DSM(Diagnostic and Statistical Manual of mental disorders) is a multi-axis nosological system adopted in the USA. Developed and published by the American Psychiatric Association (APA).

According to the DSM, when formulating a complete diagnosis, the following factors (“axes”) are taken into account:

• presence or absence
  • mental illness (axis I),
  • background psychopathy (axis II),
  • somatic disease (axis III),
• aggravating psychosocial factors (axis IV),
• general level of adaptation (axis V).

Description

First axle(axis I) includes transient, reversible disorders that come and go, such as phobias, generalized anxiety disorder (GAD), depression, addiction, etc. These disorders are "symptomatic" because patients with disorders on this axis often have the presence of mental disorders (“symptoms”) that bother them and need treatment.

Second axis(axis II) includes personality disorders and other stable, almost reversible long-term mental disorders, such as mental retardation or mental retardation.

The attitude of patients to violations of the First Axis is ego-dystonic, that is, alien, unusual for the ego, while violations of the Second Axis, including personality disorders, are ego-syntons and are considered by patients as their inherent characterological features and / or natural reactions to current situation.

third axis(axis III) contains a list of physical disorders or conditions that can be observed in a patient with mental disorders, that is, all-somatic and psychosomatic diseases(for example, epilepsy, arterial hypertension, gastric ulcer, infectious diseases, etc.). Axis III contains codes borrowed from the International Classification of Diseases - (ICD).

fourth axis(axis IV) includes past psychosocial stresses (eg, divorce, trauma, death of a loved one) related to the disease; are ranked (separately for adults and separately for children and adolescents) on a scale with a continuum from 1 (no stress) to 6 (catastrophic stress).

Fifth axis(axis V) characterizes highest level functioning observed in the patient during the past year (for example, in public, professional activity and mental activity); ranking on a scale with a continuum from 90 (upper limit) to 1 (gross dysfunction).

Since the etiology of most mental illnesses is unknown, the DSM-IV classification is based on a phenomenological principle. This approach is practical, although it lacks a weighty theoretical basis.

The focus of the DSM-IV on strict performance criteria has led to high reliability of psychiatric diagnosis and better patient care.

The fact that a psychiatric diagnosis is a stigma that makes it difficult social adaptation and the exercise of statutory rights, is recognized by the World Psychiatric Association.

Story

• 1952 - DSM-I
• 1968 (1973?) - DSM-II
• 1974 - DSM-II (homosexuality exclusion)
• 1978 (1980?) - DSM-III
• 1987 (1986?) - DSM-III-R (third edition, revised)
• 1994 - DSM IV
• 2000 - DSM-IV-TR (fourth edition, revised)
• 2013 - DSM-5 (development started in 1999, published May 18, 2013)

The addition or exclusion of diseases in the DSM is decided by a vote of psychiatrists.

Criticism

Of the 170 people who contributed to the DSM-IV and DSM-IV-TR, ninety-five (56%) had financial ties to pharmaceutical companies, according to a study published in the journal Psychotherapy and Psychosomatics. Of all the psychiatrists who were involved in the development of the DSM rubrics "Mood Disorders" and "Schizophrenia and Other Psychotic Disorders", 100% had ties to pharmaceutical companies.

However, even Allen Francis, chairman of the DSM-IV task force, has been a sharp critic of the expansion of diagnoses in the DSM-V. Writing in the Psychiatric Times in 2009, he wrote that the DSM-V would be "a bonanza for the pharmaceutical industry, but at a huge cost for new false patients caught in the DSM-V's overly wide network." After the DSM-V was published in May 2013, Allen Francis at the Congress of Psychiatrists and Psychotherapists in Berlin (November 2013) again strongly opposed this version of the DSM, which included, in his words, "a large number of new mental disorders with such blurred and indistinct boundaries that millions of people who are now considered healthy are at risk of becoming new patients.

Meanwhile, dear Russians and guests of the Russian-speaking Internet, there are also many interesting things happening on the other side of the great river.
Namely: on May 18, 2013, the fifth edition of the DSM was revealed to the world. The previous DSM-IV entered service in 1994 and has served 19 years. DSM, a.k.a. Diagnostic and Statistical Manual of Mental Disorders American classification mental pathologies (they do not recognize the standard WHO ICD). This is Scripture for all mental health professionals. And since, as you know, the Americans are the fighting vanguard of all progressive mankind, and ICD-11 (ICD, WHO International Classification of Diseases), which is supposed to be introduced in 2015, will certainly be written with an eye on the DSM, what is happening is of interest to us.

