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http://www.dsm5.org/Pages/Default.aspx

DSM 4 DSM 5
Differences
Where's Aspergers?
What are the DSM 4 DSM 5 Differences?
Let's take a look.
The American Psychiatric Association has
eliminated Aspergers from the proposed
DSM 5 along with the "Pervasive
Developmental Disorders" (PDD) category,
of which Autism and Aspergers were
subsets (see the outline on the DSM
4 page).
They have replaced PDD with the category
"Autism Spectrum Disorder" and listed
"Autism Spectrum Disorder" as the only
diagnosis in this category (see DSM 5

Outline of Neurodevelopmental
Disorders).
In the Association's own words, they have
eliminated the diagnoses of Childhood
Disintegrative Disorder, PDD-NOS, and
Aspergers, saying that they are now part
of Autism Spectrum Disorder. (You may
want to read more about PDDNOS andHigh Functioning Autism.)
I was initially not happy with this, and I'm
still not sure about it, but let's examine
the proposed DSM 5 to see if things were
eliminated or just moved around and
renamed.
Below you'll read diagnostic criteria for
Aspergers according to the current DSM 4
in the left column. You'll read the
comparable diagnostic criteria for Autism
according to the DSM 4 in the right
column. Then underneath each criterion,
you'll read about the proposed,
corresponding DSM 5 criterion for Autism.

Social Communication

Aspergers in the DSM 4

Autism

Criterion A: Qualitative impairment in


social interaction.

Criterion
impairme

The DSM 4 lists four behaviors that


The DSM 4
demonstrate impairment and requires two of demonstra
them, as opposed to the DSM 5, which requires them, as o
three that are specified.
three that

Criterion
functioni

Criterion
functioni
commun

Autism in DSM 5: Persistent deficits in


social communication and social
interaction.
The DSM 5 lists three behaviors that
demonstrate deficits, and all three are required.
When the press reports that people are
concerned about the tighter definition of Autism
in the DSM 5, this is what they are talking about.
If your child currently has a diagnosis of PDDNOS and doesn't qualify for the new definition of
Autism Spectrum Disorder, it is possible that he
or she would qualify for the new diagnosis of

Social Communication. You can read more about


the Tighter Criteria for Social Communication in
the DSM 5.

Restricted, Repetitive
Patterns of Behavior,
Interests, or Activities
Aspergers in the DSM 4

Autism

Criterion B: Restricted repetitive and


stereotyped patterns of behavior,
interests, and activities.

Criterion
repetitive
behavior

The DSM 4 lists four behaviors that


demonstrate such patterns and requires oneof
them. Those four behaviors match up to three
of the behaviors listed in the DSM 5. The DSM
5 adds one more behavior to the list and then
requires two.

The DSM 4
demonstra
them. Tho
of the beh
5 adds on
requires tw

Autism in DSM 5: Restricted,

repetitive patterns of behavior, interests,


or activities.
The DSM 5 lists four behaviors that demonstrate
such patterns. The four behaviors match up to

the DSM 4 and then adds one more. The DSM 5


requires two of these behaviors, so the DSM 5 is
not necessarily more restrictive. I guess it
depends on what behaviors your child is showing.
You can read the details on the Autism
Behaviors page.

Aspergers in the DSM 4


Criterion C: The disturbance causes
clinically significant impairment in social,
occupational, or other important areas
of functioning.

Late Language Emergence


Aspergers in the DSM 4

Autism

Criterion D: There is no clinically


significant general delay in language
(e.g., single words used by age 2 years,
communicative phrases used by age 3
years).

Criterion
impairme
manifest
following

delay
devel

in ind
mark
initiat
other

stere
langu

lack o
believ
appro
Note: Criterion D for Aspergers has been
in debate for years. Tony
Attwood, theresearcher of Aspergers, says
that kids with Aspergers may have a delay
in language.
It looks to me like the American
Psychiatric Association has removed the
debated criterion and moved it into its
own diagnosis of Late Language
Emergence (LLE). See the next paragraph
below. (You can read about my son's
experience with delay in language on
the Autism Aspergers page.)

