A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5.

Science.gov (United States)

Armour, Cherie; Műllerová, Jana; Elhai, Jon D

2016-03-01

The factor structure of posttraumatic stress disorder (PTSD) has been widely researched, but consensus regarding the exact number and nature of factors is yet to be reached. The aim of the current study was to systematically review the extant literature on PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to identify the best-fitting model. One hundred and twelve research papers published after 1994 using confirmatory factor analysis and DSM-based measures of PTSD were included in the review. In the DSM-IV literature, four-factor models received substantial support, but the five-factor Dysphoric arousal model demonstrated the best fit, regardless of gender, measurement instrument or trauma type. The recently proposed DSM-5 PTSD model was found to be a good representation of PTSD's latent structure, but studies analysing the six- and seven-factor models suggest that the DSM-5 PTSD factor structure may need further alterations. Copyright © 2015 Elsevier Ltd. All rights reserved.

DSM-V from the perspective of the DSM-IV experience.

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Walsh, B Timothy

2007-11-01

This article provides a brief overview of the development of the diagnostic criteria for eating disorders in DSM-IV. The process by which DSM-IV was developed is reviewed, including perspectives on what constitutes diagnostic validity and clinical utility, and their importance in assessing proposed changes in diagnostic criteria. The question of whether alterations in diagnostic criteria would clearly improve clinical utility was a major consideration in the DSM-IV process. Because of concerns that changes in diagnostic criteria would be disruptive and might entail loss of established knowledge, the DSM-IV Task Force assumed a generally conservative stance vis-à-vis change. The process of developing DSM-V is just beginning, and it is far from clear what alterations in diagnostic criteria for eating disorders will occur. However, the evolution of DSM-IV may provide a useful perspective on the development of DSM-V. (c) 2007 by Wiley Periodicals, Inc.

Counsellors Respond to the DSM-IV-TR

Science.gov (United States)

Strong, Tom; Gaete, Joaquin; Sametband, Ines N.; French, Jared; Eeson, Jen

2012-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is an administrative fact for many counsellors. This psychiatric approach to formulating client concerns runs counter to those used by counsellors of many approaches (e.g., systemic, feminist). Using an online survey of counsellors (N = 116), invited contributions to a website…

Approximating a DSM-5 Diagnosis of PTSD Using DSM-IV Criteria

Science.gov (United States)

Rosellini, Anthony J.; Stein, Murray B.; Colpe, Lisa J.; Heeringa, Steven G.; Petukhova, Maria V.; Sampson, Nancy A.; Schoenbaum, Michael; Ursano, Robert J.; Kessler, Ronald C.

2015-01-01

Background Diagnostic criteria for DSM-5 posttraumatic stress disorder (PTSD) are in many ways similar to DSM-IV criteria, raising the possibility that it might be possible to closely approximate DSM-5 diagnoses using DSM-IV symptoms. If so, the resulting transformation rules could be used to pool research data based on the two criteria sets. Methods The Pre-Post Deployment Study (PPDS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) administered a blended 30-day DSM-IV and DSM-5 PTSD symptom assessment based on the civilian PTSD Checklist for DSM-IV (PCL-C) and the PTSD Checklist for DSM-5 (PCL-5). This assessment was completed by 9,193 soldiers from three US Army Brigade Combat Teams approximately three months after returning from Afghanistan. PCL-C items were used to operationalize conservative and broad approximations of DSM-5 PTSD diagnoses. The operating characteristics of these approximations were examined compared to diagnoses based on actual DSM-5 criteria. Results The estimated 30-day prevalence of DSM-5 PTSD based on conservative (4.3%) and broad (4.7%) approximations of DSM-5 criteria using DSM-IV symptom assessments were similar to estimates based on actual DSM-5 criteria (4.6%). Both approximations had excellent sensitivity (92.6-95.5%), specificity (99.6-99.9%), total classification accuracy (99.4-99.6%), and area under the receiver operating characteristic curve (0.96-0.98). Conclusions DSM-IV symptoms can be used to approximate DSM-5 diagnoses of PTSD among recently-deployed soldiers, making it possible to recode symptom-level data from earlier DSM-IV studies to draw inferences about DSM-5 PTSD. However, replication is needed in broader trauma-exposed samples to evaluate the external validity of this finding. PMID:25845710

Verslavingsgedrag van DSM-IV naar DSM-5

NARCIS (Netherlands)

van den Brink, W.

2014-01-01

The 5th edition of the DSM was published in May, 2013. The new edition incorporates important changes in the classification of addiction. To compare the classification of addictive behaviours presented in DSM-IV with the classification presented in DSM-5 and to comment on the changes introduced into

DSM-IV-defined common mental disorders: Association with HIV ...

African Journals Online (AJOL)

Psychiatric diagnoses of depression, anxiety and substance abuse disorders were based on the Diagnostic and Statistical Manual, 4th edition (DSM-IV). HIVrelated fears, perceived risk and behaviour change were measured using multi-item scales. We analysed forms of behaviour change that were appropriate for risk ...

DSM-5 Personality Traits and DSM-IV Personality Disorders

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Hopwood, Christopher J.; Thomas, Katherine M.; Markon, Kristian E.; Wright, Aidan G.C.; Krueger, Robert F.

2014-01-01

Two issues pertinent to the DSM-5 proposal for personality pathology, the recovery of DSM-IV personality disorders (PDs) by proposed DSM-5 traits and the validity of the proposed DSM-5 hybrid model which incorporates both personality pathology symptoms and maladaptive traits, were evaluated in a large undergraduate sample (N = 808). Proposed DSM-5 traits as assessed with the Personality Inventory for DSM-5 explained a substantial proportion of variance in DSM-IV PDs as assessed with the Personality Diagnostic Questionnaire-4+, and trait indicators of the six proposed DSM-5 PDs were mostly specific to those disorders with some exceptions. Regression analyses support the DSM-5 hybrid model in that pathological traits and an indicator of general personality pathology severity provided incremental information about PDs. Findings are discussed in the context of broader issues around the proposed DSM-5 model of personality disorders. PMID:22250660

The 1-month prevalence of generalized anxiety disorder according to DSM-IV, DSM-V, and ICD-10 among nondemented 75-year-olds in Gothenburg, Sweden.

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Nilsson, Johan; Östling, Svante; Waern, Margda; Karlsson, Björn; Sigström, Robert; Guo, Xinxin; Skoog, Ingmar

2012-11-01

To examine the 1-month prevalence of generalized anxiety disorder (GAD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Diagnostic and Statistical Manual of Mental, Fifth Edition (DSM-V), and International Classification of Diseases, Tenth Revision (ICD-10), and the overlap between these criteria, in a population sample of 75-year-olds. We also aimed to examine comorbidity between GAD and other psychiatric diagnoses, such as depression. During 2005-2006, a comprehensive semistructured psychiatric interview was conducted by trained nurses in a representative population sample of 75-year-olds without dementia in Gothenburg, Sweden (N = 777; 299 men and 478 women). All psychiatric diagnoses were made according to DSM-IV. GAD was also diagnosed according to ICD-10 and DSM-V. The 1-month prevalence of GAD was 4.1% (N = 32) according to DSM-IV, 4.5% (N = 35) according to DSM-V, and 3.7% (N = 29) according to ICD-10. Only 46.9% of those with DSM-IV GAD fulfilled ICD-10 criteria, and only 51.7% and 44.8% of those with ICD-10 GAD fulfilled DSM-IV/V criteria. Instead, 84.4% and 74.3% of those with DSM-IV/V GAD and 89.7% of those with ICD-10 GAD had depression. Also other psychiatric diagnoses were common in those with ICD-10 and DSM-IV GAD. Only a small minority with GAD, irrespective of criteria, had no other comorbid psychiatric disorder. ICD-10 GAD was related to an increased mortality rate. While GAD was common in 75-year-olds, DSM-IV/V and ICD-10 captured different individuals. Current definitions of GAD may comprise two different expressions of the disease. There was greater congruence between GAD in either classification system and depression than between DSM-IV/V GAD and ICD-10 GAD, emphasizing the close link between these entities. 2012 American Association for Geriatric Psychiatry

