Psychology Today: Allen Frances MD on DSM-5 and comment

April 13, 2010 by

Psychology Today: Allen Frances MD on DSM-5 draft proposals and comment

Post #32 Shortlink: http://wp.me/pKrrB-Fj

Over the past 12 months, Allen Francis, MD, has published a series of often controversial commentaries on the DSM revision process in the media, via Psychiatric Times website and yesterday, on the site of Psychology Today.

Dr Frances had been chair of the DSM-IV Task Force and of the department of psychiatry at Duke University School of Medicine, Durham, NC. He is currently professor emeritus at Duke.

I have had a comment published, this morning, in response to his latest piece on Psychology Today.

Blogs
DSM5 in Distress
The DSM’s impact on mental health practice and research.
by Allen Frances, MD

DSM5: An Open Process Or Bust
The next steps need help from the field and public.
Published on April 12, 2010

“The first drafts of DSM5 were posted two months ago, allowing the field and the public a first glimpse into what had previously been an inexplicably secretive process. Today is the last day for public comment on these drafts…”

Read full text here

Comments

Public review process

Submitted by Suzy Chapman on April 13, 2010 – 3:24am.

I would like to thank Dr Frances for his commentaries around the DSM revision process. I hope he won’t mind my highlighting that draft proposals are out for review until Tuesday, 20 April – so there is another week during which health professionals, researchers, patient organisations and the lay public can input into the review process.

For some time now, professionals in the field, interest groups and the media have voiced concerns that the broadening of criteria for some DSM-5 categories would bring many more patients under a mental health diagnosis.

But if the draft proposals of the “Somatic Symptom Disorders” Work Group were to be approved there will be medical, social and economic implications to the detriment of all patient populations and especially those bundled by many within the field of liaison psychiatry and psychosomatics under the so-called “Functional Somatic Syndromes” (FSS) and “Medically Unexplained Syndromes” (MUS) umbrellas, under which they include Chronic fatigue syndrome, ME, Fibromyalgia, IBS, chemical injury, chemical sensitivity, chronic Lyme disease, GWS and others [1].

There is considerable concern amongst international patient organisations for the implications of the “Somatic Symptom Disorders” Work Group proposal for combining Somatoform Disorders, Psychological Factors Affecting Medical Condition (PFAMC), and Factitious Disorders under a common rubric called “Somatic Symptom Disorders” and for the creation of a new classification, “Complex Somatic Symptom Disorder” (CSSD).

They are particularly concerned for patients living with conditions characterised by so-called “medically unexplained symptoms” or with medical conditions for which diagnostic tests are currently lacking that provide evidence substantiating the medical seriousness of their symptoms and the need for provision of appropriate medical investigations, treatments, financial and social support, and in the case of children and young people, the putting in place of arrangements for the education of children too sick to attend mainstream school.

According to “Somatic Symptom Disorders” Work Group proposals:

“To meet criteria for CSSD, criteria A, B, and C are necessary.

A. Somatic symptoms:

Multiple somatic symptoms that are distressing, or one severe symptom

B. Misattributions, excessive concern or preoccupation with symptoms and illness: At least two of the following are required to meet this criterion:

(1) High level of health-related anxiety.

(2) Normal bodily symptoms are viewed as threatening and harmful

(3) A tendency to assume the worst about their health (catastrophizing).

(4) Belief in the medical seriousness of their symptoms despite evidence to
the contrary.

(5) Health concerns assume a central role in their lives

C. Chronicity: Although any one symptom may not be continuously present, the state of being symptomatic is chronic and persistent (at least six months).”

The CFIDS Association of America has submitted: “As drafted, the criteria for CSSD establish a “Catch 22” paradox in which six months or more of a single or multiple somatic symptoms – surely a distressing situation for a previously active individual – is classified as a mental disorder if the individual becomes “excessively” concerned about his or her health. Without establishing what “normal” behavior in response to the sustained loss of physical health and function would be and in the absence of an objective measure of what would constitute excessiveness, the creation of this category poses almost certain risk to patients without providing any offsetting improvement in diagnostic clarity or targeted treatment.” [2]

To date, there has been little public discussion by professionals or the media of the medical, social and economic implications for patients of the application of an additional diagnosis of “Complex Somatic Symptom Disorder”.

With a week to go before this initial public review period closes there is still time and I urge professionals and stakeholders to scrutinise the proposals of the “Somatic Symptom Disorder” Work Group and to submit their concerns to the Task Force.

