DSM-5 Round up: February #1

DSM-5 Round up: February #1

Post #225 Shortlink: http://wp.me/pKrrB-2F7

Update: More recent coverage:

The first in a series of three commentaries by Allen Frances, MD, on the Somatic Symptoms Disorder issue has received over 25,000 page views on Psychology Today, alone. It was also published at Huffington Post and on “Education Update,” and now also at Psychiatric Times.

Mislabeling Medical Illness As Mental Disorder

Allen Frances, MD | February 13, 2013

Fox Health News

A psychiatrist’s take on the DSM-5 Somatic Symptom Disorder diagnosis, Dr Keith Ablow, for Fox News Health:

Does somatic symptom disorder really exist?

Keith Ablow, MD |  for Fox News Health | February 14, 2013

Currents An interactive newsletter of NASW-WA

(Washington State Chapter of the National Association of Social Workers is a membership organization.)

DSM 5 Changes

DSM-5: A Summary of Proposed Changes

Carlton E. Munson, PhD, LCSW-C | February 12, 2013

The Health Care Blog

Mislabeling Medical Illness

Allen Frances, MD | February 12, 2013

Huffington Post Blogger

Bruce E. Levine
Practicing clinical psychologist, writer

DSM-5: Science or Dogma? Even Some Establishment Psychiatrists Embarrassed by Newest Diagnostic Bible

Bruce E. Levine | February 10, 2013

Earlier coverage:

Huffington Post

DSM-5: Science or Dogma? Even Some Establishment Psychiatrists Embarrassed by Newest Diagnostic Bible

Bruce E. Levine | February 10, 2013

Practicing clinical psychologist, writer

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DIE WELT/Worldcrunch All news is global

Translated (and possibly abridged) from original article in German

Worldcrunch All news is global

Psychiatrists Not Crazy About The Revised Manual Of Mental Disorders

Fanny Jiménez and Christiane Löll | February 5, 2013

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Allen Frances, MD, now blogs at Saving Normal.

Archive posts at DSM 5 in Distress will remain accessible and open for new comments.

Saving Normal
Mental health and what is normal.
by Allen Frances, M.D.

DSM 5 Boycotts and Petitions
Too many, too sectarian

Allen Frances, MD | February 8, 2013

There are already about a dozen different DSM 5 petitions and boycotts out there. This is completely understandable – there is lots in DSM 5 to be angry at or frightened about.

Unfortunately, though, this is not a case of more the merrier. Fragmentation into a number of small protests will greatly reduce their aggregate impact…

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David J. Kupfer, MD, chairs the DSM-5 Task Force. On February 8, Dr Kupfer published in defence of the SSD construct on Huffington Post. Part Three in the Allen Frances and Suzy Chapman series of commentaries on the SSD criteria was published earlier, last week, Saving Normal on Psychology Today:

Huffington Post

David J. Kupfer, M.D.
Chair, DSM-5 Task Force

Somatic Symptoms Criteria in DSM-5 Improve Diagnosis, Care

David J. Kupfer, MD | February 8, 2013

While the goal of the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is clear, accurate criteria for diagnosing mental disorders, the motivation behind the book’s revision was the improvement of diagnosis and clinical care. Somatoform disorders are one area where definitive progress was made.

Somatoform disorders are characterized by symptoms suggesting physical illness or injury, but which may not be fully explained by a general medical condition, another mental disorder, or by medication or substance side effects. The symptoms are either very distressing or result in significant disruption of an individual’s ability to function in daily life. People suffering from somatoform disorders are often initially seen in general medical settings as opposed to psychiatric settings…

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This new post from Christopher Lane on the DSM-5 ‘Somatic Symptom Disorder’ controversy has been designated a Psychology Today “Essential Read” editor pick:

Side Effects
From quirky to serious, trends in psychology and psychiatry
by Christopher Lane, Ph.D.

DSM-5 Has Gone to Press Containing a Major Scientific Gaffe
The APA declined to correct the error, despite multiple warnings.

