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There is a need to refine our current psychiatric nosology to produce diagnostic criteria and disorder categories that keep pace with advances in neuroscience while at the same time enhance clinical utility. Furthermore, dimensional aspects of psychiatric disorders require greater recognition so as to improve our understanding of boundaries between disorders and underscore the heterogeneous nature of psychopathology. The Conceptual Evolution of DSM-5 provides a framework for the evolution of the forthcoming diagnostic system in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which will help advance clinical practice and facilitate ongoing development of diagnostic criteria. This manual: • Highlights recent progress in our understanding of cross-cutting factors relevant to psychiatric diagnosis and symptom presentation • Includes detailed discussions on the role of factors such as age, gender, culture, and disability in the expression of mental disorders • Provides a review of genetic evidence supporting a cross-cutting approach to nosology • Offers suggestions for integrating cross-cutting factors with DSM-5. The Conceptual Evolution of DSM-5 was written to impart a theoretical context for understanding potential revisions to DSM-5. The authors reevaluate the structure of the current manual and discuss cross-cutting approaches to facilitate clinical practice and refine research approaches that will guide clinical trials, genetics, imaging, and treatment guidelines. The authors provide the following insights: • Detailed descriptions of age-, gender-, and culture-specific aspects relevant to psychiatric diagnosis and the need for sensitivity to these factors when making diagnoses • Discussions on the dimensional aspects of mental disorders, including overlapping symptoms relevant to many or most diagnoses • Consideration of alternative classifications of disorders that recognize disorders sharing validating features • Presentation of neuroscientific and epidemiologic evidence to expand understanding of disorders beyond that of the categorical organization presented in DSM-IV • A review of clinical implications, including how clinicians may shift their conceptualization of previously reified diagnostic criteria and their consequences. As presented to the 99th Annual Meeting of the American Psychopathological Association, The Conceptual Evolution of DSM-5 explores the rapidly changing research base for the understanding of neurodevelopmental, neurocognitive, addictive, and other psychiatric disorders. The contributions in this volume confirm that DSM-5 is intended to be a living document that can accommodate revisions to specific diagnostic areas based on new evidence that is replicable and subject to review. This efficient updating process will help researchers and clinicians keep abreast of the latest protocols for the research, diagnosis, and treatment of mental illness.
Religious and Spiritual Issues in Psychiatric Diagnosis: A Research Agenda for DSM-V examines the role of spiritual and religious considerations in the DSM revision process. The volume includes chapters on each major category of psychiatric disorder, with an analysis of the implications of religion and spirituality for their diagnosis, course, and outcome. Based on the work presented by the prominent clinicians and researchers who participated in the 2006 Corresponding Committee on Religion, Spirituality, and Psychiatry of the American Psychiatric Association, the volume addresses the spiritual and philosophical issues involved in distinguishing a psychiatric disorder from a spiritual condition. This volume is unique in reviewing the literature on spirituality and major psychiatric disorders with the objective of clarifying where existing descriptions of diagnostic criteria and of the course and outcome of these disorders require revision. In addition, the contributors identify areas that demand further research. Only in this book can clinicians find a comprehensive treatment of this important topic, as well as features that enhance understanding and encourage future scholarship. - Each chapter makes specific recommendations for revising the wording of the DSM, and each is followed by two commentaries that contextualize, analyze, and critique the chapter's recommendations.- Other chapter contributors make the case for updating the V Code for a Spiritual or Religious Problem, and discuss the place of spiritual and religious considerations in the Outline for a Cultural Formulation. - Mental health practitioners from all disciplines who seek to practice in a more integrated, holistic fashion will find in this volume a foundation for including religious and spiritual considerations in their cases, as well as recognition and validation that these problems are worthy of clinical attention. Psychiatry has often been viewed as hostile to religion, and the DSM has been criticized for neglecting this vital dimension of human experience. As interest in the intersection between spirituality and mental health continues to grow, Religious and Spiritual Issues in Psychiatric Diagnosis: A Research Agenda for DSM-V will become an ever more relevant and necessary resource for addressing these concerns in a positive, practical, and systematic way.