I started watching this story at the stage of teasers and spoilers. There, individual experts periodically came out and made very dashing statements, in terms of "oh what will happen now." For example, it was proposed to abolish the concept of "addiction", introduce the term "loss of control over impulsive behavior" and merge under this section all types of loss of control over behavior, in particular alcohol and drug addiction, to combine with problematic overeating and obesity (drug addicts and drunkards to drive under one a roof with fat men is a beautiful idea, yes). There also stick a separate disease obsessive viewing of pornography. Cancel all personality disorders at once (we know them as psychopathy) and rewrite the section from scratch. Well and all in such spirit.
But in fact, as always, the forces of stability and progressive progress have prevailed over revolutionary romance, and the final version does not contain any shocks to the foundations.

But since this is still a fresh big edition and the beginning new era, unrest of the masses still occur.

Well, how to say - "excitement"? The community of civic activists and the liberal journalism that has joined them assumes threatening poses and thrashes militantly in the chest; Big Pharma is watching attentively from the tall grass with the whole pride; somewhere in the middle, the golden calf of American health care grazes peacefully. That is, everything goes on as usual, and everything is for the best in this best of all possible worlds.

What's new?
Mental retardation (mental retardation, the archaic synonym for "mental retardation" has not been used for a long time) has been renamed into intellectual developmental disorder (congenital disorder of the intellect), but even if you call it alternatively gifted, it does not change the situation. Autism and Asperger's syndrome (plus a couple more diagnoses) have been merged into one Autism spectrum disorder (autism spectrum disorder), which already raises serious questions.
In general, there are mostly battles around the children's section.

I do not undertake to make independent judgments on issues of child and adolescent psychiatry, I act more as an outside curious observer. As always, many copies are broken around Attention deficit hyperactivity disorder (ADHD). Over the past 20 years since the introduction of the previous DSM classification, this diagnosis began to be made 3 times more often, the diagnostic criteria, as they were, and remain quite blurry and vague (judging by the American criteria, 6-7% of children suffer from distracted attention syndrome, and if according to the ICD, then about 1%), that is, most likely, there is a very serious overdiagnosis. The basis of treatment is various psychostimulants, Ritalin in the first place. And massively prescribing psychostimulants to children is obviously not a very good idea, so the debate around ADHD does not subside. For us, all this is not very relevant, because in Russia this diagnosis is rarely made due to the fact that the main drugs used are prohibited in our country, so it makes no sense for Russian doctors to make a diagnosis if there is nothing to treat anyway (out of everything that is, only struttera can somehow be recognized as a medicine, everything else - vitamins, magnesium preparations and similar powders)
Even for children and adolescents under 18, a new pathology was introduced - disruptive mood dysregulation disorder, evolutionarily the diagnosis originated from bipolar disorder in children. Exhibited in the case of long-term (at least a year), daily or almost daily changed behavior in a child - anger, mood swings, uncontrolled outbursts of irritability, difficulties in socialization. How legitimate the diagnosis is, again, is a big question. Critics quite rightly state that according to formal criteria, any restless and easily distracted child can be soldered ADHD, any gloomy, harmful and conflict-DMDD. That is, of course, it is not good that some children behave badly, but whether they should be given psychiatric diagnoses and prescribe psychopharmacological correction on this occasion is a very big question.

Another interesting thing is premenstrual dysphoric disorder. The good news for women is that now severe PMS is not only a common concept, but also a certificate from a psychiatrist. Previously, it was in the appendix, where dubious diagnoses were dumped, requiring additional study and clarification, now they have been transferred to the main section, from now on this is an independent legitimate disease.

Also, from the purgatory of dubious diagnoses, gambling has moved into the main section. I mean the good old classic gambling addiction ( computer games are not considered). She was marinated for a long time, now she has been moved to the section of addictions, in the company of alcohol and drug addictions. Now Gambling disorder is a separate diagnosis. Smokers also received their own diagnosis - Tobacco use disorder with the added criteria for nicotine withdrawal syndrome.
As for computer gambling, they argued for a long time, as a result, it remained in the “Conditions for further study” section.
In the same place, for future generations of researchers, a number of potential diagnoses remained in question, in particular: caffeine addiction (remains open question, as far as it can be considered an addiction in the clinical sense), suicidal behavior (as an independent behavioral disorder, and not as a symptom), non-suicidal self-harm (inflicting injuries, cuts, etc. on oneself without suicidal intent), long-term grief of loss (experts did not agree so far, to what extent the experience of a sudden loss can be considered a normal physiological reaction, and from what moment it is already a pathological manifestation; plus, the very understanding of “bereavement” is being discussed - whether only the death of loved ones should be considered a “bereavement” or other stressful events that may be associated with an acute grief reaction, such as the breakup of an emotionally significant relationship or the loss of a job).

