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Open Access Editorial

The DSM-5: Hyperbole, Hope or Hypothesis?

Michael Berk

Author Affiliations

School of Medicine, Deakin University, Barwon Health, Ryrie Street, Geelong, VIC 3220, Australia

Department of Psychiatry, Orygen Research Centre, and the Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia

BMC Medicine 2013, 11:128  doi:10.1186/1741-7015-11-128

Published: 14 May 2013

Abstract

The furore preceding the release of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is in contrast to the incremental changes to several diagnostic categories, which are derived from new research since its predecessor’s birth in 1990. While many of these changes are indeed controversial, they do reflect the intrinsic ambiguity of the extant literature. Additionally, this may be a mirror of the frustration of the field’s limited progress, especially given the false hopes at the dawn of the “decade of the brain”. In the absence of a coherent pathophysiology, the DSM remains no more than a set of consensus based operationalized adjectives, albeit with some degree of reliability. It does not cleave nature at its joints, nor does it aim to, but neither does alternate systems. The largest problem with the DSM system is how it’s used; sometimes too loosely by clinicians, and too rigidly by regulators, insurers, lawyers and at times researchers, who afford it reference and deference disproportionate to its overt acknowledged limitations.

Keywords:
DSM-V; Diagnosis; Pathophysiology; DSM-V; Symptoms; Classification