Sometimes described as "the nemesis of the primary care physician," somatoform disorders are frustrating, expensive to treat, and under-investigated. Somatic Presentations of Mental Disorders provides a fascinating and practical review of the epidemiology, diagnosis, and treatment of this ill-defined category of disease. Somatic Presentations of Mental Disorders summarizes the proceedings of a unique international conference that convened experts from across disciplines to review perspectives on somatoform disorders. The broad range of experience and specialization results in a compendium that addresses both theoretical and practical issues presented in somatoform disorders. For the researcher, the book offers a thorough and critical overview of the research landscape, surveying and synthesizing the available literature from around the world on all aspects of the disorder. Acknowledging the unique challenges presented in studying such a heterogeneous collection of disorders, the authors identify specific gaps in the research literature. Somatic Presentations of Mental Disorders also addresses controversial issues of nosology in advance of the publication of DSM-V. Despite its utility for researchers, the book primarily serves as an invaluable reference and resource for the practitioner. Organized with the clinician in mind, Somatic Presentations of Mental Disorders surveys the latest data on phenomenology; etiology and clinical course; and treatment options. Unlike other literature on this difficult topic, the authors thoroughly explore the entire range of this category of disorders, including conversion disorder, chronic pain and fatigue, and the multitude of presentations of medically unexplained symptoms. Aimed at both primary care and mental health practitioners, the book addresses crucial issues for effective diagnosis and treatment, including: - Comorbidity and association with anxiety and depressive disorders- Unique insights into cultural factors affecting the presentation and treatment of somatic disorders around the globe- The prevalence of misdiagnosis, and contemporary diagnostic tools and techniques to help avoid a missed organic diagnosis- The complicated interrelationship of somatoform disorders and substance abuse- The efficacy of various treatment modalities, including pharmacology and cognitive behavioral therapy- Collaboration between primary care and mental health providers to maximize treatment outcomes Comprehensive, thoughtful, and up-to-date, Somatic Presentations of Mental Disorders is a must-have both for researchers in the field and for clinicians with somatizing patients.
Written to help identify major gaps in our knowledge of how gender and age affect psychiatric diagnoses and to stimulate much-needed research to fill these gaps, Age and Gender Considerations in Psychiatric Diagnosis serves as both a valuable short-term source for the DSM-V Task Force and its disorder-specific workgroups, and a long-term guide for future studies that will contribute to revised psychiatric classifications in these three areas. Here, 47 experts present findings in three areas of psychiatric research that historically have been neglected but rightfully have received increasing attention in recent years and thus are worthy of investigation into their clinical features, etiology, and course: 1. Significant gender differences in prevalence, symptom profiles, and risk factors for mental disorders, including neurodevelopmental, neurophysiological, and environmental factors for men and women that cut across diagnostic categories-for example, the critical importance of gender in how psychiatric illness develops and presents; DSM's approach to gender to date; and relevant research findings and gaps in the epidemiology, etiology, and pathophysiology of disorders and the gender-related expression of psychopathology, including the controversial and complex question of whether DSM should have different diagnostic criteria for men and women. 2. Mental disorders in infancy and early childhood, including diagnosis and measurement of psychopathology; PTSD and social and cognitive factors related to the experience of stress; reactive attachment disorder (unique in part because of its specificity to early childhood); mood and anxiety disorders and difficulties in diagnosis; sleep disorders, including two new disorders, Night-Waking Dysomnia and Sleep-Onset Dysomnia; feeding disorders, including the need to address overeating and overfeeding (especially given the alleged U.S. epidemic of obesity); early childhood manifestations of behavior disorders; and early symptoms and diagnosis of autism. 3. Mental disorders in the elderly, such as dementia and depression, once considered normal consequences of aging but now understood to represent mental disorders, including the need to identify specific brain structure abnormalities, biomarkers, and the many contributing biological, psychosocial, and environmental factors of mental illness in late life and to understand their roles in the elderly to better diagnose and monitor disease progression. Written for clinicians and researchers alike, this thought-provoking compendium contributes critical information that helps enhance our understanding of the causes of mental disorders, develop effective preventive and treatment interventions, and inform future editions of DSM and ICD.
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