Christopher Lane, PhD | February 8, 2013

When DSM-5 is published three months from now, in the middle of May, it will contain at least one major scientific gaffe. The Trustees of the American Psychiatric Association voted to include a definition of Somatic Symptom Disorder (SSD) so broad and over-inclusive that it is certain to include medical patients with an outsized concern about their health, as well as those who are merely vigilant in trying to maintain it…

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Lightweight feature in UK Times Magazine, Saturday, February 9, 2013:

The Asperger’s effect

Louise Carpenter | February 9 2013

Once it was a taboo. Now, in Silicon Valley, it’s almost a job qualification. So has the diagnosis lost its stigma, wonders Louise Carpenter…

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Article on mental health diagnosis and DSM-5 co-authored by Dr Raj Persaud, Consultant Psychiatrist, and Professor Sir Simon Wessely, Professor of Psychological Medicine, Institute of Psychiatry, King’s College London.

http://www.simonwessely.com/dsm5.html

DSM-5 and the future of psychiatry
Did 2012 prove that psychiatric disease doesn’t exist?

From doctors.net.uk 1.2.2013

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At the end of this article is a link to a forthcoming CPD Certified conference at the Wolfson Lecture Theatre, Institute of Psychiatry, June 4-5, 2013:

Conference:

DSM-5 and the Future of Psychiatric Diagnosis: Where is the roadmap taking us?

A two day international conference following the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will take place at the Institute of Psychiatry on the 4th and 5th of June 2013.

Mental health practitioners and researchers around the world anticipate the DSM-5 that is due to published by the American Psychiatric Association within the first few months of 2013.

Discussions about the DSM-5 have stretched well beyond the world of academic psychiatry having become a matter of intense public interest and media coverage.

The aim of this conference is to have a rigorous and comprehensive discussion of the clinical, research, and public health implications of the DSM-5. The perspective is international and speakers will include top scientists, key policy makers, patient representatives, and front-line clinicians.

Speakers include:

Professor David Kupfer, Head of DSM-5 Planning Committee and Professor at the University of Pittsburgh

Professor William Carpenter, DSM-5 Task Force Member and Professor at the University of Maryland

Professor David Clark, Professor of Experimental Psychology, University of Oxford

Dr Clare Gerada, General Practitioner and Chair of the Council of the Royal College of General Practitioners

Professor Catherine Lord, Director of the Center for Autism and the Developing Brain and Professor at the University of Michigan

Professor Vikram Patel, Professor of International Mental Health, London School of Hygiene and Tropical Medicine

Professor Nikolas Rose, Head of the Department of Social Science, Health and Medicine, Kings College London

Sir Michael Rutter, First Professor of child psychiatry in the UK and Professor of Developmental Psychopathology at Kings College London

Professor Norman Sartorius, Former director of the World Health Organization’s Division of Mental Health, and a former president of the World Psychiatric Association

Price: £350 (including lunches and an evening reception)

Dates:

* Tuesday 4th June | 09:45- 17:30 (evening reception to follow)

* Wednesday 5th June | 09:45 – 17:15

Venue: Wolfson Lecture Theatre, Institute of Psychiatry

This event is CPD Certified

American Psychiatric Association launches new pages for DSM-5 – DSM-5 to cost $199

American Psychiatric Association (APA) launches new pages for DSM-5 – DSM-5 to cost $199

Post #220 Shortlink: http://wp.me/pKrrB-2CD

Unless you’ve had your head stuck in a bucket this last three years, you’ll be aware that the next edition of the American Psychiatric Association’s diagnostic manual is slated for release this May.

APA has spent $25 million on the development of DSM-5.

DSM-5 will be published by American Psychiatric Publishing Inc. and planned for release at the APA’s 166th Annual Meeting in San Francisco (May 18-22).

A hardback copy is going to set you back $199, though paid up members of the American Psychiatric Association are being offered a discount.

