![]() DSM-IV created separate diagnoses for "abuse" and "dependence" in people having problems with mind-altering substances such as marijuana and narcotics. Ultimately they settled on a formal diagnosis - potentially qualifying a patient for insurance-paid treatment if they want it - but with a less pejorative name than "disorder." The workgroup responsible for dealing with the hot-button issue considered a variety of other approaches, addressed later in this article. Instead, if they seek psychiatric treatment, they can be labeled with "gender dysphoria." Individuals who believe their biological gender doesn't match their gender identification will no longer be labeled with a disorder. One of the most controversial proposals in DSM-5 does away with the restriction that diagnosis of major depression cannot be given to patients reporting severe grief from the death of a loved one if the death occurred within the preceding two months. For example, Depressive Disorder NEC comes with 5 specifiers such as "short duration" that indicate the patient's clinical condition and why it doesn't meet criteria for one of the main depression syndromes.īereavement exclusion in major depression. In DSM-5, NOS categories are either gone entirely or replaced with NEC for "not elsewhere classified." NEC categories will include a list of "specifiers," each with a specific diagnostic code, that will convey clinical information. The head of the eating disorders workgroup, for example, cited data indicating that more than half of all patients diagnosed with an eating disorder were coded for "ED-NOS." Also, some disorders that were now well recognized and characterized were included in NOS categories, such as restless legs disorder. In practice, however, some of these became extremely popular. Use scientific evidence to justify classifications and criteria.Remove functional impairments as necessary components of the diagnostic criteria.Eliminate "not otherwise specified" (NOS) diagnoses within categories.Kupfer and Regier gave the workgroups marching orders at the outset. Here's a brief overview of the changes you can expect. Its formal release is planned for the APA's annual meeting next May in San Francisco. ![]() Kupfer said the final version has to be completed by December, when it's set to go to the printer. The final drafts are to be completed by August, then they must be approved by a scientific review committee and the task force leadership, and finally by the APA's governing bodies. The actual work of rewriting the manual fell to 13 workgroups, which tackled disorders in 20 categories. The update effort has been led by DSM-5 task force chairman David Kupfer, MD, of the University of Pittsburgh, and APA research director Darrel Regier, MD, MPH. The current version, DSM-IV, was released in 1994.
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