Table of ContentsView AllTable of ContentsHistoryMajor ChangesWho Uses ItList of DisordersHow It Is Used
Table of ContentsView All
View All
Table of Contents
History
Major Changes
Who Uses It
List of Disorders
How It Is Used
The DSM-5 is an invaluable tool given that mental disorders cannot be diagnosed in the same way as physical illnesses. The DSM-5 categorizes 298 mental disorders based on an established set of criteria, such as behavioral or emotional patterns and the duration of these patterns.
This helpspsychiatrists,psychologists, and other health providers accurately diagnosemental illnessso that the appropriate treatment can be sought and dispensed.
In 2022, a revised version called the DSM-5-TR was published.The DSM is occasionally updated as researchers gain a better understanding of mental conditions, often re-characterizing them to more accurately reflect their nature.
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History of the DSM-I Through DSM-5 Differs
The “Diagnostic and Statistical Manual of Mental Disorders” was first published in 1952 and has been revised and published in four subsequent editions and several interim versions. The latest version, the DSM-5-TR, was published in March 2022.Prior versions were identified with Roman numerals, while the DSM-5 changed to non-Roman numerals.
DSM-I
The 130-page DSM-I published in 1952 listed 109 mental disorders under three broad classifications:psychotic,neurotic, or behavioral.As with future editions, the DSM-I was criticized for characterizing certain states as pathologies (illnesses). This included homosexuality which the DSM-1 classified as a “sociopathicpersonality disturbance.”
DSM-II
The DSMII published in 1968 was only slightly longer than the DSM-O (134 pages) but contained a total of 182 mental disorders.
As with the DSM-I, the symptoms of these disorders were not always clearly defined. Rather, symptoms were often regarded as a reflection of an underlying conflict or maladaptive reaction to life problems (largely remnants ofFreudian psychoanalysisof the 1920s and 1930s).
As such, the DSM-II largely characterized mental illness as a consequence of external factors rather than a disorder of the mind.
DSM-III
The 494-page DSM-III published in 1980 was regarded as a radical revision of the earlier editions, adopting a consistent set of diagnostic criteria to classify 265 mental disorders.
Among the changes in the DSM-III, “ego-dystonic homosexuality” replaced the term “sexual orientation disturbance,” while gender identity disorder in children (GIDC) was first introduced to describe the concept ofgender dysphoria.
DSM-IV
The DSM-IV published in 1994 listed 410 disorders in 886 pages. In it, a mental disorder was for the first time defined as “a clinically significant behavioral or psychological syndrome or pattern that… is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.”
The definition was significant in that it qualified a mental disorder as one that causes distress and/or problems functioning in social, work, or family life—a definition that largely persists today.
Despite these changes, homosexuality was still described as a “sexual disorder not otherwise specified,” while “mental retardation” was still used to describe people withintellectual disabilities.
DSM-5
The DSM-5 published in 2013 was not a major revision of the DSM-4. Rather, it focused largely on deleting numerous subtypes that caused overlaps in diagnoses and sowed confusion among clinicians. From the 410 conditions listed in the DSM-4, the DSM-5 offered 298.
Among the changes:
Rather than classifying subtypes, the DSM-5 more often uses specifiers to clarify the course, severity, or special features of a disorder. For instance, specifiers for a condition like autism may be as simple as “mild,” “moderate,” or “severe.” Others may be more complex.
Among the other changes in the DSM-5, homosexuality was finally declassified as a mental illness, gender dysphoria replaced gender identity disorder, intellectual disability replaced mental retardation, and manic-depression was reclassified asbipolar 1 and bipolar 2 disorder.
Major Differences Between the DSM-IV and DSM-5
One of the main differences between the DSM-IV and DSM-5 is the discontinuation of the multiaxial model. This is a system in which five factors—psychiatric, intellectual, medical, environmental/psychological, and level of functioning—are considered to characterize and standardize diagnoses.
While these factors are still considered in DSM-5 guidelines, the multiaxial model lacked clarity and could potentially mischaracterize a condition based on how these factors were interpreted.
Other changes include:
What Is the DSM-5 Used For?
The DSM-5 contains descriptions, symptoms, and other criteria to help clinicians make reliable diagnoses of mental disorders. However, itdoes notinclude information or guidelines for the treatment of any disorder.
Instead, psychiatrists, psychologists, and other health providers will turn to clinical practice guidelines from the APA, which does offer guidance on the appropriate treatment.
Other countries use different clinical practice guidelines, which can vary based on the licensing of drugs, availability of drugs, or authorized treatments (such asketamine therapy).
The DSM-5 is written in a common language and divided into three sections:
List of Mental Disorders in the DSM-5
The DSM-5 breaks downmental disordersinto 19 broad categories. It is possible—and, in fact, common—for a person to be diagnosed with multiple disorders in one or more categories (known as a “dual diagnosis” or “multiple diagnosis”).