DSM 5: Within the Communication

Disorders category (see the DSM 5


Outline of Neurodevelopmental
Disorders), the American Psychiatric
Association created a new diagnosis
of Late Language Emergence (LLE). (This
change I like. Look for "early intervention"
below.)
Fewer than 50 words at 2 years, inability
to follow verbal instructions, limited use of
gestures and sounds to communicate,
limited symbolic play, few word
combinations at 2-1/2 years. (Notice that
the age-referenced criteria are more strict
than in the DSM 4--yay!)
"Children with LLE are at risk for Specific
Language Impairment, Social
Communication Disorder, Autism
Spectrum Disorder, Learning Disability,
ADHD, Intellectual Disability and other
developmental disorders and therefore
need to beidentified as toddlers,
referred for early intervention,
evaluated for more general cognitive
problems, and monitored for a change in
diagnosis as they approach school age."

For more information, read the Significant


Delay in Early Language page.

Delay in Cognitive
Development or Self-Help
Skills
Aspergers in the DSM 4
Criterion E: There is no clinically
significant delay in cognitive
development or in the development of
age-appropriate self-help skills, adaptive
behavior (other than social interaction),
and curiosity about the environment in
childhood.
Note: In his book titled The Complete
Guide to Asperger's Syndrome copyright
2007, Tony Attwood discusses the history
of the Aspergers diagnosis, which includes
delay in self-help skills, and therefore
seems to disagree with Criterion E in the
DSM 4.

DSM 5: The American Psychiatric

Association has removed any discussion of


cognitive delay in Autism and has instead
addressed cognitive development in a new
category and diagnosis of "Intellectual
Developmental Disorder." This means that
children could have multiple diagnoses.

Other Criteria

Autism

Criterion
functioni
play.

Aspergers in the DSM 4

Autism

Criterion F: Criteria are not met for


another specific Pervasive
Developmental Disorder or
Schizophrenia.

Criterion
better ac
or Childh

(Don't freak out about the mention of


schizophrenia. The American Psychiatric

Association is merely recognizing that it can be


hard to tell the difference between the two
diagnoses if you're quick to jump to
conclusions. You can read more on
mySchizophrenia page.)

More Information about


the DSM
Late Language Emergence
(LLE) and Early Intervention
Is early intervention at risk? Maybe...
Maybe not. The new diagnosis of Late
Language Emergence or LLE looks like a
win for our kids.

Tighter Criteria for Social


Communication
What is concerning is the tighter criteria
for social communication/social
interaction. The DSM 5 requires all three
of the behaviors that characterize deficits;
whereas the DSM 4 lists one additional for

a total of four and then requires two. Look


at the side-by-side comparison on
the Social Communicationpage.

Changed Criteria for Autism


Behaviors
Also concerning is the change of criteria
for the Autism Behaviors (restricted,
repetitive patterns of behavior, interests,
or activities) that make up the second half
of the definition of Autism Spectrum
Disorder in the proposed DSM 5. The DSM
5 requires two rather than one criterion,
and the list of criteria has changed.

Outline of
Neurodevelopmental Disorders
When I saw how the proposed DSM 5
outlines Autism, ADHD, and Late
Language Emergence, everything made
more sense to me. (Notice
that Aspergers and PDD-NOS have been
eliminated.) I hope that reading the

outline helps you, too. You may want to


compare it to the current DSM 4.

List of Severity Levels of


Autism Spectrum Disorder
Learn how the DSM 5 specifies
the severity levels within the Autism
Spectrum Disorder and how this compares
to the terms "Aspergers" and "High
Functioning Autism."

Do I say "Aspergers" or
"Autism"?
Do I continue to say "Aspergers"? or do I
change to the one of the new DSM 5
diagnoses? I guess that all depends to
whom you're talking.

DSM 5
The Recently Updated Manual of
Mental Disorders
The DSM 5 is the recently revised Diagnostic and
Statistical Manual of Mental Disorders, which the

American Psychiatric Association publish in May


2013.