The bi-directional associations between psychotic experiences and DSM-IV mental disorders

Science.gov (United States)

McGrath, John J.; Saha, Sukanta; Al-Hamzawi, Ali; Andrade, Laura; Benjet, Corina; Bromet, Evelyn J.; Browne, Mark Oakley; Caldas de Almeida, Jose M.; Chiu, Wai Tat; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Haro, Josep Maria; Have, Margreet ten; Hu, Chiyi; Kovess-Masfety, Viviane; Lim, Carmen C. W.; Navarro-Mateu, Fernando; Sampson, Nancy; Posada-Villa, José; Kendler, Kenneth; Kessler, Ronald C.

2016-01-01

Objective While it is now recognized that psychotic experiences (PEs) are associated with an increased risk of later mental disorders, we lack a detailed understanding of the reciprocal time-lagged relationships between first onsets of PEs and mental disorders. Methods The WHO World Mental Health (WMH) surveys assessed lifetime prevalence and age-of-onset of PEs and 21 common DSM-IV mental disorders among 31,261 adult respondents from 18 countries. Results Temporally primary PEs were significantly associated with subsequent first onset of 8 of the 21 mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, social phobia, post-traumatic stress disorder, adult separation anxiety disorder, bulimia nervosa, alcohol abuse), with ORs (95%CI) ranging from 1.3 (1.2–1.5; major depressive disorder) to 2.0 (1.5–2.6; bipolar disorder). In contrast, 18 of 21 primary mental disorders were significantly associated with subsequent first onset of PEs, with ORs (95% CI) ranging from 1.5 (1.0–2.1; childhood separation anxiety disorder) to 2.8 (1.0–7.8; anorexia nervosa). Conclusions While temporally primary PEs are associated with an elevated risk of several subsequent mental disorders, we found that most mental disorder are associated with an elevated risk of subsequent PEs. Further investigation of the underlying factors accounting for these time-order relationships might shed light on the etiology of PEs. PMID:26988628

Prevalence of DSM-IV and DSM-5 Alcohol, Cocaine, Opioid, and Cannabis Use Disorders in a Largely Substance Dependent Sample

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Peer, Kyle; Rennert, Lior; Lynch, Kevin G.; Farrer, Lindsay; Gelernter, Joel; Kranzler, Henry R.

2012-01-01

BACKGROUND The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will soon replace the DSM-IV, which has existed for nearly two decades. The changes in diagnostic criteria have important implications for research and for the clinical care of individuals with Substance Use Disorders (SUDs). METHODS We used the Semi-Structured Assessment for Drug Dependence and Alcoholism to evaluate the lifetime presence of DSM-IV abuse and dependence diagnoses and DSM-5 mild, moderate, or severe SUDs for alcohol, cocaine, opioids, and cannabis in a sample of 7,543 individuals recruited to participate in genetic studies of substance dependence. RESULTS Switches between diagnostic systems consistently resulted in a modestly greater prevalence for DSM-5 SUDs, based largely on the assignment of DSM-5 diagnoses to DSM-IV “diagnostic ophans” (i.e., individuals meeting one or two criteria for dependence and none for abuse, and thus not receiving a DSM-IV SUD diagnosis). The vast majority of these diagnostic switches were attributable to the requirement that only two of 11 criteria be met for a DSM-5 SUD diagnosis. We found evidence to support the omission from DSM-5 of the legal criterion due to its limited diagnostic utility. The addition of craving as a criterion in DSM-5 did not substantially affect the likelihood of an SUD diagnosis. CONCLUSION The greatest advantage of DSM-5 appears to be its ability to capture diagnostic orphans. In this sample, changes reflected in DSM-5 had a minimal impact on the prevalence of SUD diagnoses. PMID:22884164

DSM-IV Diagnosis of Conduct Disorder and Oppositional Defiant Disorder: Implications and Guidelines for School Mental Health Teams.

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Atkins, Marc S.; McKay, Mary McKernan; Talbott, Elizabeth; Arvanitis, Patrice

1996-01-01

Reviews the DSM-IV criteria for conduct disorder (CD) and oppositional defiant disorder (ODD), comparing their counterparts in DSM-III-R. Results from DSM-IV field trials indicate interrater and test-retest reliability were only marginally improved compared to prior criteria. Although overlooked in DSM-IV, community factors, gender differences,…

DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis.

Science.gov (United States)

Newby, Jill M; Hobbs, Megan J; Mahoney, Alison E J; Wong, Shiu Kelvin; Andrews, Gavin

2017-10-01

To investigate the reliability, validity and utility of DSM-5 illness anxiety disorder (IAD) and somatic symptom disorder (SSD), and explore their overlap with DSM-IV Hypochondriasis in a health anxious sample. Treatment-seeking patients with health anxiety (N=118) completed structured diagnostic interviews to assess DSM-IV Hypochondriasis, DSM-5 IAD, SSD, and comorbid mental disorders, and completed self-report measures of health anxiety, comorbid symptoms, cognitions and behaviours, and service utilization. IAD and SSD were more reliable diagnoses than Hypochondriasis (kappa estimates: IAD: 0.80, SSD: 0.92, Hypochondriasis: 0.60). 45% of patients were diagnosed with SSD, 47% with IAD, and 8% with comorbid IAD/SSD. Most patients with IAD fluctuated between seeking and avoiding care (61%), whereas care-seeking (25%) and care-avoidant subtypes were less common (14%). Half the sample met criteria for DSM-IV Hypochondriasis; of those, 56% met criteria for SSD criteria, 36% for IAD, and 8% for comorbid IAD/SSD. Compared to IAD, SSD was characterized by more severe health anxiety, somatic symptoms, depression, and higher health service use, and higher rates of major depressive disorder, panic disorder and agoraphobia. DSM-5 IAD and SSD classifications reliably detect more cases of clinically significant health anxiety than DSM-IV Hypochondriasis. The differences between IAD and SSD appear to be due to severity. Future research should explore the generalizability of these findings to other samples, and whether diagnostic status predicts treatment response and long-term outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

A comparison of DSM-5 and DSM-IV diagnostic criteria for posttraumatic stress disorder in traumatized refugees

OpenAIRE

Schnyder, Ulrich; Müller, Julia; Morina, Naser; Schick, Matthis; Bryant, Richard A; Nickerson, Angela

2015-01-01

The aim of this study was to compare the prevalence rate and factor structure of posttraumatic stress disorder (PTSD) based on the diagnostic criteria of the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; DSM-5; American Psychiatric Association, , ) in traumatized refugees. There were 134 adult treatment-seeking, severely and multiply traumatized patients from various refugee backgrounds were assessed in their mother tongue using a computerized...

