DSM-5 draft criteria draws nearly 2,300 responses in final public comment period

DSM-5 draft criteria draws nearly 2,300 responses in final public comment period

Post #187 Shortlink: http://wp.me/pKrrB-2j0

According to a Press Release issued yesterday by the American Psychiatric Association (APA), the final public comment period on draft diagnostic criteria for the forthcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5) drew 2,298 responses.

APA previously reported receiving around 8,600 comments in the first stakeholder comment period and around 2,100 submissions in the second review.

During the second public comment period (May-June 2011), the specific diagnostic categories that received the most comments had been the sexual and gender identity disorders, followed closely by somatic symptom disorders and anxiety disorders.  (As reported by DSM-5 Task Force Vice-chair, Darrel Regier M.D.)

For this final review that closed on June 15, APA reports, “Although each disorder area drew a wide range of comments, the two Work Groups with the highest number were the Neurodevelopmental Work Group (397 comments) and the Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic Stress and Dissociative Disorders Work Group (545 comments). APA also received more than 800 comments focused broadly on DSM-5.”

No publication of field trial data

What the News Release fails to address is APA’s withholding of its field trial results while the third and final feedback exercise was in progress, other than releasing some Kappa data to press and conference at its Annual Meeting, in May. Professional stakeholders, advocacy organizations and lay public have been obliged to submit feedback on the third draft without the benefit of scrutiny of reliability and prevalence data to inform their submissions.

[See: Deborah Brauser for Medscape Medical News: interview with Darrel Regier, May 8, 2012 and reports by 1 Boring Old Man]

APA has given no indication of whether it still intends placing Kappa results and other field trial findings in the public domain or whether reports on its field trial findings will only be accessible at some point in the future published in subscription only or pay by the paper peer review journals, from which many stakeholders would be disenfranchised.

On June 17, I asked American Psychiatric Association’s CEO and Medical Director, Dr James H. Scully, why the field trial report was withheld; whether Task Force still intends placing field trial data in the public domain and when a report might be anticipated. I’ve received no response.

Collating submissions

I continue to collate copies of submissions from patient organizations, patients and advocates on these pages in response to the proposals of the Somatic Symptom Disorders Work Group. If professional body submissions include comment on this specific section of DSM-5, I would be interested in receiving copies with a view to publication of extracts or links to full submissions.

Given that thresholds for the Somatic Symptom Disorder criteria have been lowered for the third draft and given the implications for their constituencies, the response of US, UK and international patient organizations to calls for submissions in this third and final review was abysmal.

I’d like to thank patients, advocates and those organizations that did submit comment in response to the proposals of the Somatic Symptom Disorders Work Group.  I’d also like to thank Maarten Maartensz for his commentaries on DSM-5 proposals over the past two years.

APA News Release June 26, 2012 appended:

Open PDF Press Release No. 12-30

DSM-5 Draft Criteria Draws Nearly 2,300 Responses

Mental health diagnostic manual closes final public comment period

ARLINGTON, Va. (June 26, 2012) – The final public comment period for the draft diagnostic criteria of the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5) drew 2,298 responses from across the country and abroad. The six-week comment period ended June 15.

This feedback, submitted online to the American Psychiatric Association (APA), adds to the extensive responses submitted during the two other open comment periods. In total, more than 15,000 comments about the proposed DSM-5 criteria have been received since 2010 from mental health clinicians and researchers, the overall medical community, and patients, families and advocates. As was the case following the other comment periods, the DSM-5 Task Force and Work Groups will now review and consider each response as they begin final revisions to the criteria.

“Every comment period has provided valuable perspective from a wide range of professionals, consumers and advocates,” said APA President Dilip V. Jeste, MD. “We are grateful for their participation and willingness to review the draft proposals and to share their opinions and experiences. The Work Groups consider the feedback a huge asset as they shape the final DSM-5 proposals.”

Although each disorder area drew a wide range of comments, the two Work Groups with the highest number were the Neurodevelopmental Work Group (397 comments) and the Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic Stress and Dissociative Disorders Work Group (545 comments). APA also received more than 800 comments focused broadly on DSM-5.

After the Work Groups make their last revisions to the draft diagnostic criteria, the proposals will receive multi-level reviews by the entire DSM-5 Task Force, a separate Scientific Review Committee and a Clinical and Public Health Committee. The latter two committees will be working to evaluate the strength of scientific evidence supporting significant changes and to assess the impact of changes for clinicians and public health.

The Task Force will make recommendations to the APA Board of Trustees for its final decisions on the manual’s fifth edition late this year.

The American Psychiatric Association is a national medical specialty society whose more than 36,000 physicians specialize in the diagnosis, treatment prevention and research of mental illnesses, including substance abuse disorders. Visit the APA at www.psych.org  and www.healthyminds.org.