Psychiatrists, psychologists, primary health care physicians, therapists, counselors, social workers and allied health professionals don’t have to use DSM-5.

Instead, when codes are required they can use the codes in Chapter 5 of ICD-9-CM (Mental Disorders) and Chapter 5 of ICD-10-CM (Mental, Behavioral and Neurodevelopmental disorders), when ICD-10-CM is implemented*.

*Effective implementation date for ICD-10-CM (and ICD-10-PCS) is currently October 1, 2014. Until that time the codes in ICD-10-CM are not valid for any purpose or use.

Image Copyright Dx Revision Watch 2013

Don’t like it? Don’t use it. Use ICD codes instead.

Since 2003, ICD-9-CM diagnostic codes have been mandated for third-party billing and reporting by HIPAA for all electronic transactions for billing and reimbursement. The codes in DSM are crosswalked to ICD codes.

So you can use ICD-9-CM codes.

And when ICD-10-CM is implemented, it isn’t going to cost you a cent – it will be freely available on the internet.

The ICD-10-CM draft, currently subject to partial code freeze, and its associated documentation can be accessed here on the CDC site; so you can already have a poke around:

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

On January 23, Allen Frances, MD, who had oversight of the Task Force that developed DSM-IV had this to say about the $199 manual:

Price Gouging: Why Will DSM-5 Cost $199 a Copy?

 

APA launches new pages for DSM-5

Last week the APA launched new pages to promote DSM-5.

Report by John Gever for Medpage Today:

Psych Group Posts Glimpses of Final DSM-5

John Gever, Senior Editor, MedPage Today | January 21, 2013

Peeks into the final DSM-5, the controversial new edition of the American Psychiatric Association’s diagnostic manual, are now available from the group prior to the guide’s official May 22 debut…

PR piece by Mark Moran for Psychiatric News, organ of the American Psychiatric Association:

Psychiatric News | January 18, 2013
Volume 48 Number 2 page 1-6
10.1176/appi.pn.2013.1b10
American Psychiatric Association
Professional News

Continuity and Changes Mark New Text of DSM-5

Mark Moran

The DSM-5 Task Force chair discusses conceptual themes driving changes to the new manual. This is the first in a series continuing through May that will summarize the diagnostic and organizational differences between DSM-IV and DSM-5.

DSM-5, approved by the APA Board of Trustees in December, reflects the “state of the clinical science” in psychiatric diagnosis, incorporating important findings from genetic, neurobiological, and treatment research, while also maintaining substantial continuity for maximum clinical utility…

Go here for the DSM-5 Collection.

Psychiatric News Alert, where those not intending to boycott DSM-5 are encouraged to explore and pre-order a copy ($199):

Psychiatric News Alert

Tuesday, January 22, 2013

New DSM-5 Series Includes Supplementary Information; Order Your Manual Now!

The new DSM-5 pages can be found here, with articles, fact sheets and videos:

http://www.psychiatry.org/dsm5

Documents include:

DSM-5 Table of Contents  [Lists disorder sections and the categories that sit under them.]

Changes to DSM-5

Continuity and Changes Mark New Text of DSM-5, Psychiatric News, January 18, 2013

Highlights of Changes from DSM-IV-TR to DSM-5
DSM-5 Provides New Take on Developmental Disorders, Psychiatric News, January 18, 2013

DSM-5 Fact Sheets

From Planning to Publication: Developing DSM-5
The People Behind DSM-5
The Organization of DSM-5

Making a Case for New Disorders
Autism Spectrum Disorder
Specific Learning Disorder
Intellectual Disability
Social Communication Disorder
Attention-Deficit/Hyperactivity Disorder

DSM-5 Video Series

How and why was DSM-5 developed?
What has been the goal for revising DSM-5?

What are the changes to autism spectrum disorder in DSM-5?
What will be the impact of DSM-5 changes to autism spectrum disorder?
What are the changes to learning disorder in DSM-5?
What will be the impact of the revised specific learning disorder diagnosis?

