DSM 5 Year End Summary

There have been three positive developments:
1) Scientific Review: A work group reporting directly to the APA Board of Trustees (BOT) has been charged with independently reviewing the evidence supporting changes proposed for
DSM 5. Too bad that the report will be confidential and that most of the reviewers are not independent, having been closely involved with the existing work on DSM 5.
2)The APA Assembly Asserts Itself: and provides sorely needed governance over DSM 5, filling the void created by failed BOT leadership.
3) Constructive Dissent From Within: John Livesley of the Personality Disorders work group has courageously published a dissent detailing the folly of its proposals. Perhaps others working on DSM 5 will follow his lead and open a much needed public discussion of other potentially harmful DSM proposals.
The rest of the DSM 5 news continues to be extremely worrisome.
1) Debilitating Delays Continue: Aside from being off point, the DSM 5 field trials have fallen remarkably far behind schedule. Originally meant to start in July 2009, then rescheduled to begin in July of 2010, the project is still not fully off the ground. An impossibly complicated design guarantees further inevitable delays and the second portion of the trials will have to be cancelled altogether or truncated to the point of irrelevance. Poor planning and disorganized execution will inevitably lead to rushed attempts to cut corners in order to meet the irrevocable May 2013 publication deadline. The field trials will almost surely turn out to have been a colossal waste of time, money, and effort.
2)Board of Trustees Abdication: The BOT remains passive and spends almost no time or thought on DSM 5, somehow not understanding how crucial it is for the future of the APA and the welfare of our patients.
3) Continued Opaqueness: The posting of the latest DSM 5 criteria sets has been delayed so long that the field can have no influence on the suggestions finally being field tested. They have also received no forensic review.
4)Sloppy Coordination With the New Official Codes: The reconciliation of DSM 5 with the new ICD-10-CM codes that will govern it has been left to the very last minute and is being done carelessly.
5)Late Start On writing The Text: The leadership has finally appointed a group charged with writing the DSM 5 text. But the effort is a very late in starting and has a decentralized structure unlikely to produce a consistent and well organized document. In the preparation of DSM IV, I found text writing by far the most time consuming, demanding, and onerous task. I fear that DSM 5 may not have the time and expertise to write a readable manual.
All in all, another year that has largely been wasted. Time is running out. The race to meet the 2013 deadline will not be pretty. The DSM 5 process needs to trim its goals, improve its methods, and radically increase its efficiency.