The former large group of the spectrum of anxiety disorders was divided. Generalized anxiety disorders, panic attacks, phobic disorders - isolated phobias, agoraphobia and social phobia remained in the anxiety disorders themselves. Separately, a group of obsessive-compulsive disorders was singled out, where, from the new one, Compulsive hoarding was introduced, it is also “pathological gathering” (popularly known as Plyushkin's syndrome). So, if someone clutters up or collects without measure, then you can safely put an obsessive-compalsive. And they also singled out a group of post-traumatic stress disorders.

In the schizophrenia section, all existing subtypes (paranoid, catatonic, residual, and others) were deleted. In principle, they did the right thing, it's time.
Well, a lot of little things. Pedophiles were given a separate diagnosis, senile dementia was renamed a neurodegenerative disorder, the criteria for psychogenic overeating (binge eating disorder) were clarified, and so on.

In general, as mentioned above, nothing particularly scandalous happened and everything in the world goes on as usual, which is what you want.

DSM IV Cet article concerne le DSM IV et ses particularités.. Pour une approche plus générale, voir Manuel diagnostic et statistique des troubles mentaux. Le DSM IV ((en) Diagnostic and Statistical Manual Revision 4) est un outil de… … Wikipédia en Français

DSM IV

DSM IV- Cet article concerne le DSM IV et ses particularités.. Pour une approche plus générale, voir Manuel diagnostic et statistique des troubles mentaux. Le DSM IV ((en) Diagnostic and Statistical Manual Revision 4) est un outil de classification … Wikipédia en Français

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DSM- may denote: DSM (code) designation of bacterial strains provided by the German Collection of Microorganisms and Cell Cultures (German: Deutsche Sammlung von Mikroorganismen und Zellkulturen, DSMZ) DSM IV DSM IV (Diagnostic and ... ... Wikipedia

DSM- abbrev. Distinguished Service Medal * * * DSM abbr. Distinguished Service Medal. * * * ▪ Dutch company in full Naamloze Vennootschap Dsm (Dutch: DSM Limited Company), state owned Dutch chemical company. Until 1975 the company was known as … Universalium

DSM- Saltar a navegación, búsqueda Las siglas DSM pueden referirse a: En psiquiatría, Manual diagnóstico y estadístico de los trastornos mentales. En computación, Distributed Shared Memory, o memorias distribuidas compartidas. También puede tratarse… … Wikipedia Español

DSM- Abreviatura de Diagnostic and Statiscal Manual of Mental Disorders. Con el DSM III R se identifica la versión revisada de la tercera edición del manual. Diccionario Mosby Medicina, Enfermería y Ciencias de la Salud, Ediciones Hancourt, S.A. 1999 … Diccionario medico

DSM IV- iniciales de Diagnostic and Statiscal Manual of Mental Disorders, revisión IV, una clasificación de las enfermedades mentales Diccionario ilustrado de Términos Médicos. Alvaro Galiano. 2010 … Diccionario medico

DSM- DSM, Abkürzung für Diagnostic and Statistical Manual of Mental Disorders. Klassifikationssysteme psychischer Störungen … Universal-Lexikon

Books

• DSM-5 in Action , Sophia Dziegielewski F.. Full exploitation of the DSM-5 allows for more comprehensive care By demystifying the DSM-5, author Sophia Dziegielewski goes beyond the traditional diagnostic assessment and suggests both… electronic book
• DSM-5 Learning Companion for Counselors, Casey A. Barrio Minton. Written for an audience that includes private practitioners; counselors working in mental health centers, psychiatric hospitals, employee assistance programs, and other community settings; as...

