Many blog posts and articles about mental illnesses and addictions refer to the DSM-5. What is the DSM-5 and what is its importance in the mental health field?
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What Is the DSM-5?
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a reference book that establishes standardized diagnostic criteria for mental and behavioral health conditions. The book also includes a host of additional information on these conditions, including:
- Development and course
- Risk and prognostic factors
- Differential diagnoses
- Culture-related diagnostic issues
- Gender-related diagnostic issues
- Prevalence
- Functional consequences
- Comorbidities
The DSM-5 was published by the American Psychiatric Association (APA), with contributions from more than 200 subject matter experts. It is used primarily by clinicians and other mental health professionals in the United States.
History
The development of the DSM was partially a response to the International Classification of Diseases (ICD), which is published by the World Health Organization (WHO):
- The ICD-6, which was released in 1949, was the first version of that resource to include mental health disorders.
- Three years later, in 1952, the APA released the first edition of the DSM.
The DSM I included information on 106 disorders. For purposes of comparison, the DSM-5 includes 297 conditions.
Since the initial publication of the DSM I, the APA has released four comprehensive revisions:
- DSM II (1968)
- DSM III (1974)
- DSM IV (1980)
- DSM-5 (2013)
The APA has also published one special supplement and two limited updates:
- The DSM I Special Supplement (1965) outlined the APA’s plans to better align the DSM with the ICD in future revisions.
- DSM-III-R (1978) corrected “inconsistencies in the system and instances in which the diagnostic criteria [in the DSM-III] were not clear.”
- Changes in the DSM-5-TR (2022) included addressing out-of-date material, revising stigmatizing language, and making “necessary clarifications to certain diagnostic criteria” from the previous version.
DSM-5 vs. ICD-11
The DSM-5 and the ICD-11 – which is the most recent edition of that resource, published in 2022 – share features such as:
- Both books include information about many of the same mental illnesses.
- They use similar codes for diseases and disorders, which is helpful for insurance processing.
- Both books reflect the input and expertise of a wide range of subject matter experts.
Four differences between the two books are:
- The ICD is the older publication, dating to 1893. As noted earlier, the first version of the DSM appeared in 1952.
- The ICD-11 includes information about medical conditions as well as mental health disorders, while the DSM-5 focuses solely on mental illnesses.
- The ICD-11 is used by clinicians and other healthcare personnel throughout the world. Use of the DSM-5 is mostly limited to experts in the U.S.
- New versions of the ICD require approval from the World Health Assembly, which includes health ministers from the 193 nations that participate in WHO. The DSM-5 was reviewed and approved by a team from the APA.
How Is the DSM-5 Organized?
The DSM-5 is organized into three sections plus an appendix.
Section I: Basics
Section I of the DSM-5 includes three subsections:
- Introduction
- Use of the Manual
- Cautionary Statement for Forensic Use of DSM-5
Key elements from the cautionary statement include:
- Disorder definitions in the DSM-5 were developed to meet the needs of “clinicians, public health professionals, and research investigators.”
- The DSM-5 does not include treatment recommendations for any disorders.
- Though anyone can acquire and read the DSM-5, its use by “nonclinical, nonmedical, or otherwise insufficiently trained individuals” for diagnostic purposes is not advised.
Section II: Diagnostic Criteria and Codes
Diagnostic criteria and related information for the 297 conditions in the DSM-5 is organized into the following subsections:
- Neurodevelopmental Disorders
- Schizophrenia Spectrum and Other Psychotic Disorders
- Bipolar and Related Disorders
- Depressive Disorders
- Anxiety Disorders
- Obsessive-Compulsive and Related Disorders
- Trauma- and Stressor-Related Disorders
- Dissociative Disorders
- Somatic Symptom Disorders
- Feeding and Eating Disorders
- Elimination Disorders
- 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
The APA website includes a downloadable document with all of the conditions contained in each of the subsections above.
Section III: Emerging Measures and Models
The third section of the DSM-5 includes four subsections:
- Assessment Measures
- Cultural Formulation
- Alternative DSM-5 Model for Personality Disorders
- Conditions for Further Study
In previous versions of the DSM-5, this type of information was included in the appendix. The decision to move it into a separate section highlights its importance in the eyes of the APA.
Appendix
The appendix includes the following subsections:
- Highlights of Changes From DSM-IV to DSM-5
- Glossary of Technical Terms
- Glossary of Cultural Concepts of Distress
- Alphabetical Listing of DSM-5 Diagnoses and Codes (ICD-9-CM and ICD-10-CM)
- Numerical Listing of DSM-5 Diagnoses and Codes (ICD-9-CM)
- Numerical Listing of DSM-5 Diagnoses and Codes (ICD-10-CM)
- DSM-5 Advisors and Other Contributors
The book concludes with an index of disorders and relevant terminology.
Who Can Use the DSM-5?
There are no legal limits on who can acquire and read the DSM-5:
- When this post was published, the DSM-5-TR was available for purchase on the APA website for $170 (paperback or e-book) or $220 (hardback).
- Several online sources continue to sell the DSM-5, with typical prices ranging from $25-$55 based on condition.
- The book can also be accessed through many public libraries in the U.S.
However, when it comes to using the book, it is important to heed the cautionary statement in Section I of the book (which we mentioned earlier in today’s post).
If you are not a clinician or other qualified professional, you are welcome to read the DSM-5 to educate yourself about the disorders it describes. It can be a valuable resource if you or someone you care about has developed a certain condition, and you want to learn more about it.
But for non-professionals, use of the DSM-5 should be limited solely to personal education. Unless you are a trained professional, you cannot diagnose anyone with a mental illness based on the DSM-5, the ICD-11, or any other relevant resource.
Find Mental Health Help in Atlanta
If you’re concerned that you may have a mental health disorder or an addiction, North Atlanta Behavioral Health is here for you. We can assess your needs, help you understand the scope of the challenge you’re facing, and, if necessary, recommend appropriate types of treatment.
If you choose to receive care at our center, your options include a partial hospitalization program (PHP) and an intensive outpatient program (IOP). A member of our team will be happy to discuss the features and benefits of these programs with you, so that you can make an informed decision about your treatment.
To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Admissions page or call us today.
