The Diagnostic and Statistical Manual of Mental Disorders, or the DSM as it is known, is undergoing a major revision.  After thirteen years of working on this version, the final revisions will soon be adopted.  These changes are important because the DSM is the most important manual in treating and classifying mental illness.  Every day over 4.4 million people receive mental health services in America, and the classifications in the DSM are what guide doctors, insurance companies, and schools alike.  It also impacts grants for researchers.

Many changes have been adopted, but the following is a list of the most important ones:

1. Autism- What was formerly known as “Autistic Disorder” will now be “Autism Spectrum Disorder”.  The manual will include very specific examples to help practitioners classify patients.  Asperger’s syndrome will no longer be a distinct disorder, instead of falling under Autism Spectrum Disorder.  Commentators expect these changes to cause quite a debate because access to educational and social services is based on an official diagnosis.

2. Binge-eating Disorder- This is now a separate disorder in and of itself, and no longer under the “proposed” category.  In the past, doctors have just considered binge-eating to be a symptom of depression and anxiety.

3. Depression diagnosis broadened- Depressive disorder has now been expanded to include bereavement.  In the past edition, symptoms of depression due to the loss of a loved one were an exception to depression, but now that exception has been removed.  There have always been critics that the definition of depression is too broad, but now the definition has become broader.

4. New category for extreme temper tantrums- There is a new diagnosis now for children who present with extreme irritability and behavioral outbursts more than three times a week for over a year.  The diagnosis is called disruptive mood dysregulation disorder, or DMDD.  There are many critics that say that normal childhood behavior is being pathologized, but the APA says that to the contrary, the new diagnosis will prevent children from being misdiagnosed with bipolar disorder, which is often treated with very powerful anti-psychotic drugs.

5. Gender Identity Disorder removed- Gender Identity Disorder will be removed from the manual, and will be replaced by gender dysphoria, which is defined as emotional distress over one’s gender.  Critics thought that Gender Identity Disorder made a legitimate issue into a mental disorder.

6. Sex Addiction not recognized- Despite much controversy, the hypersexual disorder was not included in the DSM.  Board members say there was not enough evidence to include it, but others say the decision was highly politicized.

Whether you think these are changes for the better or not, there is no doubt that the DSM is the most important book for classifying and defining all types of mental illness and disorder for both adults and children.  We are all affected by these changes.  What do you think about these changes?  Do you think bereavement should be a form of depression or a natural emotion that comes from an inevitable reality of life?  Do you think children who tantrum more than others should be considered to have a disorder?

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