The APA’s DSM-5 Development site can still be found here DSM-5 Development.

Proposals for changes to DSM-IV categories and criteria, as they had stood at the third draft, were frozen on June 15, 2012.

Any revisions made to criteria sets following closure of the third and final comment period are subject to embargo and the DSM-5 Development site has not been updated to reflect changes made to categories and criteria beyond June 15.

The entire third draft of proposals was removed from the DSM-5 Development site on November 15.

You can read APA’s rationale for removing the draft on an updated Permissions, Licensing & Reprints page.

American Psychiatric Association Board of Trustees approves final DSM-5 diagnostic criteria

American Psychiatric Association Board of Trustees approves final DSM-5 diagnostic criteria

Post #2012 Shortlink: http://wp.me/pKrrB-2xu

Yesterday, December 1, the American Psychiatric Association issued a news release – full text posted below or open PDF here: APA News Release 12.01.12

or download here: http://www.psychiatry.org/advocacy–newsroom/news-releases

There was also an alert published on Pyschiatric News here: APA Board of Trustees Approves DSM-5

A message from APA President Dilip Jeste, M.D., on DSM-5 was also published.

I’ll be compiling links to media coverage in the next post.

Contact: For Immediate Release:

Eve Herold, 703-907- 8640 December 1, 2012

press@psych.org  Release No. 12-43

Erin Connors, 703-907-8562

econnors@psych.org

Tamara Moore, 610-360-3405

tmoore@gymr.com

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 American Psychiatric Publishing.

The manual will include approximately the same number of disorders that 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 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:

Section 1 will give an introduction to DSM-5 with information on how to use the updated manual;

Section 2 will outline the categorical diagnoses according to a revised chapter organization; and

Section 3 will include conditions that require further research before their consideration as formal disorders, as well as cultural formulations, glossary, the names of individuals involved in DSM-5’s development and other information.

Summary of Decisions for DSM-5

Key decisions made by the Board of Trustees include:*

• Overall Substantive Changes

o Chapter order

o Removal of multiaxial system

• Section 2 Disorders

o Autism spectrum disorder

o Binge eating disorder

o Disruptive mood dysregulation disorder

o Excoriation (skin-picking) disorder

o Hoarding disorder

o Pedophilic disorder

o Personality disorders

o Posttraumatic stress disorder

o Removal of bereavement exclusion

o Specific learning disorders

o Substance use disorder

• Section 3 Disorders

o Attenuated psychosis syndrome

o Internet use gaming disorder

o Non-suicidal self-injury

o Suicidal behavioral disorder

• Disorders Not Accepted for Sections 2 or 3

o Anxious depression

o Hypersexual disorder

o Parental alienation syndrome

o Sensory processing disorder

* 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 to evaluate the proposals—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 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 inclusive 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

 • Chapter order: DSM-5’s 20 chapters will be restructured based on disorders’ apparent relatedness to one another, as reflected by similarities in disorders’ underlying vulnerabilities and symptom characteristics. The changes will align DSM-5 with the World Health Organization’s (WHO) International Classification of Diseases, eleventh edition (ICD-11) and are expected to facilitate improved communication and common use of diagnoses across disorders within chapters.

 • Removal of multiaxial system: DSM-5 will move to a nonaxial documentation of diagnosis, combining the former Axes I, II, and III, with separate notations for psychosocial and contextual factors (formerly Axis IV) and disability (formerly Axis V).

Section 2 Disorders

1. Autism spectrum disorder: The criteria will incorporate several diagnoses from DSM-IV including autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder (not otherwise specified), into the diagnosis of autism spectrum disorder for DSM-5 to help more accurately and consistently diagnose children with autism.

2. Binge eating disorder will be moved from DSM-IV’s Appendix B: Criteria Sets and Axes Provided for Further Study to DSM-5 Section 2. The change is intended to better represent the symptoms and behaviors of people with this condition.

