DSM-5-TR: Mental Health Manual

By Gloria M. Rivera
[808 words, 6 minutes read time]

Meet the DSM-5-TR™

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR™) is a reference book on mental health and brain-related conditions and disorders.

Having such a manual is important as it provides consistency in the terminology of descriptions, symptoms and other criteria for diagnosing and classifying mental health disorders.

This manual is used not only by psychologists and psychiatrists, but by social workers, nurses, and other health and mental health professionals in the United States. It is also used in research, public health policy, education, reimbursement systems, and forensic science in the United States.

Although it does not provide treatment or medication regimens, by providing a uniform criteria it allows the standardization of mental health diagnosis and, by consequence, treatment and prognosis. For example, when a psychiatrist from California reads a medical record that includes a mental health diagnosis made by a psychiatrist in Florida, they can be sure that this mental health condition has been properly diagnosed based on shared criteria. 

The DSM Through Time

This book has been written, edited, reviewed, and published by the American Psychiatric Association (APA) since 1952 .

To date, there have been 6 editions of the DSM:

    • DSM-I: The first edition of the DSM, published in 1952
    • DSM-III-R: published in 1987
    • DSM-IV: published in 1994
    • DSM-5: The fifth edition of the DSM, published in March 2022

Image: 1952 edition of the DSM (DSM-I). Source: Wikipedia

DSM-5-TR:  Context and Development

The DSM-5-TR™, published in 2022, is the first revision of DSM-5 since its original publication in 2013. Like the previous text revision (DSM‐IV‐TR™), its main goal is to do a text revision and update based on new and updated information.

To do so, in Spring 2019, a revision committee started working on this version that involved the work of over 200 subject matter experts, including many who were involved in the development of DSM-5. These experts were diverse clinicians and scientific researchers with backgrounds in psychiatry, psychology, social work, pediatrics, neurology, nursing, epidemiology, and anthropology from the United States and abroad. 

Changes and Updates to the DSM-5

In this edition, the main changes to the DSM were classified in 4 categories:(1) addition of diagnostic entities and symptom codes, (2) changes in diagnostic criteria, (3) updated terminology, and (4) comprehensive text updates.

1.   Addition of Diagnostic Entities and Symptom Codes

The following conditions and their diagnostic criteria have been added: Prolonged Grief Disorder, Unspecified Mood Disorder, and Stimulant‐Induced Mild Neurocognitive Disorder.

Generally, free-standing symptoms, which are symptoms that can occur independently of a specific disorder, are not included as standalone entries in diagnostic manuals like the DSM-5. However, some symptoms, independent of any particular psychiatric diagnosis, may be clinically important. Now, symptoms like the patient having suicidal behavior in the past (“potentially self‐injurious behavior with at least some intent to die”) and injuries that were not meant to cause their own death (“intentional self‐inflicted damage to the body likely to induce bleeding, bruising, or pain in the absence of suicidal intent”) can be recorded with their own code.

2.  Changes in diagnostic criteria or definitions

As mentioned before, most mental health diagnosis requires a patient to meet a certain number of criteria included in the DSM. In this case, more than 70 disorders have been updated to prevent misdiagnosis.

For example, criterion A for Autism Spectrum Disorder that are related to social communication and social interaction or the characteristics of the severity of a manic episode.

3.  Updated terminology

As translators and interpreters, we know that word choice is very important. Therefore, changes reflecting current preferred usage was implemented for terms such as “intellectual developmental disorder” that now replaces “intellectual disability” or “experienced gender” that I think reflects much better the person’s experience than “desired gender.”

4.  Comprehensive updates

The work to update the DSM-5-TR™ was a long process that started in 2019. The goal was correcting errors, clarifying ambiguities, or resolving inconsistencies between the diagnostic criteria and text as some could affect a mental health practitioner clinical process.

The review also included the insight of experts in sex and gender, suicide, culture, and DEI.

It is available in multiple languages!

The DSM-5-TR  has been translated into multiple languages, such as Chinese (traditional and simplified), Czech, Danish, Dutch, Farsi, French, German, Greek, Hungarian, Italian, Japanese, Korean, Polish,  Portuguese (Brazil,  Portugal, and PALOP), Romanian, Spanish (Spain and Argentina), Swedish, Turkish, and Ukranian.

Resources:

Accessed on October 11, 2024.

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