DSM-IV: a nosology sold before its time?

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Zimmerman, M; Jampala, V C; Sierles, F S; Taylor, M A

1991-04-01

The purpose of this study was to determine whether American psychiatrists believe that DSM-IV is being published too soon after DSM-III-R. The authors conducted a mail survey of the attitudes of practicing psychiatrists (N = 454), residency program directors (N = 128), residents (N = 1,331), and researchers (N = 196) toward the scheduled publication of DSM-IV in the early 1990s. They found that the majority of all four groups believed that DSM-IV is being published prematurely. In contrast to respondents who believed that the timing of DSM-IV is appropriate, those who indicated that it is being published too soon had more recently completed their residency training and also believed that DSM-III-R was published prematurely. There was no association between the psychiatrists' responses and their theoretical orientation, Board certification status, ownership of the DSM manuals, the length of time they had used DSM-III, and the diagnostic manual (DSM-III or DSM-III-R) they were currently using. The belief that DSM-IV is being published too soon could contribute to underuse of DSM-IV by substantial numbers of psychiatrists. Thus, to foster compliance with it, APA must preserve in its efforts to demonstrate that the advantages of publishing it in 1993 outweigh the disadvantages of adopting yet another manual.

DSM-5 and mental disorders in older individuals: an overview

Science.gov (United States)

Sachdev, Perminder S.; Mohan, Adith; Taylor, Lauren; Jeste, Dilip V.

2015-01-01

About every 20 years, the American Psychiatric Association revises its official classification of mental disorders. The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, exciting considerable commentary, debate and criticism. This article briefly describes the process that led to the DSM-5 and the main changes from the previous version (DSM-IV) that would be of interest to a geriatric psychiatrist. While there have been a number of changes in the areas of schizophrenia, bipolar disorder, depressive disorders and anxiety disorders, the majority of these changes are minor and unlikely to have major treatment implications. The classification of neurocognitive disorders has however seen a major revision and elaboration in comparison with DSM-IV, with the introduction of Mild and Major Neurocognitive Disorders, the latter equated with dementia. A common language is introduced for the criteria of the various etiological subtypes of neurocognitive disorders. All physicians treating patients with neurocognitive disorders should familiarize themselves with these criteria. Their use in research has the potential to harmonize the field. PMID:26332215

DSM-5 and Mental Disorders in Older Individuals: An Overview.

Science.gov (United States)

Sachdev, Perminder S; Mohan, Adith; Taylor, Lauren; Jeste, Dilip V

2015-01-01

After participating in this activity, learners should be better able to:• Assess the changes in DSM-5 relative to earlier versions.• Evaluate the implications of the DSM-5 for practicing geriatric psychiatrists. About every 20 years, the American Psychiatric Association revises its official classification of mental disorders. The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, prompting considerable commentary, debate, and criticism. This article briefly describes the process leading up to DSM-5 and the main changes from the previous version (DSM-IV) that would be of interest to a geriatric psychiatrist. The changes in the areas of schizophrenia, bipolar disorder, depressive disorders, and anxiety disorders have been many, but the majority of them are minor and unlikely to have major treatment implications. The classification of neurocognitive disorders, however, has seen a major revision and elaboration in comparison to DSM-IV; of special note is the introduction of "mild and major neurocognitive disorders," the latter equated with dementia. A common language has also been introduced for the criteria for the various etiological subtypes of neurocognitive disorders. All physicians treating patients with neurocognitive disorders should familiarize themselves with these criteria. Their use in research has the potential to harmonize the field.

Narcissistic pathology as core personality dysfunction: comparing the DSM-IV and the DSM-5 proposal for narcissistic personality disorder.

Science.gov (United States)

Morey, Leslie C; Stagner, Brian H

2012-08-01

Narcissistic personality disorder and related concepts have a complex history and have been subject to extensive theoretical discourse but relatively little empirical research. An initial proposal for the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) that suggested eliminating this disorder as a discrete personality disorder type met with considerable controversy that ultimately led to its reinstatement in subsequent proposals. Nonetheless, the DSM-5 proposal for personality disorders as a whole would involve a significantly different formulation of narcissistic personality from that described in DSM-IV-one that places a greater emphasis on shared deficits among all personality disorders that tap elements thought to fall on the narcissistic spectrum, such as deficits in empathic capacity. This article describes this revised formulation, and presents a case study that illustrates the similarities and differences in the DSM-IV and proposed DSM-5 portrayal of narcissistic issues and related clinical problems over the course of a particular treatment. © 2012 Wiley Periodicals, Inc.

Associations between DSM-IV mental disorders and subsequent self-reported diagnosis of cancer

Science.gov (United States)

O'Neill, Siobhan; Posada-Villa, Jose; Medina-Mora, Maria Elena; Al-Hamzawi, Ali Obaid; Piazza, Marina; Tachimori, Hisateru; Hu, Chiyi; Lim, Carmen; Bruffaerts, Ronny; Lépine, Jean-Pierre; Matschinger, Herbert; de Girolamo, Giovanni; de Jonge, Peter; Alonso, Jordi; Caldas-de-Almeida, Jose Miguel; Florescu, Silvia; Kiejna, Andrzej; Levinson, Daphna; Kessler, Ronald C.; Scott, Kate M.

2016-01-01

Objective The associations between mental disorders and cancer remain unclear. It is also unknown whether any associations vary according to life stage or gender. This paper examines these research questions using data from the World Mental Health Survey Initiative. Methods The World Health Organization Composite International Diagnostic Interview retrospectively assessed the lifetime prevalence of 16 DSM-IV mental disorders in face-to-face household population surveys in nineteen countries (n = 52,095). Cancer was indicated by self-report of diagnosis. Smoking was assessed in questions about current and past tobacco use. Survival analyses estimated associations between first onset of mental disorders and subsequently reported cancer. Results After adjustment for comorbidity, panic disorder, specific phobia and alcohol abuse were associated with a subsequently self-reported diagnosis of cancer. There was an association between number of mental disorders and the likelihood of reporting a cancer diagnosis following the onset of the mental disorder. This suggests that the associations between mental disorders and cancer risk may be generalised, rather than specific to a particular disorder. Depression is more strongly associated with self-reported cancers diagnosed early in life and in women. PTSD is also associated with cancers diagnosed early in life. Conclusion This study reports the magnitude of the associations between mental disorders and a self-reported diagnosis of cancer and provides information about the relevance of comorbidity, gender and the impact at different stages of life. The findings point to a link between the two conditions and lend support to arguments for early identification and treatment of mental disorders. PMID:24529039

Can DSM-IV borderline personality disorder be diagnosed via dimensional personality traits? Implications for the DSM-5 personality disorder proposal.

