March 1st, 2017

DSM-5 open to suggested updates

The world of information has changed since 1952. That was the year that the American Psychiatric Association released the first version of the Diagnostic and Statistical Manual of Mental Disorders or DSM. A listing of diagnostic criteria and codes used by mental health professionals, across the country and around the world, the current DSM-5 was released in 2013.

But, while that version took more than a decade to craft and publish, ongoing updates are now released immediately via a dedicated Web site ( Since the release of DSM-5, the manual has already seen changes to several codes.

In the online version of the manual, each change has a note next to it highlighting and explaining the update. The plan, said Michael B. First, M.D., a professor of clinical psychiatry at Columbia University and a member of the American Psychiatric Association’s DSM steering committee, is to create a searchable site listing all changes for those who have different versions of the manual – and to make it easier to know if a deeper search is necessary.

“We are in the process of making a list of updates easier to find on the site,” said First.

The bigger change will be in how future updates are created. In order to open up the process of keeping current with scientific advances and to give an option for input to a wider variety of professionals, advocates, and the public, the DSM-5 steering committee has initiated an online link for suggested updates to the manual.

“The last version of the DSM took years of hard work and involved thousands of people,” said First. “That is one reason it was only done periodically, due to time and resources. But the downside is that new developments could not be reflected immediately. When there are things that would be helpful to be included, we now have a mechanism to get them in there.”

The link went live in December. At press time, the new “suggestion box” had not seen any activity but First pointed out that the time-intensive process for submitting suggestions will slow that process a bit. Submissions must include backing empirical data in order to be considered for review.

“We have set up a fairly elaborate process for vetting any changes,” he said. “It requires a lot of work so we expect it to take some period of time. But we already know of some researchers who are working on proposals.”

“This process has been opened up for wider input but the board still has to maintain the same standards of quality so any changes must meet the same criteria as with previous updates,” he added.

How these ongoing updates will affect a possible sixth version of the DSM remains to be seen.

“When we will need to do a DSM-6 is less clear,” said First. “With instant updates, there is no longer a roadblock to getting changes made. I don’t know what will constitute a need for a DSM-6 update but it will not be in the near future.”

By Catherine Robertson Souter

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