Description
What’s New in DSM-5? A Quick Guide
Many changes occurred from DSM-IV to DSM-5. Here is a sum-mary of some of the most important revisions. Many of these changes are highlighted in the “Thinking Critically about DSM-5” boxes throughout this edition.
• The chapters of the DSM have been re-organized to reflect a consideration of developmental and lifespan issues. Disorders that are thought to reflect developmental perturbations or that manifest early in life (e.g., neurodevelopmental disorders and disorders such as schizophrenia) are listed before disorders that occur later in life.
• The multiaxial system has been abandoned. No distinction is now made between Axis I and Axis II disorders.
• DSM-5 allows for more gender-related differences to be taken into consideration for mental health problems.
• It is extremely important for the clinician to understand the client’s cultural background in appraising mental health prob-lems. DSM-5 contains a structured interview that focuses upon the patient’s cultural background and characteristic approach to problems.
• The term intellectual disability is now used instead of the term mental retardation.
• A new diagnosis of autism spectrum disorder now encompasses autism, Asperger’s disorder, and other forms of pervasive devel-opmental disorder. The diagnosis of Asperger’s disorder has been eliminated from the DSM.
• Changes to the diagnostic criteria for attention deficit disorder now mean that symptoms that occur before age 12 (rather than age 7) have diagnostic significance.
• A new diagnosis, called disruptive mood regulation disorder, has been added. This will be used to diagnose children up to age 18 who show persistent irritability and frequent episodes of extreme and uncontrolled behavior.
• The subtypes of schizophrenia have been eliminated.
• The special significance afforded to bizarre delusions with regard to the diagnosis of schizophrenia has been removed.
• Bipolar and related disorders are now described in a separate chapter of the DSM and are no longer listed with depressive disorders.
• Premenstrual dysphoric disorder has been promoted from the appendix of DSM-IV and is now listed as a new diagnosis.
• A new diagnosis of persistent depressive disorder now sub-sumes dysthymia and chronic major depressive disorder.
• The bereavement exclusion has been removed in the diagnosis of major depressive episode.
• The diagnosis of phobia no longer requires that the person rec-ognize that his or her anxiety is unreasonable.
• Panic disorder and agoraphobia have been unlinked and are now separate diagnoses in DSM-5.
• Obsessive-compulsive disorder is no longer classified as an anxiety disorder. DSM-5 contains a new chapter that covers obsessive compulsive and related disorders.
• New disorders in the obsessive compulsive and related disor-ders category include hoarding disorder and excoriation
(skin picking) disorder.
• Post-traumatic stress disorder is no longer considered to be an anxiety disorder. Instead, it is listed in a new chapter that cov-ers trauma- and stressor-related disorders.
• The diagnostic criteria for post-traumatic stress disorder have been significantly revised. The definition of what counts as
a traumatic event has been clarified and made more explicit. DSM-5 now also recognizes four-symptom clusters rather than the three noted in DSM-IV.
• Dissociative fugue is no longer listed as a separate diagnosis. Instead, it is listed as a form of dissociative amnesia.
• The DSM-IV diagnoses of hypochondriasis, somatoform dis-order, and pain disorder have been removed and are now sub-sumed into the new diagnosis of somatic symptom disorder.
• Binge eating disorder has been moved from the appendix of DSM-IV and is now listed as an official diagnosis.
• The frequency of binge eating and purging episodes has been reduced for the diagnosis of bulimia nervosa.
• Amenorrhea is no longer required for the diagnosis of anorexia nervosa.
• The DSM-IV diagnoses of dementia and amnestic disorder have been eliminated and are now subsumed into a new cat-egory called major neurocognitive disorder.
• Mild neurocognitive disorder has been added as a new diagnosis.
• No changes have been made to the diagnostic criteria for per-sonality disorders.
• Substance-related disorders are divided into two separate groups: substance use disorders and substance-induced disorders.
• A new disorder, gambling disorder, has been included in substance-related and addictive disorders.
• Included for the first time in Section III of DSM-5 are several new disorders regarded as being in need of further study. These include attenuated psychosis syndrome, non-suicidal self-injury disorder, Internet gaming disorder, and caffeine use disorder.