Psychiatr News June 6, 2008
Volume 43, Number 11, page 12
© 2008 American Psychiatric Association
DSM-V Development Will Be Complex and Open Process
Jun Yan
Expert clinicians and researchers will reexamine APA's Diagnostic
and Statistical Manual of Mental Disorders to improve the reliability and
validity of the disease classifications in the authoritative text.
More than 120 leading experts in psychiatry, neuroscience, genetics,
epidemiology, pediatrics, statistics, nursing, and social work will
collaborate to draft the next edition of the most important manual in
psychiatry, DSM-V, within the next four years.
At a news conference on May 1, APA released a list of more than 120
world-renowned clinicians and scientists who will undertake the massive effort
of revising DSM. Every work group member's name, affiliation,
biographic information, and potential conflicts of interest are disclosed in
detail at
<www.dsm5.org>.
In the next four years, these contributors, divided into 13 work groups,
will review a sea of research evidence, revise current diagnostic criteria for
field tests, and, based on feedback from the field tests, make changes as
required. A final draft of the groups' findings will be submitted to the APA
Council on Research, the Assembly, and the Board of Trustees for review.
DSM-V is anticipated to be released in May 2012.
Work group members will meet regularly in person and by conference calls.
Their first priority will be "to see how much the accumulated research
evidence over the past 15 to 20 years is applicable to improving the
diagnostic process in clinical practice," said David Kufper, M.D., chair
of the DSM-V Task Force. In addition, the work groups will determine
whether current diagnostic criteria need to be modified, whether new disorders
should be added, or whether there is sufficient evidence to delete any current
diagnoses.
Darrel Regier, M.D., M.P.H., vice chair of the task force, indicated at the
press conference that the work groups will pay particular attention to
cross-cutting issues in mental disorders over a person's lifespan, including
how early neurological development may influence various mental disorders.
"We will discuss possible changes in the criteria as one moves from
childhood...to late life." He said the impact of gender and culture on
different expressions of mental disorders will also be addressed in this
revision.
"We are rethinking the fundamental structure of DSM, which
would be a first since 1980, when DSM-III was produced," said
Regier. He referred to a new approach of looking at each spectrum of multiple
mental disorders that are currently separate but may be biologically or
symptomatically linked. Such a revised diagnostic structure will help
clinicians better understand the relationship between disorders and treatment
implications.
The DSM-V Task Force members who will lead the effort in each work
group were announced in 2007. Work group members were nominated by the task
force chair, vice-chair, and work group chairs based on their international
expertise in specific fields. All work group members were reviewed for
potential conflicts of interest and approved by the APA Board.
Like the task force members, all work group members are required by APA to
disclose significant relationships since 2005 with entities that have an
interest in psychiatric diagnoses and treatments, including pharmaceutical
companies and nonprofit or advocacy organizations. All work group and task
force members have agreed to abide by rules intended to prevent conflict of
interest or bias. For example, each work group member's annual income derived
from industry sources (excluding unrestricted research grants) cannot exceed
$10,000 in a calendar year throughout the time of their involvement with
DSM-V.
"We are fortunate to have such a high caliber of researchers in this
undertaking," Carolyn Robinowitz, M.D., then-APA president, said at the
news conference. She noted that the work group members will not receive
monetary compensation for this work. "The goal of the APA Board of
Trustees is to ensure that each contributor to DSM-V represents the
best [expertise] in his or her field and that the process is open,
transparent, and free of bias."
"DSM is the foundation for psychiatric diagnosis in much of
the world," incoming APA President Nada Stotland, M.D., M.P.H., told
Psychiatric News. "The signs and symptoms of psychiatric
disorders are affected by culture, gender, race, age, sexual
orientation—by complex interactions between nature, nurture, and current
circumstances. APA accepts the responsibility for crafting this enormously
important document and depends upon the expertise of researchers and
clinicians from all the branches of our field, and we welcome the comments and
suggestions of not only our members, but anyone with an interest and an
idea."
In addition to the names of the DSM-V Task Force and work
group members, other related information is posted at
<www.dsm5.org>.
Related Article:
-
Citing Importance of Advocacy, Robinowitz Urges, 'Just Do It'
- Mark Moran
Psychiatr News 2008 43: 1-37.
[Full Text]
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