You probably have heard all the controversy about


the proposed changes, but just in case you haven't,
here's what is happening.
The American Psychiatric Association has proposed
the elimination of Aspergers Syndrome as a
diagnosis that is distinct from Autism. If the DSM 5
goes forward as currently proposed, Aspergers will
not be a diagnosis any longer. Basically, they are
saying that Aspergers is Autism, phasing out the
term "Aspergers" (at least in the United States)
altogether.
Aspergers Syndrome has always been a form of
Autism. It's hard to find someone who disagrees.
The problem with the change to the diagnostic
criteria is threefold.
1.Many adults with Aspergers strongly identify
with their diagnosis and don't want their
diagnosis changed to Autism Spectrum
Disorder.

2.Parents of children who have more Aspergers


characteristics than Autism characteristics need
to be able to find information about Aspergers
easily rather than have to sort through all the
Autism information to find what they need to
know because parenting a child with Aspergers
is similar but still different than parenting a
child with Autism.
A teen recorded a video about his own
Aspergers characteristics and posted it on
YouTube. In the video titled "In My Mind," Alex
Olinkiewicz says that with Aspergers, he is half
Autistic and half NT. I love his description! I
agree with him completely because while
parenting a child with Aspergers, I sometimes
forget that my child is not NT. But when I work
with children who have Autism, their Autism is
much more apparent all day long.
3.Although the DSM 5 committee says that it's
trying to align its diagnoses with the World
Health Organization's (WHO) International
Statistical Classification of Diseases and Related
Health Problems, the proposed ICD 11 does
include Aspergers. So it seems that if you want
to have an Aspergers Syndrome diagnosis, then
you need to not live in the United States.
You can read how the Autism Speaks organization
has addressed the elimination of Aspergers in
its letter to the DSM work group.

Good Change
One of the changes that the Association has made is
a good one. That's the removal of "clinically
significant delays in language" from the definition of
Autism.
The delay in language has been one of the
significant differences cited between Aspergers and
Autism according to the current DSM 4. Aspergers
supposedly has no delay but Autism does. However,
current research does not support that distinction. A
delay in language may or may not happen with
Aspergers.
One draft of the DSM 5 moved this diagnostic
criteria into a new diagnosis of Late Language
Emergence with a recommendation for early and
continuing intervention. I loved it!
However, the Neurodevelopmental Disorders work
group has since removed the Late Language
Emergence diagnosis. Now the child would probably
get a diagnosis of Speech Disorder or possibly of
Language Disorder. You can read the entire outline
of the DSM 5 Neurodevelopmental Disorders for
yourself.

Bad Change
What is not so good is the tighter criteria for social
communication, which is half of the definition of
Autism. This is the change that parents complain
about and that you read about in the news.

Although my Trio Man is not effected by this


change, I do sympathize and agree with the families
who would be. I don't think it's right to put more
families in a situation where they need services but
can't get them because the criteria for the diagnosis
has changed. There's no other diagnosis in the
proposal to help these kids get the services that
they need.
However, the first studies of the proposed DSM 5
show that children will not lose their diagnosis. Of
course there are those who say that there are flaws
in these studies and more studies are needed. Time
will tell.
For a side-by-side comparison of social
communication in the current and proposed DSMs,
go to the Tighter Criteria for Social
Communication page.
You may also be affected by the second half of the
definition of Autism, for which the criteria has
changed. The proposed DSM lists four behaviors
that demonstrate such patterns. The four behaviors
match up to the DSM 4 and then adds one more.
The DSM 5 requires two of these behaviors, so the
DSM 5 is not necessarily more restrictive. I guess it
depends on what behaviors your child is showing.
You can read more on the Autism Behaviors page.

Summary of Changes
If you're like me, then reading the outline will help
you understand how the Association has changed

the diagnoses. You can read the proposed outline


for Neurodevelopmental Disorders and compare it to
the current outline in the DSM 4's Disorders Usually
First Diagnosed in Infancy, Childhood, and
Adolescence.
Notice the addition of Late Language Emergence,
where ADHD is in comparison to Autism, and that
Aspergers and PDD-NOS are no longer listed.
You may also want to read my side-by-side
comparison of Autism and Aspergers in the DSM 4
and DSM 5. If you currently have a diagnosis
of PDD-NOS or High-Functioning Autism, then you
may want to read a bit about them as well. It's also
interesting to read how the World Health
Organization (WHO) names and organizes its list of
Disorders of Psychological Development in the ICD
10.
The proposal lists severity levels of Autism. Perhaps
Aspergers is supposed to be severity level 1. Read
more on the List of Severity Levels page.
And if you want my opinion on what to tell your
family, see the Do I say "Aspergers"? page.