3. Disruptive mood dysregulation disorder will be included in DSM-5 to diagnose children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year. The diagnosis is intended to address concerns about potential over-diagnosis and overtreatment of bipolar disorder in children.

4. Excoriation (skin-picking) disorder is new to DSM-5 and will be included in the Obsessive-Compulsive and Related Disorders chapter.

5. Hoarding disorder is new to DSM-5. Its addition to DSM is supported by extensive scientific research on this disorder. This disorder will help characterize people with persistent difficulty discarding or parting with possessions, regardless of their actual value. The behavior usually has harmful effects—emotional, physical, social, financial and even legal—for a hoarder and family members.

6. Pedophilic disorder criteria will remain unchanged from DSM-IV, but the disorder name will be revised from pedophilia to pedophilic disorder.

7. Personality disorders: DSM-5 will maintain the categorical model and criteria for the 10 personality disorders included in DSM-IV and will include the new trait-specific methodology in a separate area of Section 3 to encourage further study how this could be used to diagnose personality disorders in clinical practice.

8. Posttraumatic stress disorder (PTSD) will be included in a new chapter in DSM-5 on Trauma- and Stressor-Related Disorders. DSM-5 pays more attention to the behavioral symptoms that accompany PTSD and proposes four distinct diagnostic clusters instead of three. PTSD will also be more developmentally sensitive for children and adolescents.

9. Removal of bereavement exclusion: the exclusion criterion in DSM-IV applied to people experiencing depressive symptoms lasting less than two months following the death of a loved one has been removed and replaced by several notes within the text delineating the differences between grief and depression. This reflects the recognition that bereavement is a severe psychosocial stressor that can precipitate a major depressive episode beginning soon after the loss of a loved one.

10. Specific learning disorder broadens the DSM-IV criteria to represent distinct disorders which interfere with the acquisition and use of one or more of the following academic skills: oral language, reading, written language, or mathematics.

11. Substance use disorder will combine the DSM-IV categories of substance abuse and substance dependence. In this one overarching disorder, the criteria have not only been combined, but strengthened. Previous substance abuse criteria required only one symptom while the DSM-5’s mild substance use disorder requires two to three symptoms.

http://www.psychnews.org/files/DSM-message.pdf

PDF: Message from APA President on DSM-5

A Message From APA President Dilip Jeste, M.D., on DSM-5

December 1, 2012

I am pleased to announce that DSM-5 has just been approved by APA’s Board of Trustees. Getting to the finish line has taken a decade of arduous work and tens of thousands of pro-bono hours from more than 1,500 experts in psychiatry, psychology, social work, psychiatric nursing, pediatrics, neurology, and other related fields from 39 countries. We look forward to the book’s publication next May.

The goal of the DSM-5 process has been to develop a scientifically based manual of psychiatric diagnosis that is useful for clinicians and our patients. APA’s interest in developing DSM dates back to the organization’s inception in 1844, when one of its original missions was to gather statistics on the prevalence of mental illness. In 1917, the Association officially adopted the first system for uniform statistical reporting called the Statistical Manual for the Use of Hospitals for Mental Diseases, which was adopted successfully by mental hospitals throughout the country. It was expanded into the first Diagnostic and Statistical Manual (DSM) in 1952 and first revised (DSM-II) in 1968. Like the rest of the field in that era, these first two versions were substantially influenced by psychoanalytic theories.

With advances in clinical and scientific knowledge, changes in diagnostic systems are inevitable. The World Health Organization’s International Classification of Diseases (ICD)—the standard diagnostic tool for epidemiology, health management, and clinical care used around the world, which covers all medical diagnoses—has been through 10 editions since the late 1800s and is now preparing its 11th edition, due in 2015. Likewise, DSM has undergone changes to take into account progress in our understanding of mental illnesses. DSM-III, published in 1980 under the leadership of Dr. Robert Spitzer, and DSM-IV, published in 1994 under the leadership of Dr. Allen Frances, represented the state of science of psychiatry at those times and significantly advanced the field.

