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The truth about DSM-5

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The vast majority of psychiatrists and health care professionals understand that the "Diagnostic and Statistical Manual of Mental Disorders" aka "DSM" is a handbook to help clinicians and researchers to evaluate and communicate about mental disorders, described through common symptoms and behaviors exhibited by patients. 

It is not a how-to guide on how to practice psychiatry, or any other mental health discipline. It is a tool with tremendous value for diagnosing patients that should be used as a part of a comprehensive patient assessment.

The upcoming edition, commonly referred to as "DSM-5," will update the diagnostic categories and criteria that describe them, integrate dimensional measures into several disorders to help provide a fuller diagnostic picture, and revise the book’s organizational framework to signal potential underlying vulnerabilities as well as symptom characteristics of many conditions. Most importantly, the changes proposed to diagnostic criteria reflect the best scientific evidence since the current version was published nearly 20 years ago.

Some of the revised criteria were tested in field trials in routine clinical settings with typical clinicians and patients. The results of these field trials, published in the peer-reviewed American Journal of Psychiatry, show that most proposed diagnoses could be diagnosed reliably in real-world settings, but that others needed to be rethought or revised further before being introduced into clinical practice.

Fox News Medical A Team contributor Dr. Keith Ablow’s lack of information, or disregard for it, about the DSM-5 is apparent in his comments on FoxNews.com and Fox News Channel. The motivation and basis for his criticisms are obscure, but the counterproductive effects of his opinions are clear. 

By attempting to undermine the credibility of the DSM, and casting aspersion on the American Psychiatric Association -- which represents the majority of the medical specialty of which he purports to be a member -- he misleads people who may be affected by mental disorders and potentially discourages them from seeking care. 

This disregard for factual information is evident in his comments on the proposed criteria for Major Depressive Disorder and Generalized Anxiety Disorder. 

As currently proposed, these diagnoses’ criteria remain exactly the same as they were in DSM-IV, authored during Allen Frances’ tenure as DSM task force chairman. In fact, the Work Group and Task Force have been conservative in their approach to revisions aiming to bring the mental health field closer to a true understanding of mental disorders and --to quote his own words -- “how patients get sick to begin with, and how, therefore, they can get well.” 

We wish that Dr. Ablow would be more thoughtful about expressing such reckless statements.

Jeffrey Lieberman, M.D., is a professor and chair of Psychiatry at Columbia University. He is also the president elect of the APA. For more information on DSM-5, go to www.dsm5.org or www.DSM5facts.org.