Science.gov (United States)

Miller, Joshua D; Morse, Jennifer Q; Nolf, Kimberly; Stepp, Stephanie D; Pilkonis, Paul A

2012-11-01

The proposal for the diagnosis of personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5;American Psychiatric Association, in preparation) involves, in part, the use of elevated scores on dimensional personality traits. For instance, the diagnosis of borderline personality disorder (BPD) in the DSM-5 will require evidence of self- and interpersonal impairment as well as elevated scores on traits of emotional lability, anxiousness, separation insecurity, depressivity, impulsivity, risk taking, and hostility. Using a sample of individuals from the community (N = 134), half of whom were receiving psychiatric treatment, we tested whether the summation of relevant personality trait scores, using data derived from a measure of the Five-Factor Model of personality (FFM), would result in a construct that corresponds to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV, American Psychiatric Association, 2000) BPD construct as scored by expert consensus ratings. The DSM-IV and FFM BPD scores were significantly correlated (r = .60) and generated highly similar patterns of relations (ricc = .84) with key constructs from BPD's nomological network. These data should serve to allay concerns that the DSM-5's new diagnostic approach will be detrimental to the identification of BPD. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel.

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Kuester, Annika; Köhler, Kai; Ehring, Thomas; Knaevelsrud, Christine; Kober, Louisa; Krüger-Gottschalk, Antje; Schäfer, Ingo; Schellong, Julia; Wesemann, Ulrich; Rau, Heinrich

2017-01-01

Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). Objectives: This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces. Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated. Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p  DSM-IV, DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD-10 versus the consequences of its deletion as proposed for ICD-11.

Common and Unique Factors Associated with DSM-IV-TR Internalizing Disorders in Children

Science.gov (United States)

Higa-McMillan, Charmaine K.; Smith, Rita L.; Chorpita, Bruce F.; Hayashi, Kentaro

2008-01-01

With the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association. "Diagnostic and statistical manual of mental disorders DSM-IV Fourth Edition-Text Revision". Author, Washington, DC. 2000) ahead, decisions will be made about the future of taxonomic conceptualizations. This study examined the…

Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III

Science.gov (United States)

Goldstein, Risë B.; Chou, S. Patricia; Smith, Sharon M.; Jung, Jeesun; Zhang, Haitao; Saha, Tulshi D.; Pickering, Roger P.; June Ruan, W.; Huang, Boji; Grant, Bridget F.

2015-01-01

Objective: The purpose of this study was to examine prevalences and concordances between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and Fifth Edition (DSM-5) substance use disorders (SUDs) in a newly completed U.S. epidemiologic survey. Method: The National Epidemiologic Survey on Alcohol and Related Conditions–III surveyed 36,309 civilian, noninstitutionalized adults. SUDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule–5. Concordances between DSM-IV and DSM-5 disorders were assessed using kappa statistics. Results: Prevalences of past-year substance-specific DSM-5 disorders (2+ criteria) were modestly higher than those of DSM-IV dependence and abuse combined for alcohol, sedatives/tranquilizers, opioids, and heroin, but lower for cannabis, cocaine, and stimulants. Lifetime prevalences were lower under DSM-5. Prevalences were similar between moderate to severe (4+ criteria) DSM-5 disorders and dependence, whereas prevalences of DSM-5 disorders at 3+ criteria (DSM-5 [3+]) were higher, particularly for cannabis. Past-year concordances were excellent for DSM-IV dependence and abuse combined versus any DSM-5 and DSM-IV dependence versus DSM-5 moderate to severe disorders; lifetime concordances were fair to excellent. Past-year concordances between DSM-IV and DSM-5 (3+) were generally similar to or modestly higher than those with any DSM-5 disorder; lifetime concordances were mostly lower. Conclusions: Findings are consistent with those informing the development of DSM-5. Future research should examine differences in patterns between past-year and lifetime disorders, particularly for cannabis. Other questions warranting investigation include whether different combinations of the same numbers of criteria carry different clinical or nosologic implications, whether changes innosology yield changes in treatment demand, and whether changes in characteristics of individuals with DSM-5 SUDs

Poor Utility of the Age of Onset Criterion for DSM-IV Attention Deficit/Hyperactivity Disorder: Recommendations for DSM-V and ICD-11

Science.gov (United States)

Todd, Richard D.; Huang, Hongyan; Henderson, Cynthia A.

2008-01-01

Background: To test whether the retrospective reporting of the age of onset impairment criterion for attention deficit/hyperactivity disorder (ADHD) required in the "Diagnostic and Statistical Manual of Mental Disorders-IV" (DSM-IV) complicates identification of new and known child and adolescent cases later in life. Methods: A birth-records-based…

Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression

Science.gov (United States)

Scott, Kate M.; de Jonge, Peter; Alonso, Jordi; Viana, Maria Carmen; Liu, Zhaorui; O’Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J.; de Girolamo, Giovanni; Florescu, Silvia E.; Hu, Chiyi; Taib, Nezar Ismet; Lépine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Medina-Mora, Maria Elena; Piazza, Marina; Posada-Villa, José A.; Uda, Hidenori; Wojtyniak, Bogdan J.; Lim, Carmen C. W.; Kessler, Ronald C.

2013-01-01

Background Prior studies on the depression-heart disease association have not usually used diagnostic measures of depression, nor taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific association, or the comorbidity between depression and other mental disorders. Additionally, the relative magnitude of associations of a range of mental disorders with heart disease onset is unknown. Methods Face-to-face household surveys were conducted in 19 countries (n=52,095; person years=2,141,194). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Heart disease was indicated by self-report of physician’s diagnosis, or self-report of heart attack, together with their timing (year). Survival analyses estimated associations between first onset of mental disorders and subsequent heart disease onset. Results After comorbidity adjustment, depression, panic disorder, specific phobia, post-traumatic stress disorder and alcohol use disorders were associated with heart disease onset (ORs 1.3–1.6). Increasing number of mental disorders was associated with heart disease in a dose-response fashion. Mood disorders and alcohol abuse were more strongly associated with earlier onset than later onset heart disease. Associations did not vary by gender. Conclusions Depression, anxiety and alcohol use disorders were significantly associated with heart disease onset; depression was the weakest predictor. If confirmed in future prospective studies, the breadth of psychopathology’s links with heart disease onset has substantial clinical and public health implications. PMID:23993321

Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression.

Science.gov (United States)

Scott, Kate M; de Jonge, Peter; Alonso, Jordi; Viana, Maria Carmen; Liu, Zhaorui; O'Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J; de Girolamo, Giovanni; Florescu, Silvia E; Hu, Chiyi; Taib, Nezar Ismet; Lépine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Medina-Mora, Maria Elena; Piazza, Marina; Posada-Villa, José A; Uda, Hidenori; Wojtyniak, Bogdan J; Lim, Carmen C W; Kessler, Ronald C

2013-10-15

Prior studies on the depression-heart disease association have not usually used diagnostic measures of depression, or taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific association, or the comorbidity between depression and other mental disorders. Additionally, the relative magnitude of associations of a range of mental disorders with heart disease onset is unknown. Face-to-face household surveys were conducted in 19 countries (n=52,095; person years=2,141,194). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Heart disease was indicated by self-report of physician's diagnosis, or self-report of heart attack, together with their timing (year). Survival analyses estimated associations between first onset of mental disorders and subsequent heart disease onset. After comorbidity adjustment, depression, panic disorder, specific phobia, post-traumatic stress disorder and alcohol use disorders were associated with heart disease onset (ORs 1.3-1.6). Increasing number of mental disorders was associated with heart disease in a dose-response fashion. Mood disorders and alcohol abuse were more strongly associated with earlier onset than later onset heart disease. Associations did not vary by gender. Depression, anxiety and alcohol use disorders were significantly associated with heart disease onset; depression was the weakest predictor. If confirmed in future prospective studies, the breadth of psychopathology's links with heart disease onset has substantial clinical and public health implications. © 2013.

