DSM-5: Potential Impact of Key Changes on Pharmacy Practice

Abstract and Introduction

Abstract

The Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5), the authoritative guide for practitioners in establishing diagnoses and seeking reimbursement, was published in May 2013. Previous editions of the handbook established the well-known multiaxial diagnostic system that organized all medical and psychiatric conditions requiring attention by all members of the healthcare team. The new edition includes a number of changes that can affect pharmacy practice—including, but not limited to, the elimination of the multiaxial system. In this article, changes to some of the major mental health conditions are summarized, as well as treatment interventions that may be recommended. Pharmacists should expect prescribing trends to be influenced by DSM-5, so gaining a basic familiarity with these changes is important.

Introduction

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which replaces DSM-IV-TR (Fourth Edition, Text Revision; published in 2000), is the authoritative handbook on diagnosis of mental disorders that is used by healthcare professionals in the United States and around the world.^[1] Published by the American Psychiatric Association (APA) in May 2013, this clinical resource is a guide for practitioners in establishing diagnoses, requesting reimbursement, and—for researchers—investigating and evaluating statistical health outcomes. Treatment recommendations and insurance payments to healthcare providers are often determined by DSM classifications, so the changes reflected in DSM-5 are expected to have significant clinical and practical impact. Prior to publication, critics of DSM-5 developed and circulated a petition, sponsored and signed by many mental health organizations, that called for an outside review of the document.

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