Psychiatry Group Proposes Significant Changes to Diagnostic Manual

In a process that began a decade ago, the American Psychiatric Association (APA) has released a first draft of the 5th edition of the key tool used by clinicians to diagnose mental disorders and mental illness, the Diagnostic and Statistical Manual of Mental Disorders (the "DSM"). Although the APA does not plan to release the final version until 2013, some of the proposed changes are already creating controversy, particularly changes in the classification of autism-related disorders.

The APA first published the DSM in 1952 when it became apparent that mental health professionals were diagnosing and treating mental disorders in contradictory ways. The APA combined research from the military and the World Health Organization's International Statistical Classification of Diseases to create the first manual, which was only 130 pages long (by contrast, the most-recent revision is nearly 1,000 pages). The DSM was significantly revised in 1968, 1980, and 1994 in order to keep abreast of the latest mental health research and to standardize common practices in psychiatry. The new revision follows this trend by updating language, changing some common definitions of disorders, and, in some cases, completely reevaluating how some disorders are diagnosed.

One of the major proposed changes in the new DSM is the combination of autism, Asperger's syndrome, and several other disorders under the common rubric "autism spectrum disorders. Some advocates for people with Asperger's have questioned the change, fearing that the new definition will both limit the resources available to people with Asperger's and blur the differences between people with Asperger's and others with more severe forms of autism.

The new DSM also addresses the growing number of children being diagnosed with bipolar disorder by creating a new condition called "temper regulation disorder." Unlike bipolar disorder, which is a chronic, life-long condition with episodic highs and lows that can last for months at a time, temper regulation disorder is characterized by shorter outbursts of uncontrolled anger and lack of attention. The authors of the DSM hope that the new diagnosis will prevent children from being "labeled" for life with a condition that may be curable through childhood therapy.

As part of the process of refining the new DSM, the authors have opened the process to public comments. To read the proposed changes and to leave your comments, click here.

To read an article in USA Today that describes some of the changes to the DSM, click here.