Suzy Chapman, UK patient advocate

[1] Marin H, Escobar JI: Unexplained Physical Symptoms What’s a Psychiatrist to Do? Psychiatric Times. Aug 2008, Vol. 25 No. 9 http://www.psychiatrictimes.com/display/article/10168/1171223

[2] CFIDS Association of America submission to DSM-5 public review:
http://www.cfids.org/advocacy/2010/dsm5-statement.pdf

—————————

Related material:

PULSE Today

Managing medically unexplained symptoms, 07 Apr 10

—————————

The DSM-5 public review period runs from 10 February to 20 April. Members of the public, patient representation organisations, professionals and other end users can submit responses, online.

Please take this opportunity to register comment and to alert and encourage professionals and international patient organisations to participate.

Proposed Draft Revisions to DSM Disorders and Criteria are published here on the APA’s relaunched DSM5.org website: http://www.dsm5.org/Pages/Default.aspx

Somatoform Disorders:
http://www.dsm5.org/ProposedRevisions/Pages/SomatoformDisorders.aspx

Proposed new DSM-5 category: Complex Somatic Symptom Disorder
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=368

Two Key PDF documents are associated with proposals:

      PDF Somatic Symptom Disorders Introduction DRAFT 1/29/10

      PDF Justification of Criteria – Somatic Symptoms DRAFT 1/29/10

The Alpha Draft for ICD-11 is scheduled for May 2010. I shall be posting again shortly around the ICD-11 revision process.

Filed under American Psychiatric Association (APA), CFIDS Association, Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, Functional Somatic Syndrome (FSS), ICD revision process, Javier Escobar, Somatic Symptom Disorder

Notice from IACFSME: DSM-5 May Include CFS as a Psychiatric Diagnosis

March 25, 2010 by

Notice from IACFSME: DSM-5 May Include CFS as a Psychiatric Diagnosis and submission in DSM-5 public review process

Post #28 Shortlink: http://wp.me/pKrrB-En

Notice From IACFSME   http://www.iacfsme.org/

International Association for Chronic Fatigue Syndrome

DSM-5 May Include CFS as a Psychiatric Diagnosis

March 25, 2010

Important Alert to the CFS/ME Community:

The DSM-5 Task Force of the American Psychiatric Association is asking for public comment to their proposed DSM-5 manual of psychiatric diagnoses scheduled for release in 2013. We are concerned about the possibility of CFS/ME being classified as a psychiatric disorder, based on comments made in their Work Group on somatoform disorders (see letter below). Of course, such an action would be a major setback in our ongoing efforts to legitimize and increase recognition of the illness.

We urge you to submit your comments about this disturbing possibility to the DSM-5 Task Force ( www.dsm5.org ). You only need to register on this website to submit your comments. (Once you have a login, click on Proposed Revisions, and then Complex Somatic Symptom Disorder. At the bottom of page is a section for public comments.) Comments written from the perspective of a working professional (researcher, clinician, educator) will have the most influence.

Comments must be submitted by April 20 th.

Thank you.

Fred

Fred Friedberg, PhD
President
IACFS/ME

Letter To the DSM-5 Task Force:

On behalf of the board of directors and the membership of the International Association for Chronic Fatigue Syndrome (IACSF/ME), I would like to express my deep concern about the possible reclassification of CFS as a somatoform disorder in DSM-5. Although the proposed new category of Complex Somatic Symptom Disorder (CSSD) appears reasonable, we are concerned about CFS, a complex illness condition, becoming a subtype of CSSD or a distinct stand alone psychiatric diagnosis. We base our concern on comments by Dr Simon Wessely (DSM-5 Work Group; September 6-8, 2006) who concluded that “we should accept the existence …of functional somatic symptoms/ syndromes …[apart from depression and anxiety] and respect the integrity of fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, and their cultural variants.” This comment suggests the possibility of a new DSM-5 somatoform diagnosis that subsumes CFS as one manifestation or subcategory.

It is the position of the IACFS/ME that placing CFS in the new category of CSSD would not be reasonable based upon the body of scientific evidence and the current understanding of this disease.