Validez de constructo de los trastornos de la personalidad del DSM-IV

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José Luis Besteiro

2004-01-01

Full Text Available El objetivo de este estudio cuasi-experimental fue valorar la validez de constructo de los conglomerados de trastornos de la personalidad del DSM-IV y la posible existencia de alguna de las dimensiones propuestas por los modelos factorialesbiológicos de la personalidad. Para ello se analizó la estructura factorial que emerge de un conjunto de medidas clínicas (MCMI-II, de personalidad (BFQ, psicofisiológicas (tasa cardiaca y respuesta dermoeléctrica ante tareas de estrés experimental y neuropsicológicas (tareas informatizadas que evalúan funciones ejecutivas frontales de atención sostenida, flexibilidad mental y formación de conceptos: Stroop, CPT y WCST. Se analizó una muestra de 146 sujetos (68 varones y 78 mujeres de edades comprendidas entre 17 y 65 años, diagnosticados con algún trastorno de la personalidad según criterios del DSM-IV. No se ha encontrado ningún factor que responda a alguna de las dimensiones propuestas por los modelos factoriales-biológicos para explicar los trastornos de la personalidad ni a la estructura de conglomerados del DSM-IV. Los resultados no apoyan la validez de constructo de los trastornos de la personalidad del DSM-IV.

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel

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Kuester, Annika; Köhler, Kai; Ehring, Thomas; Knaevelsrud, Christine; Kober, Louisa; Krüger-Gottschalk, Antje; Schäfer, Ingo; Schellong, Julia; Wesemann, Ulrich; Rau, Heinrich

2017-01-01

ABSTRACT Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). Objectives:This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces. Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated. Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD-10 versus the consequences of its deletion as proposed for ICD-11. PMID:29163862

ORIGINAL ARTICLES DSM-IV-defined common mental disorders ...

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mental disorders may increase HIV risk (e.g. by impairing risk perception and impulse control), ... analysis of the South African Stress and Health (SASH) study, a nationally ... taking more care over things touched; (iv) avoiding certain ... individually to assess potential differences between appropriate .... Gender (%). Male.

DIFFERENCES IN THE PROFILES OF DSM-IV AND DSM-5 ALCOHOL USE DISORDERS: IMPLICATIONS FOR CLINICIANS

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Dawson, Deborah A.; Goldstein, Risë B.; Grant, Bridget F.

2013-01-01

Background Existing information on consequences of the DSM-5 revision for diagnosis of alcohol use disorders (AUD) has gaps, including missing information critical to understanding implications of the revision for clinical practice. Methods Data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were used to compare AUD severity, alcohol consumption and treatment, sociodemographic and health characteristics and psychiatric comorbidity among individuals with DSM-IV abuse versus DSM-5 moderate AUD and DSM-IV dependence versus DSM-5 severe AUD. For each pair of disorders, we additionally compared three mutually exclusive groups: individuals positive solely for the DSM-IV disorder, those positive solely for the DSM-5 disorder and those positive for both. Results Whereas 80.5% of individuals positive for DSM-IV dependence were positive for DSM-5 severe AUD, only 58.0% of those positive for abuse were positive for moderate AUD. The profiles of individuals with DSM-IV dependence and DSM-5 severe AUD were almost identical. The only significant (pDSM-5 moderate AUD and DSM-IV abuse differed substantially. The former endorsed more AUD criteria, had higher rates of physiological dependence, were less likely to be White and male, had lower incomes, were less likely to have private and more likely to have public health insurance, and had higher levels of comorbid anxiety disorders than the latter. Conclusions Similarities between the profiles of DSM-IV and DSM-5 AUD far outweigh differences; however, clinicians may face some changes with respect to appropriate screening and referral for cases at the milder end of the AUD severity spectrum, and the mechanisms through which these will be reimbursed may shift slightly from the private to public sector. PMID:22974144

Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes.

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Willcutt, Erik G; Nigg, Joel T; Pennington, Bruce F; Solanto, Mary V; Rohde, Luis A; Tannock, Rosemary; Loo, Sandra K; Carlson, Caryn L; McBurnett, Keith; Lahey, Benjamin B

2012-11-01

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for attention deficit/hyperactivity disorder (ADHD) specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C). To aid decision making for DSM-5 and other future diagnostic systems, a comprehensive literature review and meta-analysis of 546 studies was completed to evaluate the validity of the DSM-IV model of ADHD. Results indicated that DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled. Available data overwhelmingly support the concurrent, predictive, and discriminant validity of the distinction between inattention and hyperactivity-impulsivity symptoms, and indicate that nearly all differences among the nominal subtypes are consistent with the relative levels of inattention and hyperactivity-impulsivity symptoms that define the subtypes. In contrast, the DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response, and the marked longitudinal instability of all three subtypes. Overall, we conclude that the DSM-IV ADHD subtypes provide a convenient clinical shorthand to describe the functional and behavioral correlates of current levels of inattention and hyperactivity-impulsivity symptoms, but do not identify discrete subgroups with sufficient long-term stability to justify the classification of distinct forms of the disorder. Empirical support is stronger for an alternative model that would replace the subtypes with dimensional

Reliability of DSM-IV Symptom Ratings of ADHD: Implications for DSM-V

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Solanto, Mary V.; Alvir, Jose

2009-01-01

Objective: The objective of this study was to examine the intrarater reliability of "DSM-IV" ADHD symptoms. Method: Two-hundred-two children referred for attention problems and 49 comparison children (all 7-12 years) were rated by parents and teachers on the identical "DSM-IV" items presented in two different formats, the…

Comparing personality disorder models: cross-method assessment of the FFM and DSM-IV-TR.

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Samuel, Douglas B; Widiger, Thomas W

2010-12-01

The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000) defines personality disorders as categorical entities that are distinct from each other and from normal personality traits. However, many scientists now believe that personality disorders are best conceptualized using a dimensional model of traits that span normal and abnormal personality, such as the Five-Factor Model (FFM). However, if the FFM or any dimensional model is to be considered as a credible alternative to the current model, it must first demonstrate an increment in the validity of the assessment offered within a clinical setting. Thus, the current study extended previous research by comparing the convergent and discriminant validity of the current DSM-IV-TR model to the FFM across four assessment methodologies. Eighty-eight individuals receiving ongoing psychotherapy were assessed for the FFM and the DSM-IV-TR personality disorders using self-report, informant report, structured interview, and therapist ratings. The results indicated that the FFM had an appreciable advantage over the DSM-IV-TR in terms of discriminant validity and, at the domain level, convergent validity. Implications of the findings and directions for future research are discussed.

DSM-IV und DSM-5: Was hat sich tatsächlich verändert?

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Ehret, Anna M.; Berking, Matthias

2013-01-01

Im Mai 2013 ist die fünfte Auflage des Diagnostischen und Statistischen Manuals Psychischer Störungen (DSM-5) der American Psychiatric Association erschienen. Um die Vor- und Nachteile des DSM-5 beurteilen und gegebenenfalls in Forschung und Praxis angemessen berücksichtigen zu können, sollten Wissenschaftler und Praktiker gleichermaßen über die Änderungen gegenüber dem DSM-IV informiert sein. In diesem Beitrag werden die wesentlichen Unterschiede zwischen dem DSM-IV und DSM-5 beschrieben. Ze...

Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using DSM-IV-TR and DSM-5 Criteria.

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Harstad, Elizabeth B; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J

2015-05-01

Controversy exists regarding the DSM-5 criteria for ASD. This study tested the psychometric properties of the DSM-5 model and determined how well it performed across different gender, IQ, and DSM-IV-TR sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70). DSM-5 was psychometrically superior to the DSM-IV-TR model (Comparative Fit Index of 0.970 vs 0.879, respectively). Measurement invariance revealed good model fit across gender and IQ. Younger children tended to meet fewer diagnostic criteria. Those with autistic disorder were more likely to meet social communication and repetitive behaviors criteria (p < .001) than those with PDD-NOS. DSM-5 is a robust model but will identify a different, albeit overlapping population of individuals compared to DSM-IV-TR.

Concordance of DSM-5 and DSM-IV-TR classifications for autism spectrum disorder.

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Ohashi, Kei; Mizuno, Yoshifumi; Miyachi, Taishi; Asai, Tomoko; Imaeda, Masayuki; Saitoh, Shinji

2015-12-01

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. Autism spectrum disorder (ASD) has been structured for the three subtypes of pervasive developmental disorder (PDD), but the number of impairment in social and communication dimension is not stated. The subjects were 68 children who visited the Department of Psychology and Development at Nagoya City University Hospital for the first time between the ages of 6 and 15 years old. We retrospectively re-examined the subjects using DSM-IV-TR criteria and DSM-5 criteria with two rules (two of three and one of three on the social and communication dimension) and examined the concordance rate. Forty subjects were diagnosed with PDD, and 28 were not. The mean PDD subject age was 9.4 years, and mean IQ was 84.0 on the Wechsler Intelligence Scale for Children III or 62.7 on the Tanaka-Binet test. Twenty-seven (68%) of the PDD subjects were classified with ASD using DSM-5 criteria when the two of three rule was applied, while 32 (80%) were classified with ASD when the one of three rule was applied. All subjects without PDD were not diagnosed with ASD on DSM-5 criteria. DSM-5 criteria may exclude high functioning and older subjects from ASD because they tend to be atypical. The diagnostic procedure for DSM-5 criteria is ambiguous, especially in high functioning subjects and those diagnosed at an older age. © 2015 Japan Pediatric Society.

Dsm-iv hypochondriasis in primary care

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Escobar, JI; Gara, M; Waitzkin, H; Silver, RC; Holman, A; Compton, W

1998-01-01

The object of this study was to assess the prevalence and correlates of the DSM-IV diagnosis of hypochondriasis in a primary care setting. A large sample (N = 1456) of primary care users was given a structured interview to make diagnoses of mood, anxiety, and somatoform disorders and estimate levels of disability. The prevalence of hypochondriasis (DSM-IV) was about 3%. Patients with this disorder had higher levels of medically unexplained symptoms (abridged somatization) and were more impair...

Substance use disorders: Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10).

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Hasin, Deborah; Hatzenbuehler, Mark L; Keyes, Katherine; Ogburn, Elizabeth

2006-09-01

Two major nomenclatures, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10), currently define substance use disorders for broad audiences of users with different training, experience and interests. A comparison of these definitions and their implications for DSM-V and ICD-11 has not been available. The background for the dependence concept and abuse, harmful use, withdrawal, substance-induced disorders and remission and other substance-related conditions is reviewed. Reliability evidence is presented, as is validity evidence from approaches including psychometric, genetic and animal studies. The relevance of the DSM-IV and ICD-10 compared to alternative systems (e.g. the Addiction Severity Index) is considered. Reliability and psychometric validity evidence for substance dependence is consistently strong, but more mixed for abuse and harmful use. Findings on the genetics of alcohol disorders support the validity of the dependence concept, while animal studies underscore the centrality of continued use despite negative consequences to the concept of dependence. While few studies on substance-induced disorders have been conducted, those published show good reliability and validity when elements of DSM-IV and ICD-10 are combined. Dependence in DSM-V and ICD-11 should be retained, standardizing both criteria sets and adding a severity measure. The consequences of heavy use should be measured independently of dependence; add cannabis withdrawal if further research supports existing evidence; conduct further studies of the substance-induced psychiatric categories; standardize their criteria across DSM-V and ICD-11; develop a theoretical basis for better remission criteria; consider changing substance 'abuse' to substance 'dysfunction disorder'; and conduct clinician education on the value of the diagnostic criteria.

[Schizophrenia and other psychotic disorders in DSM-5: summary of the changes compared to DSM-IV].

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Paulzen, M; Schneider, F

2014-05-01

With the introduction of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) numerous changes in the area of the schizophrenia spectrum and psychotic disorders have been implemented. Establishing a metastructure based on the characteristics of the spectrum of psychopathological disturbances should improve clarity. The classical subtypes of schizophrenia were eliminated and specific psychopathological dimensions for the assessment of disease severity were added. The special role of Schneiderian first rank symptoms was abandoned and a higher delineation towards schizoaffective disorders is made. The nosological status of catatonia is clarified and occurs together with a consistent use of catatonic disturbances over all chapters. The attenuated psychosis syndrome is added as a new condition for further study. The shared psychotic disorder in the sense of a folie à deux is no longer maintained. However, the initial goal to integrate more disorder-specific etiopathogenetic information into the reconceptualization could not be achieved. Contemporaneously to the development process of DSM-5 the National Institute of Mental Health (NIMH) carried out the research domain criteria project (RDoC) attempting to incorporate the current growth in knowledge of genetics, neurocognitive and cognitive sciences in future diagnostic systems. This article gives an overview of the changes that have been made within the revision process from DSM-IV to DSM-5.

Cognitive and Adaptive Skills in Toddlers Who Meet Criteria for Autism in DSM-IV but Not DSM-5

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Jashar, Dasal Tenzin; Brennan, Laura A.; Barton, Marianne L.; Fein, Deborah

2016-01-01

The current study compared adaptive and cognitive skills, and autism severity of toddlers with an autism spectrum disorder (ASD) diagnosis under DSM-IV but not DSM-5 criteria (DSM-IV only group) to those who met autism criteria under both diagnostic systems (DSM-5 group) and to those without ASD (non-ASD group). The toddlers in the DSM-IV only…

Influence of the DSM-IV Outline for Cultural Formulation on multidisciplinary case conferences in mental health.

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Dinh, Nathalie M H; Groleau, Danielle; Kirmayer, Laurence J; Rodriguez, Charo; Bibeau, Gilles

2012-01-01

The Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV-TR) includes an Outline for Cultural Formulation (CF) that identifies cultural information that can be used to modify diagnosis, clinical assessment and treatment plan. This study examined the use of the CF by a Cultural Consultation Service in the psychiatric assessment of patients referred by primary care providers. The study uses conversation analysis of 12 clinical case conferences to explore the ways in which the CF influenced the interaction of a multidisciplinary group of mental health professionals in conceptualizing the implications of patients' cultural background and current context for diagnosis and treatment planning. The results suggest that the CF can be a useful tool for interdisciplinary collaboration and knowledge transfer by providing a framework to systematically introduce different disciplinary perspectives and levels of description that transcend the narrow frame of disorder-centred psychiatric diagnosis, assessment and care.

Dimensions of normal and abnormal personality: Elucidating DSM-IV personality disorder symptoms in adolescents

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Tromp, N.B.; Koot, H.M.