DSM 5 Outline of
Neurodevelopmental
Disorders
When I saw how the proposed DSM 5 outlines the
neurodevelopmental disorders of Autism, ADHD,

and Late Language Emergence, everything made


more sense to me. (Notice that Aspergers and PDDNOS have been eliminated.) I hope that reading the
outline helps you, too.
For the diagnostic criteria, read the DSM 4 DSM 5
Differences page.
The DSM 4's chapter titled "Disorders Usually First
Diagnosed in Infancy, Childhood, or Adolescence"
will become "Neurodevelopmental Disorders," which
lists the following disorders.

Categories and Diagnoses


Intellectual Developmental Disorders
Intellectual Developmental Disorder
Intellectual or Global Developmental Delay Not
Elsewhere Classified
Communication Disorders
Language Disorder
Speech Disorder
Social Communication Disorder
Autism Spectrum Disorder
Autism Spectrum Disorder
Attention Deficit/Hyperactivity Disorder

Attention Deficit/Hyperactivity Disorder


Attention Deficit/Hyperactivity Disorder Not
Elsewhere Classified
Specific Learning Disorder
Specific Learning Disorder
Motor Disorders
Developmental Coordination Disorder
Stereotypic Movement Disorder
Tourette's Disorder
Chronic Motor or Vocal Tic Disorder
Provisional Tic Disorder
Tic Disorder Not Elsewhere Classified
Substance-Induced Tic Disorder
Tic Disorder Due to a General Medical Condition

Other Pages about the DSM 5


DSM 4 - DSM 5 Differences -- Where's
Aspergers?
In the Association's own words, they have
eliminated the diagnoses of Childhood Disintegrative
Disorder, PDD-NOS, and Aspergers, saying that they

are now part of Autism Spectrum Disorder. (You


may also want to read the PDD-NOS andHighFunctioning Autism pages.)
I was initially not happy with this, and I'm still not
sure about it, but let's examine the proposed DSM 5
to see if things were eliminated or just moved
around and renamed. Check out to my side-by-side
comparison.

Tighter Criteria for Social


Communication
What is concerning is the tighter criteria for social
communication/social interaction. The DSM 5
requires all three of the behaviors that characterize
deficits; whereas the DSM 4 lists one additional for
a total of four and then requires two. Look at the
side-by-side comparison on the Social
Communicationpage.

Changed Criteria for Autism Behaviors


Also concerning is the change of criteria for
the Autism Behaviors (restricted, repetitive patterns
of behavior, interests, or activities) that make up
the second half of the definition of Autism Spectrum
Disorder in the proposed DSM 5. The DSM 5
requires two rather than one criterion, and the list
of criteria has changed.

Autism Behaviors
According to the Proposed
DSM 5
Autism Behaviors are the second part of the
proposed DSM 5's definition of Autism Spectrum
Disorder, specifically "restricted, repetitive patterns
of behavior, interests, or activities." The first part is
about social communication.
*DSM stands for Diagnostic and Statistical Manual, which is
published by the American Psychiatric Association and used
by professionals to diagnose mental health conditions. The
manual not only affects decisions that doctors make but also
what the insurance companies will cover. The DSM 4 is the
recently retired manual. You can learn more about it on
the DSM 4 page.
DSM 5 was just published.
NOTE: Tony Attwood, the current researcher of Aspergers
Syndrome, does not agree with the elimination of Aspergers
Syndrome from the manual.
Read more on the DSM 4 page, the DSM 5 page, and the ICD
10 page.

The criteria for social communication have become


more strict; however, the criteria for the Autism
behaviors in the second part, "restricted, repetitive
patterns of behavior, interests, or
activities," may be tighter. I guess it depends on
which behaviors your child is showing.
In the case of social communication, the proposed
DSM 5 includes a new diagnosis of Social

Communication, for which a child with PDDNOS might be diagnosed under the new criteria.
However, there is no equivalent new diagnosis for
children who have "restricted, repetitive patterns of
behavior, interests, or activities." I guess the
researchers find that if children have the latter, they
always also have social communication disorder.
Here's a side-by-side comparison of the DSM 4 and
the DSM 5's criteria for the Autism behaviors listed
in the second part of the definitions of Autism and
Aspergers.