The classification of CFS as a psychiatric disorder in the DSM-5 ignores the accumulating biomedical evidence for the underpinnings of CFS in the domains of immunology, virology, genetics, and neuroendocrinology. Over the past 25 years, 2,000 peer review CFS studies have been published. The data support a multifactorial condition characterized by disturbances in HPA function, upregulated antiviral pathways in the immune system, and genetic abnormalities. Unlike clinical anxiety and depression, psychotropics are generally ineffective for CFS and standard medical advice to exercise and rest or resume activities often leads to symptom worsening. In contrast to clinical depression, motivation is much less affected in CFS and the desire to be active remains intact. Furthermore, large differences in gene expression have been recently found between CFS and endogenous depression (Zhang et al., 2009)

Although biomedical research to elucidate the mechanisms of CFS is a work in progress, the medical uncertainties surrounding CFS should not be used as justification to classify it as a psychiatric illness. As stated by Ricardo Araya MD: “The absence of a medical explanation [for an illness] should not confer automatic psychiatric labeling (Sept.6-8, 2006; Somatic Presentations of Mental Disorders; DSM-5 Work Group).”

With respect to DSM-5, we support a recent editorial in the British Medical Journal by Dr. Allen Francis (2010), chair of the DSM-IV task force, who stated that any new DSM diagnosis should be based on “a careful risk-benefit analysis that includes ….a consideration of all the potential unintended consequences (p. 492)”. The likely unintended consequences of a CFS diagnosis in the new DSM will be increased stigmatization and even lower levels of recognition by primary care physicians and the medical community in general. As a result, we believe such an action would be counterproductive to our ongoing efforts to educate physicians about the assessment and clinical care of these patients.

The IACFS/ME is an organization of more than 500 biomedical and behavioral professionals whose mission is to promote, stimulate, and coordinate the exchange of ideas related to CFS research, patient care, and treatment. We support scientific advocacy efforts for increased research funding. We also support public health policy initiatives to increase the recognition and reduce the stigmatization that continues to plague these debilitated and medically underserved patients.

Thank you for your attention.

Sincerely,

Fred Friedberg, PhD
President
IACFS/ME
www.iacfsme.org  

 

Submissions by US patient organisations

The March issue of CFIDSLink-e-News reports that the CFIDS Association of America is seeking input from outside experts into the DSM-5 public review process.

The Whittemore Peterson Institute has announced on its Facebook site that it intends to submit a response.

Submissions by UK patient organisations

On 4 March, I contacted seven national UK organisations.  I will update on responses received, so far, in the next couple of days. The following UK patient representative and research organisations have been contacted:

Action for M.E.
ME Association
AYME
The Young ME Sufferers Trust
Invest in ME
The 25% ME Group
ME Research UK

The DSM-5 public review period runs from 10 February to 20 April 2010. Members of the public, patient representation organisations, professionals and other end users can submit responses, online.

Please take this opportunity to comment and to alert and encourage professionals and international patient organisations to participate in the DSM-5 public review process. 

If the proposals of the “Somatic Symptom Disorders” Work Group were to be approved there will be medical, social and economic implications to the detriment of all patient populations – especially those bundled by many psychiatrists under the so-called “Functional Somatic Syndromes” (FSS) and “Medically Unexplained Syndromes” (MUS) umbrellas, under which they include CFS, ME, FM, IBS, CI, CS, chronic Lyme disease, GWS and others.

Register here: http://www.dsm5.org/Pages/Registration.aspx

Related information:

[1] APA’s new DSM-5 Development webpages: http://www.dsm5.org/Pages/Default.aspx

[2] Somatoform Disorders: http://www.dsm5.org/ProposedRevisions/Pages/SomatoformDisorders.aspx

[3] Complex Somatic Symptom Disorder (CSSD):
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=368

[4] Key documents:

     PDF Somatic Symptom Disorders Introduction DRAFT 1/29/10

     PDF Justification of Criteria – Somatic Symptoms DRAFT 1/29/10

Filed under American Psychiatric Association (APA), CISSD Project, Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, Functional Somatic Syndrome (FSS), Somatic Symptom Disorder, Somatoform Disorders

Feedback invited on DSM-5 draft criteria

March 20, 2010 by

APA President, Alan F. Schatzberg, M.D., invites feedback on the DSM-5 draft criteria from APA members, professionals and the lay public

Post #25 Shortlink: http://wp.me/pKrrB-D4

Psychiatric News March 5, 2010
Volume 45 Number 5 Page 1

Association News

Feedback Invited

The proposed revisions for DSM-5 are available for review and comment at www.dsm5.org until April 20. After comments are reviewed and further revisions made, the criteria will be tested in field trials for about a one-year period starting in July. The final draft of DSM-5 will be submitted to the APA Assembly and Board of Trustees for review and approval, with an expected publication date of May 2013.

