Inside the New DSM-5

The American Psychiatric Association recently released a proposed draft of the much anticipated fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). For those not in the know, the DSM is the standard classification of mental disorders used by mental health and other health professionals, and DSM-IV is the current go-to guide for diagnostic and research purposes. While the final version of DSM-5 won’t be available until 2013, we can share some of the highlights.

DSM Updates

The current categories “substance abuse” and “dependence” will be replaced with the new category “addiction and related disorders.” This will include substance use disorders, with each drug identified in its own category. The reasoning behind this decision is that “eliminating the category of dependence will better differentiate between the compulsive drug-seeking behavior of addiction and normal responses of tolerance and withdrawal that some patients experience when using prescribed medications that affect the central nervous system.”

Another change includes the newly created category of “behavioral addictions,” in which gambling will be the sole disorder. While Internet addiction was considered for this category, work group members reportedly decided there was insufficient research data to do so. Instead, they recommend it be included in the manual’s appendix, with a goal of encouraging additional study. This keeps Internet addiction relegated to the same category as shopping addiction, video game addiction and other so-called “process addictions.”

The last edition of DSM was published in 1994. Beginning in 2000, during the initial phase of revising DSM, the APA engaged almost 400 international research investigators in 13 NIH supported conferences. The proposed diagnostic criteria will be available for public comment until April 20 and will be reviewed and refined over the next two years. During this time, the APA will conduct three phases of field trials to test some of the proposed diagnostic criteria in real-world clinical settings.  

Addiction Rehab

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