Last DSM-5 Public Review Period Ends With 2000 Comments

Deborah Brauser

June 26, 2012

June 26, 2012 — The latest and final public comment period for the upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) ended on June 15 — but not before logging 2298 responses from around the world, the American Psychiatric Association (APA) reports.

This was the third public comment period that has been opened for online feedback regarding the manual's proposed criteria changes. To date, there have been a total of 15,000 public comments posted.

"Every comment period has provided valuable perspective from a wide range of professionals, consumers, and advocates," said Dilip V. Jeste, MD, president of the APA, in a release.

"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," said Dr. Jeste.

The Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic Stress, and Dissociative Disorders Work Group and the Neurodevelopmental Work Group garnered the most comments at 545 and 397, respectively.

Next Steps

All of the disorder-focused work groups will now review the public comments specific to their areas of expertise as part of the manual's revision process.

Once the work groups make their final diagnostic criteria recommendations, all proposals will be reviewed by the entire DSM-5 Task Force, a separate Scientific Review Committee, and a Clinical and Public Health Committee, reports the APA.

"The latter 2 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," they write in the release.

At the end of these steps, the Task Force will then make their final recommendations to the APA Board of Trustees. Print and electronic versions of the manual are still scheduled to be published in May 2013, in time for next year's APA Annual Meeting in San Francisco.

Debates Continue

In early June, Allen J. Frances, MD, from Duke University, who was chair of the DSM-IV Task Force, said in an interview arranged by Medscape Medical News that although there have been some promising changes made recently to the manual, "there are many other radical and potentially dangerous ideas in DSM-5."

He also called the recent results from the new criteria field trials "embarrassingly poor."

"It remains to be seen whether DSM-5 will be responsive to what is certain to be increasing external pressure to trim its sails and improve its quality," said Dr. Frances at the time.

In an answering interview published by Medscape Medical News soon after, DSM-5 Task Force chair David Kupfer, MD, defended the manual's proposed revisions and said that the organization "learned crucial information" from the field trials.

"Some have argued that the publication of DSM-5 should be delayed. But the current manual's shortcomings, particularly in the area of childhood disorders, compel us to move forward now, with changes supported by the most credible research available and the practical experiences provided by our field trials," said Dr. Kupfer at the time.

The latest draft criteria are posted on the APA's DSM-5 Web site.


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