Psychiatric News March 5, 2010
Volume 45 Number 5 Page 3

From the President

DSM-5: The Next Steps Begin
Alan F. Schatzberg, M.D.

Last month, APA posted the DSM-5 draft criteria on the DSM-5 Web site and held a variety of press and advocacy-group briefings about the launching (see APA Makes DSM-5 Proposals Available for Comment). The resulting coverage has been generally positive, although there will continue to be naysayers and those who want to emphasize the controversies rather than the science and great efforts than have been extended thus far…

…The next steps in the DSM process are to gather the responses from our members and the professional and lay public and determine whether any of the proposed changes need to be amended before the field trials begin in the summer.

The DSM-5 Web site can be found at www.dsm5.org. After registering, anyone can access this very informative, user-friendly site. I invite you to log on, review, and comment on the proposed changes.

Read full article here

Psychiatric News March 5, 2010
Volume 45 Number 5 Page 1

Association News

APA Makes DSM-5 Proposals Available for Comment
Jun Yan

Proposed changes to diagnostic criteria and rationales for those changes are laid out online for clinicians and the public to review and comment on before they are tested in field trials.

The much-anticipated draft revisions proposed for DSM-5 have been posted online for view and comment by psychiatrists, mental health professionals, and the public, APA announced in February.

Substantial changes to the current diagnostic criteria have been proposed by 13 work groups based on accumulated research evidence. Sugested changes include the consolidation and elimination of numerous diagnoses and the addition of several new ones. These proposed revisions and rationale for them are posted at www.dsm5.org…

…To ensure the transparency of the DSM-5 development process, APA members, other psychiatrists, mental health professionals, medical professionals, and the public are invited to review and comment on the draft criteria. After the public-comment period closes on April 20, the DSM-5 work groups will review the comments. Field trials will then test the proposed criteria, with changes, in both specialty mental health and primary care settings starting in July. The field trials are expected to be concluded in July 2011. Data obtained from these field trials will be incorporated into later drafts.

The final draft of DSM-5 will be submitted to the APA Assembly and Board of Trustees for review and final approval. The new manual is expected to be published in May 2013.

Read full article here

 

On 10 February, I posted information on the DSM-5 Somatic Symptom Disorders Work Group proposal to rename the existing DSM-IV category “Somatoform Disorders” to “Somatic Symptoms Disorders”.

I included information on the proposed new classification:

Complex Somatic Symptom Disorder (CSSD)

and proposals for combining Somatoform Disorders, Psychological Factors Affecting Medical Condition (PFAMC), and Factitious Disorders under a common rubric entitled Somatic Symptom Disorders.

Links and further information on this DSM-5 and ICD-11 Watch page: DSM-5 drafts where draft proposals and revisions and are set out for two examples:

Example [1] Complex Somatic Symptom Disorder [Proposed new classification]

and

Example [2] 316 Psychological Factors Affecting Medical Condition [Proposed for revision]

Two key PDF documents are associated with these proposals:

      Somatic Symptom Disorders Introduction  DRAFT January 29, 2010

      Justification of Criteria – Somatic Symptoms  DRAFT January 29, 2010

Filed under American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V

APA News Release: 09 March 10: APA Modifies DSM Naming Convention to Reflect Publication Changes

March 9, 2010 by

APA News Release: 09 March 10: APA Modifies DSM Naming Convention to Reflect Publication Changes 

Post #24 Shortlink: http://wp.me/pKrrB-CS 

Today, the APA has issued News Release No. 10-17 

Open PDF for News Release here: DSM Name Change 09.03.10 

Text

For Information Contact:
Eve Herold, 703-907-8640
press@psych.org
Jaime Valora, 703-907-8562
jvalora@psych.org 

For Immediate Release:
March 8, 2010
Release No. 10-17 

Graphic of working DSM-5 cover available upon request. 

APA Modifies DSM Naming Convention to Reflect Publication Changes 

ARLINGTON, Va. (March 9, 2010) – Beginning with the upcoming fifth edition, new versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) will be identified with Arabic rather than Roman numerals, marking a change in how future updates will be created, according to the American Psychiatric Association. 

The new edition will be identified as DSM-5, breaking the pattern established with publication of the DSM-II in 1968. The change reflects the ability of the APA to use new technologies to create a document that can respond more quickly when a preponderance of research supports a change. 

