DSM V: HOPE OR HYPE?

Amresh Shrivastava,

MD,MPM,MRCPsych,FRCPC

Associate professor of Psychiatry

Western University

London, Ontario

Since more than 50 years psychiatric diagnostic is being developed by a number of organisations. As research has advanced in understanding mental illnesses,need for a common language has been felt in order to provide best possible care to our patients.

The process of psychiatric diagnosis has evolved significantly. WHO as well APA both have made significant advances in developing diagnostic systems. DSM 5 recently approved by board of trustees by Americal psychiatric Association is scheduled to be released on 18th of May. This document is a significant improvement over DSM IV. It has taken more than 15 years to develop this document with great efforts by more than a thousand academic leaders in the field of mental health. This document is a significant shift from DSM IV in terms of its structure, though it claims that there is no paradigm shift from DSM IV. The fundamentals of formulating a diagnosis have been changed. A number of new initiatives have been incorporated in comparison to earlier concept of categorical distinctions; a dimensional approach has been adopted. This document considers illnesses in their developmental nature and do not divide illnesses across age spectrum. It has brought certain new categories and reorganised the criteria of the existing categories of mental disorder. The document has been developed considering latest research advances, experience of professional leaders, result of field trials, opinions of advocacy groups as well as of patients. Document development process has been transparent and inclusive. There are three major changes which have significant clinical implications:

1. Eliminating multiaxial diagnostic system

2. Considering mental illness as a disability

3. Developing newer psychiatric syndromes and thereby simplifying clinical controversies.

This presentation has some of the features representing personal opinion about DSM V.