Diagnostic Classification in the United States: A Commentary on the Progression from DSM-III to the Development of DSM-5

摘要

It has been 17 years since the latest edition of Diagnostic and Statistical Manual of Mental Disorders, DSM-IV, was published. While it was recognized for utilizing empirically-based literature reviews, establishing reliability of the criteria via field trials, and introducing the clinical significance criterion, DSM-IV has weaknesses that may have hindered research advancement and patient diagnostic assessments. Plans to address these shortcomings in the fifth edition of DSM (DSM-5) began with a systematic review of the state of the science and identification of the most significant research gaps in psychiatric diagnosis and nosology. The result was a collection of white paper publications, which led to a collaboration between the American Psychiatric Association, the World Health Organization, and the National Institutes of Health to convene a series of diagnosis-specific research planning conferences. The DSM-5 Task Force and Work Group members were then convened and charged with developing a clinically useful DSM-5 based on scientifically-sound research evidence. The current DSM-5 revision process is guided by several principles, including prioritizing clinical utility, implementing empirically-driven changes, and making DSM-5 a "living document" that can be readily amended to keep pace with scientific advances in the field. Revision strategies are being developed to harmonize with planning for the 11th edition of the International Classification of Diseases with the hope of creating a globally unified diagnostic scheme.