While the DSM-5 focuses on mental disorders, conditions involving the mind and brain are often inseparable. For this reason, the DSM-5 also covers conditions like dementia that may be purely psychiatric, purely neurological, or both.
The DSM-5-TR categories include:
Mood and Stress-Related Disorders
Cognitive Disorders
Compulsive Disorders
Functional Disorders
Gender Identity and Sexual Disorder
How the DSM-5 Is Used
For each condition, the DSM-5 outlines a list of criteria a person must meet in order to be diagnosed with that disorder. Some criteria are behavioral (like repetitive behaviors) while others may be emotional (like distress). There will also be a specific period during which a person must experience symptoms in order to be diagnosed.
The DSM-5 also offers a category called “unspecified disorder” which allows a clinician to forgo specification. It also has “other specified,” used when a patient’s symptoms fall within a group of disorders but do not meet the DSM-5 criteria exactly.
The DSM-5 Checklist
The DSM-5 checklist is a list of diagnostic criteria for each classified mental disorder. It can be used to screen for a specific disorder (such as PTSD or substance abuse disorder), characterize the severity of the condition, and monitor for changes in symptoms.
Summary
The “Diagnostic and Statistical Manual of Mental Disorders,” Fifth Edition, is the premier source of diagnostic information on mental health conditions. The 298 disorders are broken down into 19 categories with each assigned a list of criteria a person must meet to be diagnosed.
The DSM-5 does not offer treatment guidance but provides clinicians with the means to access treatments based on approved national treatment guidelines and the ICD-10 code assigned to that DSM-5 diagnosis.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: APA; 2022.American Psychiatric Association.DSM history.Suris A, Holliday R, North CS.The evolution of the classification of psychiatric disorders.Behav Sci (Basel).2016 Mar;6(1):5. doi 10.3390/bs6010005American Psychiatric Association.DSM library.Substance Abuse and Mental Health Services Administration.2. DSM-IV to DSM-5 changes: overview. In:DSM-5 Changes: Implications for Child Serious Emotional Disturbance.Rockville, MD: SAMHSA; 2016.Lingiardi V, McWilliams N.The Psychodynamic Diagnostic Manual - 2nd edition (PDM-2).World Psychiatry. 2015;14(2):237-239. doi:10.1002/wps.20233U.S. Department of Veteran’s Affairs.PTSD checklist for DSM-5 (PCL-5).
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: APA; 2022.American Psychiatric Association.DSM history.Suris A, Holliday R, North CS.The evolution of the classification of psychiatric disorders.Behav Sci (Basel).2016 Mar;6(1):5. doi 10.3390/bs6010005American Psychiatric Association.DSM library.Substance Abuse and Mental Health Services Administration.2. DSM-IV to DSM-5 changes: overview. In:DSM-5 Changes: Implications for Child Serious Emotional Disturbance.Rockville, MD: SAMHSA; 2016.Lingiardi V, McWilliams N.The Psychodynamic Diagnostic Manual - 2nd edition (PDM-2).World Psychiatry. 2015;14(2):237-239. doi:10.1002/wps.20233U.S. Department of Veteran’s Affairs.PTSD checklist for DSM-5 (PCL-5).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: APA; 2022.American Psychiatric Association.DSM history.Suris A, Holliday R, North CS.The evolution of the classification of psychiatric disorders.Behav Sci (Basel).2016 Mar;6(1):5. doi 10.3390/bs6010005American Psychiatric Association.DSM library.Substance Abuse and Mental Health Services Administration.2. DSM-IV to DSM-5 changes: overview. In:DSM-5 Changes: Implications for Child Serious Emotional Disturbance.Rockville, MD: SAMHSA; 2016.Lingiardi V, McWilliams N.The Psychodynamic Diagnostic Manual - 2nd edition (PDM-2).World Psychiatry. 2015;14(2):237-239. doi:10.1002/wps.20233U.S. Department of Veteran’s Affairs.PTSD checklist for DSM-5 (PCL-5).
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: APA; 2022.
American Psychiatric Association.DSM history.
Suris A, Holliday R, North CS.The evolution of the classification of psychiatric disorders.Behav Sci (Basel).2016 Mar;6(1):5. doi 10.3390/bs6010005
American Psychiatric Association.DSM library.
Substance Abuse and Mental Health Services Administration.2. DSM-IV to DSM-5 changes: overview. In:DSM-5 Changes: Implications for Child Serious Emotional Disturbance.Rockville, MD: SAMHSA; 2016.
Lingiardi V, McWilliams N.The Psychodynamic Diagnostic Manual - 2nd edition (PDM-2).World Psychiatry. 2015;14(2):237-239. doi:10.1002/wps.20233
U.S. Department of Veteran’s Affairs.PTSD checklist for DSM-5 (PCL-5).
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