2010-01-01

The present study aimed to elucidate dimensions of normal and abnormal personality underlying DSM-IV personality disorder (PD) symptoms in 168 adolescents referred to mental health services. Dimensions derived from the Big Five of normal personality and from Livesley's (2006) conceptualization of

Bone density, body composition, and psychopathology of anorexia nervosa spectrum disorders in DSM-IV vs DSM-5.

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Schorr, Melanie; Thomas, Jennifer J; Eddy, Kamryn T; Dichtel, Laura E; Lawson, Elizabeth A; Meenaghan, Erinne; Lederfine Paskal, Margaret; Fazeli, Pouneh K; Faje, Alexander T; Misra, Madhusmita; Klibanski, Anne; Miller, Karen K

2017-04-01

DSM-5 revised the diagnostic criteria for anorexia nervosa (AN) by eliminating the amenorrhea requirement, liberalizing weight and psychological criteria, and adding the formal diagnosis of "atypical AN" for individuals with AN psychological symptoms without low weight. We sought to determine whether bone density (BMD) is impaired in women diagnosed with AN using the new, more liberal, DSM-5 criteria. Cross-sectional study of 168 women, 18 - 45y: (1) AN by DSM-IV (DSM-IV AN) (n = 37), (2) AN by DSM-5 but not DSM-IV criteria (DSM-5 AN) (n = 33), (3) atypical AN (ATYPICAL AN) (n = 77), (4) healthy comparison group (HC) (n = 21). Measurements included dual energy X-ray absorptiometry, Eating Disorder Examination-Questionnaire, Eating Disorder Inventory-2, Hamilton Depression and Anxiety Rating Scales. BMD Z-score DSM-IV, 82% of DSM-5, and 69% of ATYPICAL. Mean Z-scores were comparably low in DSM-IV and DSM-5, intermediate in ATYPICAL, and highest in HC. Lack of prior low weight or amenorrhea was, but history of overweight/obesity was not, protective against bone loss. Mean lean mass and percent fat mass were significantly lower in all AN groups than HC. DSM-IV, DSM-5, and ATYPICAL had comparable psychopathology. Despite liberalizing diagnostic criteria, many women diagnosed with AN and atypical AN using DSM-5 criteria have low BMD. Presence or history of low weight and/or amenorrhea remain important indications for DXA. Loss of lean mass, in addition to fat mass, is present in all AN groups, and may contribute to low BMD. The deleterious effect of eating disorders on BMD extends beyond those with current low weight and amenorrhea. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:343-351). © 2016 Wiley Periodicals, Inc.

Did the DSM-5 Improve the Traumatic Stressor Criterion?: Association of DSM-IV and DSM-5 Criterion A with Posttraumatic Stress Disorder Symptoms.

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Larsen, Sadie E; Berenbaum, Howard

2017-01-01

A recent meta-analysis found that DSM-III- and DSM-IV-defined traumas were associated with only slightly higher posttraumatic stress disorder (PTSD) symptoms than nontraumatic stressors. The current study is the first to examine whether DSM-5-defined traumas were associated with higher levels of PTSD than DSM-IV-defined traumas. Further, we examined theoretically relevant event characteristics to determine whether characteristics other than those outlined in the DSM could predict PTSD symptoms. One hundred six women who had experienced a trauma or significant stressor completed questionnaires assessing PTSD, depression, impairment, and event characteristics. Events were rated for whether they qualified as DSM-IV and DSM-5 trauma. There were no significant differences between DSM-IV-defined traumas and stressors. For DSM-5, effect sizes were slightly larger but still nonsignificant (except for significantly higher hyperarousal following traumas vs. stressors). Self-reported fear for one's life significantly predicted PTSD symptoms. Our results indicate that the current DSM-5 definition of trauma, although a slight improvement from DSM-IV, is not highly predictive of who develops PTSD symptoms. Our study also indicates the importance of individual perception of life threat in the prediction of PTSD. © 2017 S. Karger AG, Basel.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

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Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

2017-09-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5.

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Chmielewski, Michael; Clark, Lee Anna; Bagby, R Michael; Watson, David

2015-08-01

Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity. Recently, the DSM-5 field trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Rather than indicating specific problems with DSM-5, however, the field trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video recordings for estimating reliability. We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 field trials, in which different clinicians conduct separate interviews. Psychiatric patients (N = 339) were diagnosed using the SCID-I/P; 218 were diagnosed a second time by an independent interviewer. Diagnostic reliability using the audio-recording method (N = 49) was "good" to "excellent" (M κ = .80) and comparable to the DSM-IV field trials estimates. Reliability using the test-retest method (N = 218) was "poor" to "fair" (M κ = .47) and similar to DSM-5 field-trials' estimates. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. Moreover, there was no association between change in self-report and change in diagnostic status. These results demonstrate the influence of method on estimates of diagnostic reliability. (c) 2015 APA, all rights reserved).

A Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder.

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Yaylaci, Ferhat; Miral, Suha

2017-01-01

Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria. Clinical severity was determined using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). A statistically significant decrease (19.3 %) was detected in the diagnostic ratio with DSM-5. Age and symptom severity differed significantly between those who were and were not diagnosed with PDD using DSM-5. B4 criteria in DSM-5 was most common criterion. Results indicate that individuals diagnosed with PDD by DSM-IV-TR criteria may not be diagnosed using DSM-5 criteria.

Bone density, body composition, and psychopathology of anorexia nervosa spectrum disorders in DSM-IV vs DSM-5

Science.gov (United States)

Schorr, Melanie; Thomas, Jennifer J.; Eddy, Kamryn T.; Dichtel, Laura E.; Lawson, Elizabeth A.; Meenaghan, Erinne; Paskal, Margaret Lederfine; Fazeli, Pouneh K.; Faje, Alexander T.; Misra, Madhusmita; Klibanski, Anne; Miller, Karen K.

2016-01-01

Objective DSM-5 revised diagnostic criteria for anorexia nervosa (AN) by eliminating the amenorrhea requirement, liberalizing weight and psychological criteria, and adding the formal diagnosis of “atypical AN” for individuals with AN psychological symptoms without low weight. We sought to determine whether bone density (BMD) is impaired in women diagnosed with AN using the new, more liberal DSM-5 criteria. Method Cross-sectional study of 168 women, 18–45y: 1) AN by DSM-IV (DSM-IV)(n=37), 2) AN by DSM-5 but not DSM-IV criteria (DSM-5)(n=33), 3) atypical AN (ATYPICAL)(n=77), 4) healthy comparison group (HC)(n=21). Measurements included dual energy x-ray absorptiometry, Eating Disorder Examination-Questionnaire, Eating Disorder Inventory-2, Hamilton Depression and Anxiety Rating Scales. Results BMD Z-score DSM-5, and 69% of ATYPICAL. Mean Z-scores were comparably low in DSM-IV and DSM-5, intermediate in ATYPICAL, and highest in HC. Lack of prior low weight or amenorrhea was, but history of overweight/obesity was not, protective against bone loss. Mean lean mass and percent fat mass were significantly lower in all AN groups than HC. DSM-IV, DSM-5 and ATYPICAL had comparable psychopathology. Discussion Despite liberalizing diagnostic criteria, many women diagnosed with AN and atypical AN using DSM-5 criteria have low BMD. Presence or history of low weight and/or amenorrhea remain important indications for DXA. Loss of lean mass, in addition to fat mass, is present in all AN groups, and may contribute to low BMD. The deleterious effect of eating disorders on BMD extends beyond those with current low weight and amenorrhea. PMID:27527115