In the two decades since the publication of DSM-IV, we have witnessed a wealth of new studies on epidemiology, neurobiology, psychopathology, and treatment of various mental illnesses. So, it was time for APA to consider making necessary modifications in the diagnostic categories and criteria based on new scientific evidence. But there were, of course, challenges inherent in revising an established diagnostic system.

The primary criterion for any diagnostic revisions should be strictly scientific evidence. However, there are sometimes differences of opinion among scientific experts. At present, most psychiatric disorders lack validated diagnostic biomarkers, and although considerable advances are being made in the arena of neurobiology, psychiatric diagnoses are still mostly based on clinician assessment.

Also, there are unintended consequences of psychiatric diagnosis. Some arise from the unfortunate social stigma and discrimination in getting jobs or even obtaining health insurance (notwithstanding the mental health parity law) associated with a psychiatric illness. There is also the double-edged sword of underdiagnosis and overdiagnosis. Narrowing diagnostic criteria may be blamed for excluding some patients from insurance coverage and needed services, while expanded efforts to diagnose (and treat) patients in the early stages of illness to prevent its chronicity are sometimes criticized for increasing its prevalence and potentially expanding the market for the pharmaceutical industry. (It should be noted, however, that DSM is not a treatment manual and that diagnosis does not equate to a need for pharmacotherapy.)

APA has carefully sought to balance the benefits of the latest scientific evidence with the risks of changing diagnostic categories and criteria. We realize that, given conflicting views among different stakeholders, there will be inevitable disagreements about some of the proposals—whether they involve retaining the traditional DSM-IV criteria or modifying them.

The process of developing DSM-5 began in earnest in 2006, when APA appointed Dr. David Kupfer as chair and Dr. Darrel Regier as vice chair of the task force to oversee the development of DSM-5. The task force included the chairs of 13 diagnostic work groups, who scrutinized the research and literature base, analyzed the findings of field trials, reviewed public comments, and wrote the content for specific disorder categories within DSM-5. To ensure transparency and reduce industry-related conflicts of interest, APA instituted a strict policy that all task force and work group members had to make open disclosures and restrict their income from industry. In fact, the vast majority of the task force and work group members had no financial relationship with industry.

To obtain independent reviews of the work groups’ diagnostic proposals, the APA Board of Trustees appointed several review committees. These included the Scientific Review Committee (co-chaired by Drs. Ken Kendler and Robert Freeman), Clinical and Public Health Committee (co-chaired by Drs. Jack McIntyre and Joel Yager), and APA Assembly Committee (chaired by Dr. Glenn Martin). Additionally, there was a forensic review by members of the Council on Psychiatry and Law. Drs. Paul Appelbaum and Michael First were consultants on forensic issues and criteria/public comments, respectively. Reviews by all these groups were coordinated in meetings of the Summit Group, which included the task force and review committee co-chairs and consultants along with members of the Executive Committee of the Board of Trustees.

There has been much more public interest and media scrutiny of DSM-5 than any previous revisions. This reflects greater public awareness and media interest in mental illness, as well as widespread use of the Internet and social media. To facilitate this transparent process, APA created a Web site (www.dsm5.org ) where preliminary draft revisions were available for the public to examine, critique, and comment on. More than 13,000 Web site comments and 12,000 additional comments from e-mails, letters, and other forms of communication were received. Members of the DSM-5 work groups reviewed the feedback submitted to the Web site and, where appropriate, made modifications in their proposed diagnostic criteria.

We believe that DSM-5 reflects our best scientific understanding of psychiatric disorders and will optimally serve clinical and public health needs. Our hope is that the DSM-5 will lead to more accurate diagnoses, better access to mental health services, and improved patient outcomes.

Flyer: DSM-5 Core titles from American Psychiatric Publishing

Flyer: DSM-5 Core titles from American Psychiatric Publishing

Post #211 Shortlink: http://wp.me/pKrrB-2×5

The third stakeholder review and comment period on proposals for revisions to categories and criteria for the next edition of the Diagnostic and Statistical Manual of Mental Disorders, to be known as DSM-5, was launched on May 4.

