Yesterday the American Psychiatric Association (APA) released the proposed draft diagnostic criteria for the fifth addition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) on its website www.dsm5.org. The DSM contains the criteria to make a diagnosis for various mental disorders. Mental Health Professionals use this manual to diagnose patients and to help 3rd party payers (e.g., insurance) understand the needs of the patient. The book has sometimes been called the ‘bible' for any professional who makes psychiatric diagnoses in the United States and many other countries.
The draft criteria represent content changes under consideration. According to the chair of the task force making the revisions, "The DSM-5 Task Force and Work Group members are working to develop criteria for diagnoses that not only reflect new advances in the science and conceptualization of mental disorders, but also reflect the needs of our patients."
The information posted on the website includes the proposed criteria, the rationale, the supporting research, and the criteria from previous version for comparison. The proposed diagnostic criteria will be available on the Website www.dsm5.org, for public comment until April 20, 2010. APA is inviting health professionals, consumers of mental health services, and family members to visit the site to review and comment on the draft criteria.
My readers are most likely to be interested in the changes to the Sexual and Gender Identity Disorder criteria. For example, they are proposing to add a new diagnosis of "Hypersexual Disorder" that represents recurrent and intense sexual fantasies, sexual urges, and sexual behavior" in addition to other criteria.They also list Gender Identity Disorder under the group of disorders with no changes from the previous version of the DSM.
There is also a special issue of the journal Archives of Sexual Behavior that is currently online, but not yet in print, that reviews some of the rational for the proposed changes to the Sexual and Gender Identity Disorders diagnoses. To find the articles click on right on "online first" and then search the journal for DSM. A subscription to the journal may be required to view the articles.
Update: I just got off the phone with Dr. Kenneth Zucker, chair of the Sexual and Gender Identity diagnostic working group. He was kind enough to provide some additional information and clarifications about the proposed revisions to this set of disorders. First, he clarified that revisions are being made to the Gender Identity Disorders criteria, which is why I redacted the sentence above. My prior description was factually correct that Gender Identity Disorders are listed under the section "Disorders with No Change from DSM-IV." However, this may be confusing because it means that these diagnoses are not being added, removed, or subsumed elsewhere. It does not mean that they are being left unchanged. In fact, many changes have been proposed to this section. If you click on the specific disorder it indicates the proposed revisions. The numbers correspond to the next page where a rationale is provided. Dr. Zucker was also kind enough to point out that under the references section of the rational page, there are links to the forthcoming articles in the Archives of Sexual Behavior and other journals that describe some of the research that was used to support the proposed criteria and revisions. This is an easier way to find these articles than going directly to the journal's website and searching for them.
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