Kuhl, Ph.D., senior science writer and DSM-5 staff text editor, to coordinate the efforts of the work groups into a cohesive whole. William E. Narrow, M.D., M.P.H., led the research group that developed the overall research strategy for DSM-5, including the field trials, that greatly enhanced the evidence base for this revision. In addition, we are grateful to those who contributed so much time to the independent review of the revision proposals, including Kenneth S. Kendler, M.D., and Robert Freedman, M.D., co-chairs of the Scien- tific Review Committee; John S. McIntyre, M.D., and Joel Yager, M.D., co-chairs of the
Clinical and Public Health Committee; and Glenn Martin, M.D., chair of the APA Assem- bly review process. Special thanks go to Helena C. Kraemer, Ph.D., for her expert statistical consultation; Michael B. First, M.D., for his valuable input on the coding and review of cri- teria; and Paul S. Appelbaum, M.D., for feedback on forensic issues. Maria N. Ward,
M.Ed., RHIT, CCS—P, also helped in verifying all ICD coding. The Summit Group, which included these consultants, the chairs of all review groups, the task force chairs, and the
APA executive officers, chaired by Dilip V. Jeste, M.D., provided leadership and vision in helping to achieve compromise and consensus. This level of commitment has contributed to the balance and objectivity that we feel are hallmarks of DSM-5.
We especially wish to recognize the outstanding APA Division of Research staff— identified in the Task Force and Work Group listing at the front of this manual—who worked tirelessly to interact with the task force, work groups, advisors, and reviewers to resolve issues, serve as liaisons between the groups, direct and manage the academic and routine clinical practice field trials, and record decisions in this important process. In par- ticular, we appreciate the support and guidance provided by James H. Scully Ir., M.D.,
Medical Director and CEO of the APA, through the years and travails of the development process. Finally, we thank the editorial and production staff of American Psychiatric Pub- lishing—specifically, Rebecca Rinehart, Publisher; John McDuffie, Editorial Director; Ann
Eng, Senior Editor; Greg Kuny, Managing Editor; and Tammy Cordova, Graphics Design
Manager—for their guidance in bringing this all together and creating the final product. It is the culmination of efforts of many talented individuals who dedicated their time, exper- tise, and passion that made DSM-S possible.
David I. Kupfer, M.D.
Darrel A. Regier, M.D., M.P.H.
December 19, 2012
Introduction..................................................5
Cautionary Statement for Forensic Use of DSM-5..................25
This section is a basic orientation to the purpose, structure, content, and use of DSM-S. It is not intended to provide an exhaustive account of the evo- lution of DSM-5, but rather to give readers a succinct overview of its key ele- ments. The introductory section describes the public, professional, and expert review process that was used to extensively evaluate the diagnostic criteria presented in Section II. A summary of the DSM-5 structure, harmonization with
ICD-11, and the transition to a non-axial system with a new approach to as- sessing disability is also presented. “Use of the Manual" includes “Definition of a Mental Disorder,” forensic considerations, and a brief overview of the diag- nostic process and use of coding and recording procedures.
The creation of the fifth edition of Diagnostic and Statistical Manual ofMental Disorders (DSM-S) was a massive undertaking that involved hundreds of people working toward a common goal over a 12-year process. Much thought and deliberation were involved in evaluating the diagnostic criteria, considering the organization of every aspect of the man- ual, and creating new features believed to be most useful to clinicians. All of these efforts were directed toward the goal of enhancing the Clinical usefulness of DSM-5 as a guide in the diagnosis of mental disorders.