From those principles derive the most original features of the DSM-III: the use of stringent diagnostic criteria, of a possible quantitative nature and the adoption of a multi-axial system. Some of the most striking changes introduced are the logical consequences of the principles e.
Others changes such as the introduction of new diagnostic categories or changes in the limits of classical ones especially schizophrenia and manic-depressive psychosis reflect a reaction against previous trends of American psychiatry and a strict adherence to a pragmatic and empirical thinking. Diagnostic and statistical manual of mental disorders 3rd ed. Diagnostic and statistical manual of mental disorders 4th ed. Diagnostic and statistical manual of mental disorders 5th ed.
World Health Organization. International statistical classification of diseases and related health problems 10th ed. International statistical classification of diseases and related health problems 11th ed. Inaccurately defined categories of mental illness like mania, melancholia, monomania, general paralysis of the insane, dementia, and dipsomania were included in the US Census of In , the American Medico-Psychological Association published a manual of classification of mental illnesses that listed 22 categories.
The manual was designed for the use of Institutions for the Insane. Office of the US Surgeon General adopted the Standard to classify illnesses on the battle grounds and among veterans returning from the war. The Veterans Administration adopted the Standard with few modifications. After the war, psychiatrist with experience of using the Standard during the Second World War continued to use it in civilian practice.
It resembled the Standard. In the year , the APA set up a committee on nomenclature and statistics. This committee published the first DSM in the year It did not carry any number attached to its title. Authors of the manual had perhaps not envisaged that the manual would be revised periodically.
This would facilitate subsequent revisions being numbered as 5. While facilitating the numbering, it is also a tacit acceptance that the DSM 5 is not the ultimate manual of classification of mental disorders.
It is a document that reflects current consensus of the leading academicians, clinicians, and researchers in the field of mental health. The diagnostic criteria continued to result in rather frequent diagnosis of comorbidity.
Heterogeneity within the diagnostic groups was unacceptable to the researchers and it contaminated treatment outcome. The erratic thresholds for inclusion and exclusion could not differentiate the normal from abnormal or syndromal from subsyndromal disorders.
Clinicians would then resort to the not otherwise specified NOS diagnoses. The DSM IV did not consider emerging clinical conditions like addiction to the internet or the so called nocturnal refrigerator raids. These are some of the salient features that prompted leaders in the field led by Dr.
Steven M. It reflects the need for urgency and prominence of mental disorders. An important component of mental disorders is that unlike physical illnesses that incorporate a socially acceptable sick role, mental disorders could stigmatize personal sense of identity. The planning conference included experts in family and twin studies, molecular genetics, basic and clinical neurosciences, cognitive and behavioral sciences, and covered issues in development throughout the lifespan and disability.
The conference focused on issues like lacunae in the DSM IV system of classification, disability and impairment, newer insights from the research in neuroscience, need for improved nomenclature, and the impact of cross cultural issues. By the year , Dr. Darrel A. All the working group members were reviewed for potential conflict of interest and approved by the APA Board of Trustees. David Kupfer, MD and Dr. Reiger led the team of more than participants working in 13 work groups, six study groups, and a task force of advocates, clinicians, and researchers since the year Each committee had co-chairs from both the US and another country.
The entire process maintained transparency by publishing minutes of every meeting and monographs of their proceedings on the APA website, presentations at scientific conferences with question-and-answer opportunity at countless national and international conferences, they held grand rounds at leading university medical center, and presented posters as well as papers at the annual meetings of the APA.
The years of relentless efforts include evidence based planning; field trials; revising; seeking; and incorporating feedback, suggestions, and objections from the stake holders, public, patient, and other interested groups worldwide; revising again; and obtaining approval of the Board of Trustees of the APA. DSM 5 does not claim to be the ultimate or the final word in classification of mental disorders.
It is a manual that reflects current state of knowledge and consensus among leaders in the field. Section I is the basics which includes introduction, instruction on how to use the manual, and a chapter on cautionary statement for forensic use of DSM 5.
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