“While knowledge about mental illnesses has grown significantly in the last half century, knowledge of neurobiology will continue to advance,” said APA President Alan F. Schatzberg, M.D. “Some of the changes coming with DSM-5 will facilitate new approaches to research that will lead to further advances.”

Following the publication of the DSM-5, ongoing review groups will be established to coordinate and oversee periodic assessments of advancements. The review groups will determine if a more intensive assessment or changes to the diagnostic criteria are warranted. APA practice guidelines and other diagnostic manuals are updated following a similar process.

“Advances in research will continue to drive changes to the DSM,” said David Kupfer, M.D., chair of the DSM-5 Task Force, which is in charge of the current revision process. “Our primary commitment will continue to be to create a manual that is based on science and is useful in diagnosing and treating patients.”

Incremental updates will be identified with decimals, i.e. DSM-5.1, DSM-5.2, etc., until a new edition is required.

“The research base is evolving at different rates for different disorders,” said Darrel Regier, M.D., M.P.H., vice chair of the DSM Task Force and executive director of the American Psychiatric Institute for Research and Education. “By making the DSM-5 a living document, we will ensure that the DSM will remain a common language in the field. It will hasten our response to breakthroughs in research.”

The anticipated bibliographic citation to the book is American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC, American Psychiatric Association, 2013.

Draft criteria for DSM-5 are available for review and comment until April 20 at www.dsm5.org. 

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.psych.org, www.HealthyMinds.org and http://www.psychiatryonline.com/ .

### 

Filed under American Psychiatric Association (APA), DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V

Two key DSM-5 draft proposal documents (Somatic Symptom Disorders)

February 16, 2010 by

Two key DSM-5 draft proposal documents (Somatic Symptom Disorders)

Post #20 Shortlink: http://wp.me/pKrrB-zN

On 10 February, I posted information on the DSM-5 Somatic Symptom Disorders Work Group’s proposal to rename DSM-IV category “Somatoform Disorders” to “Somatic Symptoms Disorders”.

I included information on the proposed new classification:

Complex Somatic Symptom Disorder (CSSD)

and proposals for combining Somatoform Disorders, Psychological Factors Affecting Medical Condition (PFAMC), and Factitious Disorders under a common rubric entitled Somatic Symptom Disorders.

Links and further information on this Dx Revision Watch page: DSM-5 drafts where draft proposals and revisions and are set out for two examples:

Example [1] Complex Somatic Symptom Disorder [Proposed new classification]

and

Example [2] 316 Psychological Factors Affecting Medical Condition [Proposed should be revised]

Two key PDF documents are associated with these proposals:

     PDF Somatic Symptom Disorders Introduction DRAFT 1/29/10 DRAFT January 29, 2010
     PDF Justification of Criteria – Somatic Symptoms DRAFT 1/29/10 DRAFT January 29, 2010

 

Source: Academy of Psychosomatic Medicine Annual Meeting, Nevada, November 2009 workshop presentation, Francis Creed, MD, FRCP: Can We Now Explain Medically Unexplained Symptoms? [4]

Related material

1] APA’s new DSM-5 Development pages 

2] DSM-5 and ICD-11 Watch page: DSM-5 drafts (links and information on proposed revisons to DSM-IV “Somatoform Disorders” and draft criteria for DSM-5 “Somatic Symptom Disorders” )

3] Submitting comments in the DSM-5 Draft Proposal review process  Post #21 (to follow)

4] Academy of Psychosomatic Medicine Annual Meeting, Nevada, November 2009.  Workshop presentations: DSM-V for Psychosomatic Medicine: Current Progress and Controversies

PRESENTERS’ SLIDES
Francis Creed, MD, FRCP: Can We Now Explain Medically Unexplained Symptoms? [Slides only]
Lawson Wulsin, MD, FAPM: DSM V for Psychosomatic Medicine: Current Progress and Controversies [Slides only]
Joel Dimsdale, MD, FAPM: Update on DSM V Somatic Symptoms Workgroup [Text only]

Filed under American Psychiatric Association (APA), CISSD Project, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, Functional Somatic Syndrome (FSS), Somatic Symptom Disorder, Somatoform Disorders

DSM-5 Psychiatric/General Medical Interface Study Group

February 15, 2010 by

DSM-5 Psychiatric/General Medical Interface Study Group and  Somatic Symptom Disorders Work Group  

Post #19 Shortlink: http://wp.me/pKrrB-zC

On 10 February, when the American Psychiatric Association (APA) published draft proposals for DSM-5 categories, it launched new DSM-5 Development web pages. Links on this site posted prior to 10 February will link to the old APA DSM-V pages. This will be attended to as soon as possible.

