Structural changes in DSM-5: the beginning of a transformation?

• Published in: Tijdschrift voor psychiatrie Vol. 56; no. 3; p. 152
• Main Authors: van Amelsvoort, T A M J, Van Den Eede, F, Goethals, K, van Marle, H J C, Beekman, A J
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 2014
• Subjects: Diagnostic and Statistical Manual of Mental Disorders; Humans; Mental Disorders - classification; Mental Disorders - diagnosis; Psychometrics; Severity of Illness Index
• ISSN: 0303-7339

The dsm-5 received both praise and criticism following its publication in May 2013. Some blamed the dsm classification system for the unsatisfactory diagnostic system within psychiatry. Over the last 30 years or so there have been no major breakthroughs in our field and there has been no reduction in the number of mental health problems in Western society. It is time for a change; the question is whether DSM-5 will succeed in bringing about this change. To update and analyse the structural, diagnosis-independent changes that have been incorporated in DSM-5. We discuss the changes. The most important structural, diagnosis-independent changes include: 1. the separate classification of disorders that begin in childhood from those that begin in adolescence has been abolished; 2. the multi-axial system has disappeared; 3. the approach has become more dimensional, which allows for the assessment of the severity of a disorder. In the DSM-5 there are clear signs that a transformation of our psychiatric assessment system has begun; this can only be seen as a positive development, but is probably just the tip of the iceberg. Further changes are likely to occur, some in the near future, others in the long term.