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for release in May 2013. On February 10, the draft DSM-5 was published on the American Psychiatric Association (APA) website, where anyone can leave comments until July 15. Obviously, this version of the document is not final, because additional changes will be made until 2012. However, it is already clear that a number of mental illnesses will be deleted from the Psychiatrist's Bible, or at least will be included in the next edition under a different name. A change in approach is proposed for the following disorders:

• Gender Identity Disorder, will probably be renamed "gender dysphoria". Significantly changed diagnostic criteria states of acute dissatisfaction with their gender status.
• Internet addiction and sex addiction, to tell the truth, have never been officially recognized in any edition of the DSM. However, in recent times these problems have become so widespread that many psychiatrists tend to consider these addictions a real diagnosis. The DSM-5 will include a category of behavioral addictions that will include gambling addiction. The appendices to the document will call for more research to be included in the registry of future editions of the guidelines also for sexual and Internet addiction.
• hypochondriacal syndrome, manifested in constant anxiety about the possibility of getting sick and looking for symptoms of various ailments, will no longer be considered one of the four somatoform mental disorders. DSM-5 classifies this problem under the category of anxiety disorders.
• Asperger's Syndrome is a developmental disorder and is characterized socially and emotionally inappropriate behavior while maintaining an average level of intelligence. From 2013, the syndrome will be classified under the general diagnostic category of autism spectrum disorders. This does not mean that the term "Asperger's syndrome" will be done away with, but it will no longer be considered an autonomous disease.
• Drug addiction and substance abuse may be reduced to the general category of "drug addiction and related disorders". Specialists emphasize that the use of the term "addiction" inevitably ran into a number of difficulties, since there are "normal" forms of physical dependence on drugs such as opioid painkillers.
• Mental retardation, long a controversial term, will be renamed "intellectual disability".
• transvestite fetishism, associated with intense and repetitive sexual urges and fantasies and provoking a man to have a collection of women's clothing that he tries on when left alone, will still continue to make a slight mess in the classification of diseases. The new draft DSM-5 will begin using the term "transvestite disorders" to describe the above disorders.
• Histrionic Personality Disorder characterized by an inexhaustible need for attention and the use of their appearance for this purpose. DSM-5 eliminates not only this disease, but also all other "chauvinistic" (sexist) diseases at once.

In general, in the next manual, it is planned to radically change the approach to diagnosing mental illness: in accordance with it, the doctor must first identify a “general” personality disorder in a patient, and then characterize it with specific signs. Currently, psychiatrists immediately diagnose a specific personality disorder.

With DSM-III, a multi-axis system was introduced. Patients are classified according to 5 independent parameters (axes). Preparations for the DSM-IV began in 1988 and were completed in 1994. The DSM-IV described 400 mental disorders in 17 categories. It also uses a multi-axis system, just like the DSM-III and DSM-III-R.

The ICD-9-CM (ICD-9-CM) codes were used to codify disorders in the DSM-IV. The next version (DSM-5) specifies two codes: the ICD-9 code -KM and the ICD-10 code -KM for statistical purposes. ICD-10: Clinical modification(ICD-10-KM) differs from the usual ICD-10 also by changed names (for example, hebephrenic schizophrenia in ICD-10-KM is called disorganized schizophrenia, as in the DSM).

Exclusion of homosexuality from the list of mental disorders

DSM-IV-TR

In 2000, a "revised" (English "text revision", literally "text revision") version of the DSM-IV, known as the DSM-IV-TR. The diagnostic categories and the vast majority of specific criteria for diagnosis have remained unchanged. Updated text sections providing Additional information for each diagnosis, as well as some of the diagnostic codes to maintain consistency with the ICD.

DSM-5

Also associated with recent successful psychiatric genome studies that have identified a common gene polymorphism between psychiatric disorders: schizophrenia, bipolar affective disorder, attention deficit hyperactivity disorder, major depressive disorder, and autism spectrum disorder. These states were accepted as the first four chapters of the DSM-5. Similarly, authors have tried to group mental disorders based on neuroscience rather than psychopathology.

Collaboration with WHO and APA in the development of DSM-5

Dates of publications of the diagnostic and statistical manual

see also

Notes

1. Burlachuk L. F. Dictionary-reference book on psychodiagnostics. - 3rd ed. - St. Petersburg. : Piter Publishing House. - S. 126-128. - 688 p. - ISBN 978-5-94723-387-2.
2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) . - Washington, DC: American Psychiatric Publishing, 1980. - P. 380. - 494 p. - ISBN 978-0-521-31528-9.
3. Stuart H. Fighting the stigma caused by mental disorders: past perspectives, present activities, and future directions // World Psychiatry (English)Russian: journal. - 2008. - October (vol. 7, no. 3). - P. 185-188. -