Proposed updates for DSM-5 released

The American Psychiatric Association last week released proposed diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The revisions, which are open to public comment until April 20, were developed by 13 work groups and include changes such as: Elimination of the diagnostic category of substance dependence. Both substance abuse and dependence will fall under a new category of "addiction and related disorders." New suicide scales, which include research-based criteria, to help identify individuals most at risk. A new category of "behavioral addictions," in which gambling will be the only disorder. Internet addiction was considered for this category, but found to be insufficiently researched. A single category of "autism spectrum disorders" to include autistic disorder, Asperger's disorder, childhood disintegrative disorder and pervasive developmental disorder. A change from the term "mental retardation" to "intellectual disability." A new "risk syndromes" category to identify earlier stages of mental disorders, including dementia. Changes in definitions of some eating disorders to emphasize development in adults. Addition of "dimensional assessments" to diagnostic evaluations to take into account the severity of symptoms and cross-cutting symptoms (such as insomnia or anxiety) that occur across different diagnoses.

After public comments are collected, the new criteria will undergo review and refinement, including field trials, over the next two years. The changes can be viewed and comments submitted at the DSM-5 Web site. The final DSM-5 is expected to be released in May 2013, according to a press release. The last edition of the DSM was published in 1994.