DSM and DSM-5
6DSM and DSM-5
Throughout the history of medicine, there has been a need to classify mental disorders. It was not until recently that there were agreements on the disorders to be included and the most favorable method to organize them. There were various classification systems that were developed and applied over the years and they differed when it came to the relative emphasis on the etiology, phenomenology as well as course of the main defining features.
Diagnostic and Statistical Manual of mental disorders (DSM) sets out to offer a common language as well as a standard criteria when it comes to the classification of mental disorders (American Psychiatric Association, 2013, American Psychiatric Association 1994). The history of DSM dates back to the period of world war II since the US psychiatrist were greatly involved in the processing, selection assessment as well as in the treatment of the soldiers. DSM has developed through three major phases (Kawa & Giordano, 2012). The first phase encompassed the formulation as well as the release of the first and the following second edition. The second phase entails the period that is rather revolutionary that is, the DSM-III while the third phase of development is termed as the post-DSM-III to the present. In this period, the DSM-IV in addition to the DSM-IV Text-revised editions was released (Kawan & Giordano, 2012).
There are a number of changes that have occurred in DSM 5 that are in a way different from DSM-IV-R. One of such changes relates to the change in terminology. In this regard, terms such as NOS (Not Otherwise Specified) have been eliminated in the diagnosis within the categories and the term general medical condition has been replaced with another medical condition just to mention a few of them (Wittchen, Beesdo & Gloster 2009, Wittchen 2011). Another major change is that, the number of examples used has been added to the criterion with the aim of facilitating the application across the lifespan (Saxena et al., 2012). Additionally, the subtypes have been replaced and DSM 5 is now making use of presentation specifies that tend to map directly with the preceding subtypes. In relation to the organizational structure, DSM-5 is divided into three major sections and this division is done through the use of Roman numbers so as to designate each of the sections. For example, section I and section II (Demazeux & Singy, 2015). Additionally, section III also has a section termed as condition for further study. It includes those aspects that were determined that there is no scientific evidence to support their clinical use. The table below shows the complete listing of the chapters in DSM-5
A major reason as to why DSM-5 may be better than DSM-IV-R is that, it tends to have more stringent derivation of some improved methods, for example, diagnostic instruments (Phillips, First & Pincus, 2003). Another reason is that, DSM-5 to some extent unified research and at the same time demystified stigmatization concept that was mainly associated with mental disorders (Friedman et al., 2011). A reason as to why DSM-5 may not be better than DSM-IV-R is that DSM-5 has a lot of controversy and this has been a major blow to its credibility and at the same time, the public has lost faith in the effectiveness and reliability of psychiatry. This concept can be attributed to the idea that DMS-5 made use of unsafe and unsound scientific new diagnoses which may have harmful and unintended consequences. Additionally, DSM-5 has little central direction when it comes to the work group and also in relation to insufficient quality control (Thomason, 2014).
It is clearly evident that DSM has evolved and changed a lot over the years to the current version which is DSM-5. The criticism associated with DSM-5 need to be solved with the aim of improving the public opinions of the psychiatry and also to enhance it applicability and reliability in various situations.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders. Washington: American Psychiatric Association.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Publishing.
Demazeux, S. & Singy, P. (2015). The DSM-5 in Perspective: Philosophical Reflections on the Psychiatric Babel. Berlin: Springer.
Friedman, M. J.; Resick, P. A.; Bryant, R. A.; Strain, J.; Horowitz, M. & Spiegel, D. (2011). Classification of trauma and stressor-related disorders in DSM-5. Depression and Anxiety
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Kawa, S. & Giordano, J. (2012). A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: Issues and Implications for the future of psychiatric canon and practice. World Psychiatry, 7 (2).
Phillips, K., First, M., & Pincus, H. (2003). Advancing DSM: Dilemmas in Psychiatric Diagnosis. Arlington, American Psychiatric Press.
Saxena, S., Esparza, P., Regier, D., Saraceno, B. & Sartorius N. (2012). Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders: Refining the Research Agenda for DSM-5 and ICD-11. Arlington, American Psychiatric Press.
Thomason, T. C. (2014). Criticisms, benefits, and limitations of the DSM-5. Arizona Counseling Journal, 30.
Wittchen H-U, Jacobi J, Rehm J, et al. (2011). The size and burden of mental disorders and other disorders of the brain in Europe. European Neuropsychology pharmacology, 21, 655–679.
Wittchen, H-U., Beesdo, K. & Gloster A (2009). A new meta-structure of mental disorders: helpful step into the future or harmful step back into the past? Psychology Med, 39, 2083–2089.