American Psychiatric Association Board of Trustees Approves DSM-5
Diagnostic manual passes major milestone before May 2013 publication
ARLINGTON, Va. (December 1, 2012) – The American Psychiatric Association (APA) Board of Trustees has approved the final diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The trustees’ action marks the end of the manual’s comprehensive revision process, which has spanned over a decade and included contributions from more than 1,500 experts in psychiatry, psychology, social work, psychiatric nursing, pediatrics, neurology, and other related fields from 39 countries. These final criteria will be available when DSM-5 is completed and published in spring 2013.
“The Board of Trustees approval of the criteria is a vote of confidence for DSM-5,” said Dilip Jeste, MD, president of APA. “We developed DSM-5 by utilizing the best experts in the field and extensive reviews of the scientific literature and original research, and we have produced a manual that best represents the current science and will be useful to clinicians and the patients they serve.”
DSM-5 is the guidebook used by clinicians and researchers to diagnose and classify mental disorders. Now that the criteria have been approved, review of the criteria and text describing the disorders will continue to undergo final editing and then publication by the American Psychiatric Publishing.
The manual will include approximately the same number of disorders as were included in DSM-IV. This goes against the trend from other areas of medicine that increase the number of diagnoses annually.
“We have sought to be very conservative in our approach to revising DSM-5. Our work has been aimed at more accurately defining mental disorders that have a real impact on people’s lives, not expanding the scope of psychiatry,” said David J. Kupfer, MD, chair of the DSM-5 Task Force. “I’m thrilled to have the Board of Trustees’ support for the revisions and for us to move forward toward the publication.”
Organization of DSM-5
DSM-5 will be comprised of three sections:
Summary of Decsions for DSM-5
Key decisions made by the Board of Trustees include:*
* More information on select decisions is available in Attachment A.
Collaborative Process for Development of DSM-5
Beginning in 1999, during the initial phase of this DSM revision, the APA engaged almost 400 international research investigators in 13 conferences supported by the National Institutes of Health. To invite comments from the wider research, clinical and consumer communities, the APA launched a DSM-5 Prelude website in 2004 to garner questions, comments, and research findings during the development process.
Starting in 2007 and 2008, the DSM-5 Task Force and Work Groups, made up of more than 160 world-renowned clinicians and researchers, were tasked with building on the previous seven years of scientific reviews, conducting additional focused reviews, and garnering input from a breadth of advisors as the basis for proposing draft criteria. In addition to the Work Groups in diagnostic categories, study groups were assigned to review gender, age and cross-cultural issues. The Work Groups have led the effort to review the scientific advances and research-based information that have formed the basis of the content for DSM-5.
The first draft of proposed changes was posted publicly on the website www.DSM5.org in February 2010 and the site also posted two subsequent drafts. With each draft, the site accepted feedback on proposed changes, receiving more than 13,000 comments on draft diagnostic criteria from mental health clinicians and researchers, the overall medical community, and patients, families, and advocates. Following each comment period, the DSM-5 Task Force and Work Groups reviewed and considered each response and made revisions where warranted.
The Work Groups’ proposals were evaluated by the Task Force and two panels convened specifically for more independent evaluation of DSM-5—a Scientific Review Committee and a Clinical and Public Health Committee. The Scientific Review Committee looked at the supporting data for proposed changes. The Clinical and Public Health Committee was charged with assessing the potential impact of changes to clinical practice and public health. Additionally, there was a forensic review by members of the Council on Psychiatry and Law.
All of the independent reviews were coordinated in meetings of the Summit Group, which includes the DSM-5 Task Force co-chairs, and review committee co-chairs, consultants, and members of the Executive Committee of the Board of Trustees. The criteria were then put before the APA Assembly for review and approval. The Board of Trustees’ review was the final step in this multilevel, comprehensive process.
“At every step of development, we have worked to make the process as open and independent as possible. The level of transparency we have strived for is not seen in any other area of medicine,” said James H. Scully, MD, medical director and chief executive officer of APA.
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The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at www.psychiatry.org.
Attachment A: Select Decisions Made by APA Board of Trustees
Overall Changes
Section 2 Disorders