Diagnostic and Statistical Manual of Mental Disorders (DSM)

by

Thomas Widiger

Introduction

Mental health professionals and scientists must have a common language to communicate with their colleagues, with professional agencies, and with patients and the general public. The primary purpose of an official, authoritative diagnostic nomenclature is to provide this common language that minimizes the use of idiosyncratic and invalid concepts. The American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) provides this common language for the description of psychopathology. DSM-IV-TR is the current edition of the APA’s diagnostic manual. With a couple of exceptions, it contains the same diagnoses and diagnostic criterion sets that were developed for the 1994 DSM-IV. DSM-IV-TR (with the exceptions) constituted only a revision of the text discussion of each disorder. No new diagnoses were added, and none were deleted. The exceptions were revisions to the criterion sets for tic disorders and paraphilias.

General Overviews

Allen Frances was the chair of DSM-IV, Harold Pincus was the vice chair, and Michael First was the text editor. Frances, et al. 1995 provides an easy-to-follow guide for the major decisions that were made for DSM-IV. Harold Pincus was the chair of DSM-IV-TR (American Psychiatric Association 2000) and Michael First was the co-chair. First and Pincus 2002 provides the rationale for the development of DSM-IV-TR. Norman Sartorius directed the mental disorders section of the World Health Organization’s International Classification of Diseases. The importance of having clinicians, researchers, and countries from around the world all using the same diagnostic system is discussed in Sartorius, et al. 1993.

• American Psychiatric Association. 2000. Diagnostic and statistical manual of mental disorders (DSM-IV-TR). 4th ed. Washington, DC: American Psychiatric Association.

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  This text provides the American Psychiatric Association’s list of officially recognized mental disorders. The text includes the diagnostic criterion sets for each disorder, along with a description of course, associated features, laboratory and physical exam findings, and other information that might be useful for diagnosis.

• First, M. B., and H. A. Pincus. 2002. The DSM-IV text revision: Rationale and potential impact on clinical practice. Psychiatric Services 53: 588–592.

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  Provides the rationale for the development of DSM-IV-TR, as well as the explanation for the revisions to the tic disorders and paraphilias.

• Frances, A. J., M. B. First, and H. A. Pincus. 1995. DSM-IV guidebook. Washington, DC: American Psychiatric Press.

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  A straightforward guide for the construction and application of the DSM-IV-TR, the lead author of which was the chair of DSM-IV.

• Sartorius, N., C. T. Kaelber, J. E. Cooper, M. Roper, D. S. Rae, W. Gulbinat, T. B. Ustun, and D. A. Regier. 1993. Progress toward achieving a common language in psychiatry. Archives of General Psychiatry 50:115–124.

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  This is an excellent historical and current argument for the importance of developing an authoritative diagnostic system.