Last Chance for Public Feedback on DSM-5

Caroline Cassels

May 02, 2012

May 2, 2012 — For a third and final time, the American Psychiatric Association (APA) has opened up the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for public comment.

This final period of public feedback will last 6 weeks and will close on June 15.

The APA reports that in preparation for this final comment period, members of the DSM-5 Task Force and Work Groups have updated proposals for diagnostic criteria.

The revised criteria reflect recently published research, results from DSM-5 field testing of the criteria, and public comments received since 2010.

According to the APA, key changes posted for this round of public review include the following:

  • Revised proposals to place Attenuated Psychosis Syndrome and Mixed Anxiety Depressive Disorder in Section III of the manual, covering conditions that require further research before their consideration as formal disorders

  • Added language to Major Depressive Disorder criteria to help differentiate between normal bereavement associated with a significant loss and a diagnosis of a mental disorder

  • Added rationale for changes to Personality Disorders, with field trial data now supporting the reliability of dimensional measures and the categorical diagnosis of Borderline Personality Disorder

  • Modified diagnostic criteria for Pedophilic Disorder to make the category more consistent with the World Health Organization's International Classification of Diseases

  • Condensed diagnoses within Communication Disorders to only include Language Disorders and Speech Disorders

  • A proposal for a new diagnosis of Suicidal Behavioral Disorder

  • Modified diagnostic criteria for numerous disorders, including some in the Neurocognitive Disorders and Anxiety Disorders chapters

  • A proposed Cultural Formulation Interview, which includes specific questions to help clinicians more effectively assess cultural aspects of psychiatric diagnosis

All responses submitted via the DSM-5 Web site will be considered by the DSM-5 Work Groups, which are charged with assessing the latest scientific evidence and recommending the disorder definitions and criteria to be included in the manual.

Dr. John Oldham

Nearly 10,800 comments from healthcare professionals, mental health advocates, families, and consumers were submitted in the first 2 public comment periods in 2010 and 2011.

"The comments we have received over the past 2 years have helped sharpen our focus, not only on the strongest research and clinical evidence to support DSM-5 criteria but on the real-world implications of these changes," said APA President John M. Oldham, MD. "We appreciate the public's interest and continued participation in the DSM-5 development process."

After that, the site will remain viewable but will be closed to comments as the Work Groups and Task Force complete revisions and submit criteria for evaluation by the Scientific Review Committee and the Clinical and Public Health Committee. The Task Force will then make final recommendations to the APA Board of Trustees.

Dr. David Kupfer

The final version of DSM-5 is expected to go before the Board of Trustees in December 2012.

"As with every stage in this thorough development process, DSM-5 is benefitting from a depth of research, expertise, and diverse opinion that will ultimately strengthen the final document," noted David J. Kupfer, MD, chair of the DSM-5 Task Force.

Publication of DSM-5 is expected in May 2013.

A detailed list of changes made to draft proposals since July 2011 is available online.


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