The Diagnostic and Statistical Manual of Mental Disorders has been a mainstay for the mental health world for decades. In 2013, the DSM-5 emerged on the scene as the latest version of this diagnostic manual.

What Is the Diagnostic and Statistical Manual (DSM)?

The Diagnostic and Statistical Manual (DSM) is a resource that is used to identify criteria for the diagnosis of mental health conditions. The DSM-5 is a book that helps professionals differentiate one diagnosis from another and offers a clear criterion for the diagnosis of each condition, along with rule-out options and other pertinent facts about cultural discrepancies, rates of prevalence and treatment options

DSM-5 vs. ICD-10

In the world of physical and mental health care, diagnosis is key to determining treatment options. In both settings, providers have access to clinical manuals to help evaluate and diagnose specific conditions. The mental health world uses the DSM for diagnosis, while the medical field uses the International Classification of Diseases (ICD). 

The difference between the DSM and ICD is primarily a matter of intent and purpose. The ICD is now in its 10th edition. It is created by a global organization (World Health Organization), which is committed to public health, while the DSM is developed by the American Psychological Association) and is specific to mental health. Both the DSM-5 and ICD-10 provide crucial information for the diagnosis and treatment of physical and mental health disorders. 

History of the DSM

The first DSM was published in 1952 as a complement to the medical manual, ICD-6 at the time. The original DSM provided a much needed diagnostic tool for mental health issues that the ICD was lacking. Through the years, DSM has made significant changes as new and updated information has emerged in the mental health field. The history of the DSM-5 dates back to 2000 when groups were formed to establish a plan for the new DSM and determine areas of research. By 2007, the groups had done extensive research and amassed significant amounts of information that informed the creation of the DSM-5 by task groups. The manual was drafted over the next six years and published in 2013.

Summary of Major Updates

DSM-5 changes have been significant compared to more recent versions of the manual. Many of these major changes were initially met with criticism by mental health professionals who felt that the new diagnoses, such as disruptive mood dysregulation disorder, were not fully supported by empirical data. There were many significant revisions of long-standing diagnostic categories, including autism spectrum, substance abuse and post-traumatic stress disorder, and removal of other specifications such as bereavement disorder. 

Disorder Classifications & Sections

In the DSM-5, disorders are classified by type and clustered by range and severity of symptoms. There are 21 categories into which the specific disorders are divided. The categories are the general umbrella under which those disorders fall. Each individual condition, or DSM-5 diagnosis, is listed under the appropriate category and given an “F-code” which is the code it is billed under. The code is also used in medical and mental health records as a shorthand means of indicating a specific diagnosis. This coding system allows conditions to be narrowed down based on specific symptoms, duration and severity. 

How Mental Health Professionals Use the DSM-5

The DSM-5 provides mental health professionals with a resource to determine a patient’s diagnosis. The determination of a diagnosis is based on a set of criteria that has been established by teams of researchers and professionals in the field. The DSM mental disorders have been through vast revisions over the years. The category of substance use disorder in the DSM-5 has been the subject of significant revision, particularly since more is being learned in the field of addiction medicine and research. Revisions are an important part of the growth process for the DSM and for the field of mental health. 

Just as our culture shifts and changes, our understanding of the human mind also adapts and grows. Science informs our understanding of mental health and provides us with new perspectives on identifying and treating people’s needs. Professionals use the DSM-5 to narrow down diagnoses based on specific criteria, duration and severity. This designation helps providers decide which steps to take to best serve people’s needs. 

Accuracy of the DSM-5

While there has been criticism of the DSM-5, it continues to remain the standard tool for diagnosing mental health issues. The DSM-5 offers accurate diagnostic information for professionals assessing the needs and symptoms of clients. Differentiating between varying conditions and symptoms can impact diagnosis and treatment. It is imperative that providers have an accurate idea of what their patients are going through so that treatment can match up with clinical need.

Future of the DSM

The DSM will undoubtedly go through many more rounds of revision over the next several decades. As we learn more about mental health conditions and the mind-body connection, diagnoses will change, as well as criteria for varying disorders. Scientific discoveries show us new horizons in mental health and treatment, and these discoveries will certainly impact the way we diagnose and treat conditions in the future.