also criticizes the DSM-5 for a lack of validity , although it recognizes its high reliability as a strength.

literature

  • Peter Falkai, Hans-Ulrich Wittchen (Ed.): Diagnostic and statistical manual of mental disorders DSM-5 . 1st edition. Hogrefe, Göttingen 2015, ISBN 978-3-8017-2599-0 .

Web links

Individual evidence

  1. ↑ a b DSM: History of the Manual. American Psychiatric Association, 2014, accessed June 10, 2017 .
  2. ↑ Peter Falkai, Hans-Ulrich Wittchen (ed.): Diagnostic and statistical manual of mental disorders DSM-5 . Hogrefe, 2015, ISBN 978-3-8017-2599-0 , pp. 26-27 .
  3. ↑ DSM-5: The Future of Psychiatric Diagnosis ( Memento January 30, 2013 in the Internet Archive ) - official DSM-5 development website
  4. ↑ Markus Jäger (2015): Current psychiatric diagnostics . Chapter 2.5 - Overview of psychiatric diagnostics in the DSM-5 (p. 38). Thieme publishing house. ISBN 978-3-13-200531-0 .
  5. ↑ Eva Asselmann, Hamburg Chamber of Psychotherapists (2014): DSM-5 - Significant innovations and implications for ICD-11 (slide 10).
  6. ↑ Anna M. Ehret (2013): DSM-IV and DSM-5: What has actually changed? (Review) . In: behavior therapy . tape 23 , no. 4 , p. 258-266 , doi : 10.1159 / 000356537 ( karger.com [PDF]).
  7. ↑ James Davies: Cracked: Why Psychiatry is Doing More Harm Than Good . Icon Books, London 2013.
  8. ↑ Allen Frances: Psychologists Start Petition Against DSM 5. Psychology Today , accessed January 23, 2017 .
  9. ↑ http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001190
  10. ^ Alenka Tschischka: Hotly discussed: DSM-V . In: report psychologie . tape 38 , no. 5 , 2013, p. 214 .
  11. ↑ «We have turned the immaturity of children into illness». derbund.ch, January 4, 2014, accessed on January 20, 2015 .
  12. ↑ Frank Jacobi, Wolfgang Maier, Andreas Heinz: Diagnostic and Statistical Manual Of Mental Disorders: Help on the indication . In: Ärzteblatt . Volume 110, No. 49 , 2013 ( online [PDF; accessed January 20, 2015]).
  13. ↑ Thomas Insel: Director's Blog: Transforming Diagnosis. National Institute of Mental Health, April 29, 2013, accessed on June 11, 2017 (English): “The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" - each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. "