The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States. It is intended to be applicable in a wide array of contexts and used by clinicians and researchers of many different orientations (e.g., biological, psychodynamic, cognitive, behavioral, interpersonal, family/systems). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the current edition and has been designed for use across clinical settings (inpatient, outpatient, partial hospital, consultation-liaison, clinic, private practice, and primary care), with community populations. It can be used by a wide range of health and mental health professionals, including psychiatrists and other physicians, psychologists, social workers, nurses, occupational and rehabilitation therapists, and counselors. It is also a necessary tool for collecting and communicating accurate public health statistics.
The DSM consists of three major components: the diagnostic classification, the diagnostic criteria sets, and the descriptive text.
The diagnostic classification is the list of the mental disorders that are officially part of the DSM system. “Making a DSM diagnosis” consists of selecting those disorders from the classification that best reflect the signs and symptoms that are exhibited by the individual being evaluated. Associated with each diagnostic label is a diagnostic code, which is typically used by institutions and agencies for data collection and billing purposes. These diagnostic codes are derived from the coding system used by all health care professionals in the United States, known as the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM).
Diagnostic Criteria Sets
For each disorder included in DSM, a set of diagnostic criteria indicate what symptoms must be present (and for how long) as well as symptoms, disorders, and conditions that must not be present in order to qualify for a particular diagnosis. Many users of DSM find these diagnostic criteria particularly useful because they provide a concise description of each disorder. Furthermore, use of diagnostic criteria has been shown to increase diagnostic reliability (i.e., likelihood that different users will assign the same diagnosis to an individual). However, it is important to remember that these criteria are meant to be used as guidelines informed by clinical judgment and are not meant to be used in a cookbook fashion.
Finally, the third component of DSM is the descriptive text that accompanies each disorder. The text of DSM-5 systematically describes each disorder under the following headings: “Diagnostic Features”; “Associated Features Supporting Diagnosis”; “Subtypes and/or Specifiers”; “Prevalence”; “Development and Course”; “Risk and Prognostic Factors”; “Diagnostic Measures”; “Functional Consequences”; “Culture-Related Diagnostic Issues”; “Gender-Related Diagnostic Issues”; “Differential Diagnosis”; and “Recording Procedures”.
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