DSM 4's Restricted repetitive DSM 5's Restric


and stereotyped patterns of repetitive patte
behavior, interests, and
behavior, intere
activities for both Autism and activities for Au
Aspergers
Spectrum Disor
includes Asperg
NOS
as manifested by at least one of the
following:
Encompassing preoccupation with
one or more stereotyped and
restricted patterns of interest that
is abnormal either in intensity or
focus

as manifested by at
following:

Highly restricted
that are abnorm
focus (such as st
or preoccupation
objects, excessiv
or perseverative

Persistent preoccupation with parts


of objects
These are two separate criteria in the DSM 4
that seem to be addressed with one criterion in
the proposed DSM 5.

Apparently inflexible adherence to


specific, nonfunctional routines or
rituals

Excessive adhere
ritualized pattern
nonverbal behav
resistance to cha
motoric rituals, i
route or food, re
or extreme distre
changes)

Stereotyped and repetitive motor


mannerisms (e.g., hand or finger
flapping or twisting, or complex
whole-body movements)

Stereotyped or r
motor movemen
objects (such as
stereotypies, ech
use of objects, o
phrases)

(I could not find a DSM 4 equivalent.)

Hyper-or hypo-re
input or unusual
aspects of enviro
apparent indiffer
pain/heat/cold, a
specific sounds o
excessive smellin
objects, fascinat

spinning objects)

Other Pages About the DSM 5


Tighter Criteria for Social
Communication
What is concerning is the tighter criteria for social
communication/social interaction. The DSM 5
requires all three of the behaviors that characterize
deficits; whereas the DSM 4 lists one additional for
a total of four and then requires two. Look at the
side-by-side comparison on the Social
Communicationpage.

Outline of Neurodevelopmental
Disorders
When I saw how the proposed DSM 5
outlines Autism, ADHD, and Late Language
Emergence, everything made more sense to me.
(Notice that Aspergers and PDD-NOS have been
eliminated.) I hope that reading the outline helps
you, too. You may want to compare it to the
current DSM 4.

DSM 4 - DSM 5 Differences -- Where's


Aspergers?

In the Association's own words, they have


eliminated the diagnoses of Childhood Disintegrative
Disorder, PDD-NOS, and Aspergers, saying that they
are now part of Autism Spectrum Disorder. (You
may also want to read the PDD-NOS andHighFunctioning Autism pages.)
I was initially not happy with this, and I'm still not
sure about it, but let's examine the proposed DSM 5
to see if things were eliminated or just moved
around and renamed. Check out to my side-by-side
comparison.

DSM-5 Changes: Depression &


Depressive Disorders
By JOHN M. GROHOL, PSY.D.

The new Diagnostic and


Statistical Manual of Mental Disorders, 5th
Edition (DSM-5) has a number of important
updates and changes made to major

depression (also known as clinical


depression) and depressive disorders. This
article outlines some of the major changes to
these conditions, including the introduction of
two new disorders: disruptive mood
dysregulation disorder and premenstrual
dysphoric disorder.
Dysthymia is gone, replaced with something
called persistent depressive disorder. The
new condition includes both chronic major
depressive disorder and the previous
dysthymic disorder. Why this change? An
inability to find scientifically meaningful
differences between these two conditions led
to their combination with specifiers included
to identify different pathways to the
diagnosis and to provide continuity with
DSM-IV.
Disruptive Mood Dysregulation Disorder

Disruptive Mood Dysregulation disorder is a


new condition introduced in the DSM-5 to
address symptoms that had been labeled as
childhood bipolar disorder before the DSM5s publication. This new disorder can be
diagnosed in children up to age 18 years who
exhibit persistent irritability and frequent
episodes of extreme, out-of-control behavior.

