DSM-5 Diagnostic and Statistical Manual of Mental Disorders (5th edition) 2013 HISTORY OF CLASSIFICATION AND DIAGNOSIS • Mid 1950s • WHO (World Health Organization) published ICD (International Causes of Death; now International Statistical Classification of Diseases and Related Health Problems - ICD-10 (more universally used today for billing) - DSM-5 now cross lists classification numbers from ICD 10 HISTORY OF CLASSIFICATION AND DIAGNOSIS • • • • • • • • APA (American Psychiatric Association) published DSM I in 1952 DSM II in 1968 DSM III in 1980 DSM IIIR in 1987 DSM IV in 1994 DSM IV-TR – “text revision” in 2000 DSM-5 in 2013 BASED on MEDICAL MODEL About the DSM-5 • What is it? • The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication of the American Psychiatric Association (APA), a society of psychiatric physicians. • Who writes it? • The APA created the DSM, which contains sets of diagnostic criteria (symptoms being experienced) grouped into categories (disorders) to assist clinicians with effective diagnoses and care of people with mental health disorders. There are several diagnostic criteria manuals used worldwide, but the DSM is the one used most commonly in the United States. About the DSM-5 • Who uses it? • Following an assessment, doctors (GPs, psychiatrists, psychologists) are usually the people who will use the criteria from the DSM to match against an individual’s symptoms. • This matching process will help them decide whether the individual meets the diagnosis for a mental health disorder. More about the DSM-5 • Why is there a revised edition? • Periodically the APA updates the information in the DSM based on feedback from working people within mental health treatment, and following extensive working committee discussions with specialists who diagnose/treat the various disorders. • The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released in May 2013. DSM-5 Organization • Developmental Lifespan • DSM-5 is organized in sequence with the developmental lifespan. • This organization is evident in every chapter and within individual diagnostic categories, with disorders typically diagnosed in childhood detailed first, followed by those in adolescence, adulthood and later life. • Disorders previously addressed in a single “infancy, childhood and adolescence” chapter are now integrated throughout the manual. DSM-5 Diagnostic Categories • Neurodevelopmental Disorders • Schizophrenia Spectrum and Other Psychotic Disorders • Bipolar and Related Disorders • Depressive Disorders • Anxiety Disorders Diagnostic Categories Continued • Obsessive-Compulsive and Related Disorders • Trauma and Stressor Related Disorders • Dissociative Disorders • Somatic Symptom Disorders • Feeding and Eating Disorders • Elimination Disorders More Diagnostic Categories • • • • • • • • • Sleep-Wake Disorders Sexual Dysfunctions Gender Dysphoria Disruptive, Impulse Control, and Conduct Disorders Substance Use and Addictive Disorders Neurocognitive Disorders Personality Disorders Paraphilic Disorders Other Disorders (click on link for details) http://dsm.psychiatryonline.org/content.aspx?booki d=22&sectionid=1892914#11357 DSM-5 • Google Playstore/Play Books for $16.19! • https://play.google.com/store/books/details/Ameri can_Psychiatric_Association_DSM_5?id=pZlSAQAAQ BAJ • The complete DSM-5 accessible on any mobile device. Searchable, bookmarks, notes. Cannot copy or print. APA Links • http://www.dsm5.org/Pages/Default.aspx • FAQs: http://www.dsm5.org/Documents/FAQ%20for%20Cli nicians%208-1-13.pdf • Online Assessment Measures: http://www.psychiatry.org/practice/dsm/dsm5/onli ne-assessment-measures Neurodevelopmental Disorders • Intellectual Disability (Intellectual Developmental Disorder) • Diagnostic criteria for intellectual disability (intellectual developmental disorder) emphasize the need for an assessment of both cognitive capacity (IQ) and adaptive functioning. • Severity is determined by adaptive functioning rather than IQ score. The term mental retardation was used in DSM-IV. However, intellectual disability is the term that has come into common use over the past two decades among medical, educational, and other professionals Neurodevelopmental Disorders • COMMUNICATION DISORDERS • The DSM-5 communication disorders include language disorder (which combines DSM-IV expressive and mixed receptive-expressive language disorders), • speech sound disorder (a new name for phonological disorder), • childhood-onset fluency disorder (a new name for stuttering). • social (pragmatic) communication disorder, a new condition for persistent difficulties in the social uses of verbal and nonverbal communication. Neurodevelopmental Continued • Autism Spectrum Disorder • A new DSM-5 name that reflects a scientific consensus that four previously separate disorders (autistic disorder [autism], Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified) are actually a single condition with different levels of symptom severity in two core domains o 1) deficits in social communication and social interaction and o 2) restricted repetitive behaviors, interests, and activities (RRBs). • both components are required for diagnosis • social communication disorder is diagnosed if no RRBs are present. Neurodevelopmental • Attention-Deficit/Hyperactivity Disorder • Specific Learning Disorder o Combines DSM-IV reading disorder, mathematics disorder, disorder of written expression, and learning disorder not otherwise specified • Motor Disorders o o o o o o o developmental coordination disorder stereotypic movement disorder Tourette’s disorder persistent (chronic) motor or vocal tic disorder provisional tic disorder other specified tic disorder and unspecified tic disorder