Following closure of this final public review, revisions made by the DSM-5 Work Groups to criteria and disorder descriptions subsequent to June 15 are subject to embargo.

Final criteria sets and accompanying texts won’t be released until the DSM-5 is published, next year.

The release of DSM-5 is slated for May 18-22, 2013, during the APA’s 2013 Annual Meeting in San Francisco, CA.

A couple of days ago, the third draft was removed in its entirety from the DSM-5 Development website.

In advance of release of DSM-5, the publishing arm of the American Psychiatric Association has issued a promotional flyer for its DSM-5 CORE TITLES:

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

American Psychiatric Association

Desk Reference to the Diagnostic Criteria from DSM-5

American Psychiatric Association

DSM-5 Clinical Cases

John W. Barnhill, M.D., David J. Kupfer, M.D., and Darrel A. Regier, M.D., M.P.H.

DSM-5 Guidebook

Donald W. Black, M.D., and Jon E. Grant, M.D., M.P.H., J.D.

Study Guide to DSM-5

Laura Weiss Roberts, M.D., M.A.

DSM-5 Handbook of Differential Diagnosis

Michael B. First, M.D.

DSM-5 Self-Exam Questions

Test Questions for the Diagnostic Criteria

Philip R. Muskin, M.D.

Note that the flyer states:

• New disorders include, but are not limited to, somatic symptom disorder, hoarding disorder, mild and major neurocognitive disorder, anxiety illness disorder, and premenstrual dysphoric disorder…

According to DSM-5 draft three, the proposed name for the disorder that replaces “Hypochondriasis” in DSM-IV is intended to be “J01 Illness Anxiety Disorder” not “anxiety illness disorder,” as the flyer has it. It is to be hoped that proofs of the manual will be subject to closer scrutiny than this flyer evidently underwent.

The flyer can be opened here 

   DSM-5 flyer

or download here http://dsm5.org/SiteCollectionDocuments/AH1259%20DSM-5%20flyer.pdf

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Related material

Further DSM-5 spin-jobs:

Psychiatric News | November 16, 2012

Volume 47 Number 22 page 1b-10

Professional News

Results of DSM Field Trials Available on AJP in Advance

Mark Moran

The field trials provide new data for the ongoing review of proposed diagnostic criteria for DSM-5

Three papers discussing the results of the DSM-5 field trials were posted October 30 by AJP in Advance. These papers describe the methods and results of the 23 diagnoses that were assessed…

and from Task Force Chair, David J. Kupfer…

Huffington Post Blog

David J. Kupfer, MD | Chair, DSM-5 Task Force | November 7, 2012

Field Trial Results Guide DSM Recommendations

Written with Helena C. Kraemer, Ph.D.

Two years ago this month, APA announced the start of field trials that would subject proposed diagnostic criteria for the future DSM-5 to rigorous, empirically sound evaluation across diverse clinical settings. And now, as the first comprehensive analyses of that effort are published, what’s clear is just how well the field trials did their job…

For comment see:

1 Boring Old Man

OMG!…

1 Boring Old Man | November 9, 2012

Side Effects

From quirky to serious, trends in psychology and psychiatry

by Christopher Lane, Ph.D.

The DSM-5 Field Trials’ Decidedly Mixed Results

Far from being a ringing endorsement, the field trials set off fresh alarm bells

Christopher Lane, Ph.D. | November 11, 2012

“What’s the chance that a second, equally expert diagnosis will agree with the first, making a particular diagnosis reliable?” asks David Kupfer, chair of the DSM-5 task force, of the decidedly mixed results of the DSM-5 field trials. First off, are you sure you really want to know?…

You Can’t Turn a Sow’s Ear Into a Silk Purse

By Allen Frances, MD | November 11, 2012

also here on Psychiatric Times (registration required):

http://www.psychiatrictimes.com/blog/frances/content/article/10168/2113993

American Psychiatric Association Annual Meeting: May 18-22, 2013, San Francisco

American Psychiatric Association 166th Annual Meeting: May 18-22, 2013, San Francisco, CA

Post #209 Shortlink: http://wp.me/pKrrB-2wB

The American Psychiatric Association (APA) has announced its 166th Annual Meeting, scheduled for May 18-22, 2013, San Francisco, CA.