Premenstrual Dysphoric Disorder

Premenstrual Dysphoric Disorder is now an


official diagnosis in the DSM-5. Its like the
symptom criteria are similar to those in the
draft revision of the DSM-5:
In most menstrual cycles during the past year,
five (or more) of the following symptoms
occurred during the final week before the onset
of menses, started to improve within a few days
after the onset of menses, and were minimal or
absent in the week postmenses, with at least one
of the symptoms being either (1), (2), (3), or
(4):
(1) marked affective liability (e.g., mood swings;
feeling suddenly sad or teaful or increased
sensitivity to rejection)
(2) marked irritability or anger or increased
interpersonal conflicts
(3) markedly depressed mood, feelings of
hopelessness, or self-deprecating thoughts
(4) marked anxiety, tension, feelings of being
keyed up or on edge
(5) decreased interest in usual activities (e.g.,
work, school, friends, hobbies)
(6) subjective sense of difficulty in concentration

(7) lethargy, easy fatigability, or marked lack of


energy
(8) marked change in appetite, overeating, or
specific food cravings
(9) hypersomnia or insomnia
(10) a subjective sense of being overwhelmed or
out of control
(11) other physical symptoms such as breast
tenderness or swelling, joint or muscle pain, a
sensation of bloating, weight gain
Major Depressive Disorder

Given that clinical depression or as the


DSM has long referred to it,major depressive
disorder is so commonly diagnosed, it
would be wise to limit changes to this popular
diagnosis. And so the APA has shown wisdom
by not changing any of the core criteria of
symptoms for major depression, nor the
requisite 2 week time period needed before it
can be diagnosed.
The coexistence within a major depressive
episode of at least three manic symptoms
(insufficient to satisfy criteria for a manic
episode) is now acknowledged by the
specifier with mixed features.

The presence of mixed features in an


episode of major depressive disorder
increases the likelihood that the illness exists
in a bipolar spectrum; however, if the
individual concerned has never met criteria
for a manic or hypomanic episode, the
diagnosis of major depressive disorder is
retained, notes the APA.
Bereavement Exclusion

Much ado has been made about the removal


of the bereavement exclusion from the
diagnosis of major depression, but in reality,
little will change for most clinicians. This
exclusion was only in effect if a person
presented with major depressive symptoms
within the first 2 months after the death of a
loved one.
This exclusion was omitted in DSM-5 for
several reasons:
The first is to remove the implication that
bereavement typically lasts only 2 months when
both physicians and grief counselors recognize
that the duration is more commonly 12 years.
Second, bereavement is recognized as a severe
psychosocial stressor that can precipitate a major
depressive episode in a vulnerable individual,
generally beginning soon after the loss. When

major depressive disorder occurs in the context


of bereavement, it adds an additional risk for
suffering, feelings of worthlessness, suicidal
ideation, poorer somatic health, worse
interpersonal and work functioning, and an
increased risk for persistent complex
bereavement disorder, which is now described
with explicit criteria in Conditions for Further
Study in DSM-5 Section III.
Third, bereavement-related major depression is
most likely to occur in individuals with past
personal and family histories of major depressive
episodes. It is genetically influenced and is
associated with similar personality
characteristics, patterns of comorbidity, and risks
of chronicity and/or recurrence as non
bereavement-related major depressive episodes.
Finally, the depressive symptoms associated with
bereavement-related depression respond to the
same psychosocial and medication treatments as
nonbereavement-related depression. In the
criteria for major depressive disorder, a detailed
footnote has replaced the more simplistic DSM-IV
exclusion to aid clinicians in making the critical
distinction be-tween the symptoms characteristic
of bereavement and those of a major depressive
episode. Thus, although most people
experiencing the loss of a loved one experience
bereavement without developing a major
depressive episode, evidence does not support
the separation of loss of a loved one from other

stressors in terms of its likelihood of precipitating


a major depressive episode or the relative
likelihood that the symptoms will remit
spontaneously.