This new DSM-5 Development website page Somatic Symptom Disorders Work Group links to biosketches and COI disclosure information for each Somatic Symptom Disorders Work Group member. Under the chairmanship of Joel E Dimsdale, MD, the nine Work Group members are:  

Somatic Symptom Disorders Work Group

Dimsdale, Joel E., M.D.
Barsky III, Arthur J., M.D. *
Creed, Francis, M.D. *
Frasure-Smith, Nancy, Ph.D.
Irwin, Michael R., M.D.
Keefe, Francis J., Ph.D.
Lee, Sing, M.D.
Levenson, James L., M.D. *
Sharpe, Michael, M.D . *
Wulsin, Lawson R., M.D. 

*Four members of the Somatic Symptom Disorders Work Group, Arthur Barsky, MD, Francis Creed, MD, James Levinson, MD and Michael Sharpe, MD, had been members of the Conceptual Issues in Somatoform and Similar Disorders (CISSD) Project workgroup.  Professor Michael Sharpe had served as the CISSD Project’s UK Chair.  

**The CISSD Project was an unofficial project undertaken between 2003 and 2007, initiated and co-ordinated by Dr Richard Sykes, PhD, former Director of Westcare UK (engulfed by Action for M.E. in mid 2002). Action for M.E. acted as Principal Administrators for the project. The Principal Collaborator was Professor Rachel Jenkins, WHO Collaborating Centre, Institute of Psychiatry, London.

The 2007 paper: Kroenke K: Somatoform disorders and recent diagnostic controversies. Psychiatr Clin North Am 2007 Dec;30(4):593-619. http://www.ncbi.nlm.nih.gov/pubmed/17938036

contains the caveat:

“Although the CISSD is an ad hoc group that includes many international experts on somatoform disorders, it was neither appointed nor sanctioned by the APA or WHO, the organizations authorized to approve revisions of DSM and ICD, respectively. As such, the CISSD recommendations should be considered advisory rather than official. Also, there were some suggestions for which the CISSD achieved near consensus but other issues where opinions diverged considerably.”

**The Dx Revision Watch pages for the CISSD Project are under construction. 

Study Groups 

According the APA:

“As development on DSM-5 progressed, the importance of addressing cross-cutting issues relevant to all of the disorder work groups became increasingly evident. As a result, six DSM-5 Study Groups were formed to address these universal topic areas.”

Psychiatric/General Medical Interface Study Group  

“The Psychiatric/General Medical Interface Study Group is chaired by Lawson R. Wulsin, M.D. The study group is examining the link between general medical disorders and psychiatric disorders. Given that most patients with mental illnesses are seen by primary care physicians, the study group aims to ensure that DSM-5 meets the needs of general medical practitioners and not just specialty mental health clinicians. The group is also developing revision strategies for the forthcoming DSM-5-PC, which is intended to be used in primary care settings. The members of the Psychiatric/General Medical Interface Study Group are listed below.” 

Psychiatric/General Medical Interface Study Group Members 

Wulsin, Lawson R., M.D. [Member, Somatic Symptoms Disorders Work Group]
Dahl, Ronald E., M.D.
Dimsdale, Joel E., M.D. [Chair, Somatic Symptoms Disorders Work Group]
Escobar, Javier I., M.D. [Member, DSM-5 Task Force and Liaison to SSD Work Group]
Jeste, Dilip V., M.D.
Kaufmann, Walter E., M.D.
Kreipe, Richard E., M.D.
Petersen, Ronald, Ph.D., M.D.
Reynolds, Charles F., M.D.
Segraves, Taylor R., M.D., Ph.D.
Walsh, Timothy B., M.D. 

Javier Escobar, MD, Director of the University of Medicine and Dentistry of New Jersey (UMDNJ) – Robert Wood Johnson Medical School (RWJMS) Medically Unexplained Physical Symptoms (MUPS) Research Center, which has been supported with over $4M in funding by the US National Institute of Mental Health (NIMH), had also been a member of the CISSD Project workgroup. 

Dr Escobar is a member of the DSM-5 Task Force, serves as Task Force liaison to the DSM-5 Somatic Symptom Disorders Work Group and according to the Task Force, works closely with this work group.  

Filed under American Psychiatric Association (APA), CISSD Project, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, Somatic Symptom Disorder, Somatoform Disorders

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