REGISTRATION DATES

EARLY BIRD REGISTRATON

Member November 1, 2012 – January 24, 2013

Nonmember November 15, 2012 – January 24, 2013

ADVANCE REGISTRATION January 25 – April 19, 2013

ONSITE REGISTRATION April 20 – May 22, 2013

Meeting website

Scientific Program

Annual Meeting Information Guide   [9MB PDF at foot of this page]

Program Highlights Preview

(Described as roughly half of the scientific program with the full program to be posted when scheduling is complete) [Click on the image at foot of page to load 9 MB PDF or download PDF from this link PREVIEW]

The DSM-5 Track starts on Page 12 of the PDF. 

 

It is planned that the DSM-5 will be released at this meeting

APA President’s Message on DSM-5  [Video 5:52 mins]

APA President Dilip Jeste, MD discusses the final stages of DSM-5 development.

Important changes to DSM-5 Development website: Draft proposals and criteria removed

Important changes to DSM-5 Development website: Draft proposals and criteria removed

Post #208 Shortlink: http://wp.me/pKrrB-2wk

Update: November 16: Webpages on the DSM-5 Development site that were no longer accessible, yesterday, via the home page or a Proposals tab menu but were still accessible via their URLs have today been placed behind a log  in.

Following closure of the third and final DSM-5 stakeholder review, revisions made by the 13 Work Groups and Task Force to proposals and criteria for DSM-5 subsequent to June 15 are subject to embargo.

You can read the DSM-5 Permissions Policy here  (Updated: 5/30/2012).

The DSM-5 Development site Terms and Conditions of Use can be read here (Effective Date: June 21, 20120).

The Terms and Conditions of Use page has not been updated to reflect very recent changes to the website.

+++

Removal of proposals for DSM-5 categories and criteria

I have a webpage change detection service set up for the home page and selected pages of the DSM-5 Development site.

Today, November 15, I was notified that the DSM-5 Development home page text has been recently edited.

The home page text has been revised and the 20 links towards the foot of the home page text to Proposed Revisions have been removed, as has the drop-down tab menu for Proposed Revisions, Rationales, Severity Specifiers for the 20 DSM-5 category sections.

The revised home text can be read here.

The home page text as it had stood prior to recent editing can be reviewed (for a while) on this Google cache page.

[…Google’s cache of http://www.dsm5.org/ . It is a snapshot of the page as it appeared on 4 Nov 2012 21:50:47 GMT…]

The DSM manual and its clinical and research criteria sets are a major cash cow for the publishing arm of the APA.

APA is protecting its intellectual property rights by removing draft criteria as they had stood at June 15, 2012 and in placing an embargo on interim revisions to the texts, prior to publication of the final categories, criteria sets and associated textual content, next year.

Consequently, draft proposals, criteria, rationales, severity specifiers and for some categories, PDF files expanding on proposals and rationales, as they had stood at the time of the third draft, are no longer available for review or for comparison with earlier iterations of the draft directly from links on the site’s home page text or from links in a Proposals tab drop-down menu along the top of the home page.

According to the DSM-5 Development home page and recent commentary from Task Force Chair, David J Kupfer, MD, DSM-5 remains on target for release in May 2013.

No recent projections for the date by which an online version of the DSM-5 is expected to be available, post publication of the print edition, have come to my attention but it is anticipated that access to any online version of the manual would be available via subscription – not as a freely accessible public domain version, as ICD-10-CM and ICD-11 will be when they are published and implemented.

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