The DSM-5 change allows the clinician to now


exercise their professional judgment as to
whether someone with symptoms of major
depression and who is in grief should be
diagnosed with depression. In many cases, I
suspect professionals will continue to refrain
from diagnosing depression if the symptoms
do not warrant it or if doing so will result
in little change to the treatment options or
choices of the patient.
Specifiers for Depressive Disorders

People who are suicidal remain a concern


public mental health concern. A new specifier
is available that helps shed light on suicidality
factors in someone who is depressed. These
factors include suicidal thinking, plans, and
the presence of other risk factors in order to
make a determination of the prominence of
suicide prevention in treatment planning for a
given individual.
A new specifier to indicate the presence of
mixed symptoms has been added across both
the bipolar and the depressive disorders,

allowing for the possibility of manic features


in individuals with a diagnosis of unipolar
depression, notes the APA.
A substantial body of research conducted
over the last two decades points to the
importance of anxiety as relevant to
prognosis and treatment decision making,
concludes the APA. The with anxious
distress specifier gives the clinician an
opportunity to rate the severity of anxious
distress in all individuals with bipolar or
depressive disorders.

DSM-5: Changes to the


Diagnostic and Statistical
Manual of Mental Disorders

Diagnostic and Statistical Manual of Mental


Disorders (DSM) is the standard classification of mental
disorders used by mental health professionals in the United
States. It contains a listing of diagnostic criteria for every
psychiatric disorder recognized by the U.S. health care
system.

Revisions Published in 2013


The American Psychiatric Association has announced
thatDSM-5, the new edition of the Diagnostic and Statistical
Manual of Mental Disorders, incorporates significant scientific
advances in more precisely identifying and diagnosing
mental disorders. DSM-5 provides a common language for
patients, caregivers, and clinicians to communicate about the
disorders.
Some of the categories for anxiety disorders have changed.
These changes will not affect your ability to find treatment or
your current health insurance. Ask your therapist or doctor
about how the new criteria may provide a more accurate way
to characterize symptoms and assess severity.

Download fact sheets about the disorders from the


American Psychiatric Association.

Anxiety and Depression Refinements


Much has remained the same in the areas of anxiety and
depression, with refinements of criteria and symptoms across
the lifespan. Some disorders included in the broad category
of anxiety disorders are now in three sequential chapters:
Anxiety Disorders, Obsessive-Compulsive and Related
Disorders, and Trauma- and Stressor-Related Disorders. This
move emphasizes the distinctiveness of each category while
signaling their interconnectedness. (See list below.)
One significant change is the developmental approach and
examination of disorders across the lifespan, including
children and older adults. Some conditions are grouped
together as syndromes because the symptoms are not
sufficiently distinct to separate the disorders. Others have
been split apart into distinct groups.
The DSM-5 is not a treatment guide, and it will not affect the
availability of treatments for patients and their loved ones.

Find a Therapist
Learn more about treatments for anxiety and
depression.

DSM-5

Disorders

Anxiety Disorders
Separation Anxiety Disorder
Selective Mutism
Specific Phobia
Social Anxiety Disorder (Social Phobia)
Panic Disorder
Panic Attack (Specifier)
Agoraphobia
Generalized Anxiety Disorder
Substance/Medication-Induced Anxiety Disorder
Anxiety Disorder Due to Another Medical Condition
Other Specified Anxiety Disorder
Unspecified Anxiety Disorder
Obsessive-Compulsive and Related Disorders
Obsessive-Compulsive Disorder
Body Dysmorphic Disorder
Hoarding Disorder
Trichotillomania (Hair-Pulling Disorder)
Excoriation (Skin-Picking) Disorder
Substance/Medication-Induced Obsessive-Compulsive and
Related Disorder
Obsessive-Compulsive and Related Disorder Due to Another
Medical Condition
Other Specified Obsessive-Compulsive and Related Disorder
Unspecified Obsessive-Compulsive and Related Disorder
Trauma- and Stressor-Related Disorders
Reactive Attachment Disorder
Disinhibited Social Engagement Disorder
Posttraumatic Stress Disorder
Acute Stress Disorder
Adjustment Disorders

Other Specified Trauma- and Stressor-Related Disorder


Unspecified Trauma- and Stressor-Related Disorder
Depressive Disorders
Disruptive Mood Dysregulation Disorder
Major Depressive Disorder, Single and Recurrent Episodes
Persistent Depressive Disorder (Dysthymia)
Premenstrual Dysphoric Disorder
Substance/Medication-Induced Depressive Disorder
Depressive Disorder Due to Another Medical Condition
Other Specified Depressive Disorder
Unspecified Depressive Disorder
Somatic Symptom and Related Disorders
Illness Anxiety Disorder
(additional disorders not listed)