Prevalence and age-of-onset distributions of DSM IV mental disorders and their severity among school going Omani adolescents and youths: WMH-CIDI findings

Directory of Open Access Journals (Sweden)

Morsi Magdi

2009-09-01

Full Text Available Abstract Background There is a dearth of studies exploring the magnitude of mental disorders amongst adolescents and youths in the Arab world. To our knowledge, this phase 2 survey in Oman is the first nationally representative school-based study to determine the prevalence of DSM-IV mental disorders (lifetime and over the preceding 12 months, their age-of-onset distributions and determine their severity over the past 12 months using the World Mental Health-Composite International Diagnostic Interview, the WMH-CIDI, used for international comparison. Methods A total of 1,682 (91.61% students out of 1836 students who formed the phase 2 random sub-sample of a multi-stage, stratified, random sampling design (phase 1, participated in the face-to-face structured interview using the Arabic-version of WMH-CIDI 3.0. Results The phase 1 results using the General Health Questionnaire (GHQ-12 and Child Depression Inventory (CDI showed depressive symptoms to be 17% prevalent in the larger sample of 5409 adolescents and youths. Amongst the phase 2 respondents from this sample, 13.9% had at least one DSM IV diagnostic label. The lifetime prevalence of Major Depressive Disorder (MDD was 3.0%; Bipolar Mood Disorder (BMD was 1%, Specific phobia 5.8% and Social phobia 1.6%. The female gender was a strong predictor of a lifetime risk of MDD (OR 3.3, 95% CI 1.7-6.3, p = 0.000; Any Mood Disorders (OR 2.5, 95% CI 1.4-4.3, p = 0.002 and Specific Phobia (OR 1.5, 95% CI 1.0-2.4, p = 0.047. The severity of illness for cases diagnosed with 12 month DSM IV disorders was found to be 80% lower in females (OR 0.2, 95%CI 0.0-0.8. The estimates over the previous 12 month period when compared with the lifetime prevalence showed a 25% to 40% lower prevalence for MDD, Specific phobia, Social phobia, Any Anxiety Disorders (AAD and Any Mood disorders (AMD while the rate was 80% lower for Separation Anxiety Disorder/Adult Separation Anxiety (SAD/ASA. Mood disorders were significantly

Autism Spectrum Disorders According to "DSM-IV-TR" and Comparison with "DSM-5" Draft Criteria: An Epidemiological Study

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Mattila, Marja-Leena; Kielinen, Marko; Linna, Sirkka-Liisa; Jussila, Katja; Ebeling, Hanna; Bloigu, Risto; Joseph, Robert M.; Moilanen, Irma

2011-01-01

Objective: The latest definitions of autism spectrum disorders (ASDs) were specified in "DSM-IV-TR" in 2000. "DSM-5" criteria are planned for 2013. Here, we estimated the prevalence of ASDs and autism according to "DSM-IV-TR," clarified confusion concerning diagnostic criteria, and evaluated "DSM-5" draft…

sA Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder

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Yaylaci, Ferhat; Miral, Suha

2017-01-01

Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria.…

Alcohol Use Disorders in Argentinian Girls and Women 12 Months Before Delivery: Comparison of DSM-IV, DSM-5, and ICD-10 Diagnostic Criteria.

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López, Mariana B; Conde, Karina; Cremonte, Mariana

The evidence of important problems related to prenatal alcohol exposure has faced researchers with the problem of understanding and screening alcohol use in this population. Although any alcohol use should be considered risky during pregnancy, identifying alcohol-drinking problems (ADPs) could be especially important because women with ADPs could not benefit from a simple advice of abstinence and because their offsprings are subjected to a higher risk of problems related with prenatal alcohol exposure. In this context, we aim to study the prevalence and characteristics of ADPs in pregnant women, evaluating the performance of different diagnostic systems in this population. The aims of the study were to describe the prevalence of ADPs obtained with the criteria of the Diagnostic and Statistical Manual of Mental Disorders in its fourth (DSM-IV) and fifth edition (DSM-5), and the International Classification of Diseases (ICD)-10, in Argentinean females aged 13 to 44 years, 12 months before delivery; to evaluate the level of agreement between these classification systems; and to analyze the performance of each diagnosis criterion in this population. Data were collected through personal interviews of a probability sample of puerperal women (N = 641) in the city of Santa Fe (Argentina), between October 2010 and February 2011. Diagnoses compatible with DSM-IV, DSM-5, and ICD-10 were obtained through the Composite International Diagnostic Interview. Agreement among diagnostic systems was measured through Cohen kappa. Diagnosis criteria performance were analyzed considering their prevalence and discriminating ability (D value). Total ADP prevalence was 6.4% for DSM-IV (4.2% abuse and 2.2% dependence), 8.1% for DSM-5 (6.4% mild, 0.8% moderate, and 0.9% severe alcohol use disorder), and 14.1% for the ICD-10 (11.9% harmful use and 2.2% dependence). DSM-5 modifications improved agreement between DSM and ICD. The least prevalent and worst discriminating ability diagnostic

Autism spectrum disorders according to DSM-IV-TR and comparison with DSM-5 draft criteria: an epidemiological study.

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Mattila, Marja-Leena; Kielinen, Marko; Linna, Sirkka-Liisa; Jussila, Katja; Ebeling, Hanna; Bloigu, Risto; Joseph, Robert M; Moilanen, Irma

2011-06-01

The latest definitions of autism spectrum disorders (ASDs) were specified in DSM-IV-TR in 2000. DSM-5 criteria are planned for 2013. Here, we estimated the prevalence of ASDs and autism according to DSM-IV-TR, clarified confusion concerning diagnostic criteria, and evaluated DSM-5 draft criteria for ASD posted by the American Psychiatry Association (APA) in February 2010. This was an epidemiological study of 5,484 eight-year-old children in Finland, 4,422 (81%) of them rated via the Autism Spectrum Screening Questionnaire by parents and/or teachers, and 110 examined by using a structured interview, semi-structured observation, IQ measurement, school-day observation, and patient records. Diagnoses were assigned according to DSM-IV-TR criteria and DSM-5 draft criteria in children with a full-scale IQ (FSIQ) ≥50. Patient records were evaluated in children with an FSIQ autism 4.1 in 1,000 according to DSM-IV-TR. Of the subjects with ASDs and autism, 65% and 61% were high-functioning (FSIQ ≥70), respectively. The prevalence of pervasive developmental disorder not otherwise specified was not estimated because of inconsistency in DSM-IV-TR criteria. DSM-5 draft criteria were shown to be less sensitive in regard to identification of subjects with ASDs, particularly those with Asperger's syndrome and some high-functioning subjects with autism. DSM-IV-TR helps with the definition of ASDs only up to a point. We suggest modifications to five details of DSM-5 draft criteria posted by the APA in February 2010. Completing revision of DSM criteria for ASDs is a challenging task. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

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Mazurek, Micah O.; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M.; Hundley, Rachel J.; Poulsen, Marie; Kanne, Stephen M.; Macklin, Eric A.; Handen, Benjamin L.

2017-01-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children…

Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders.

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Huerta, Marisela; Bishop, Somer L; Duncan, Amie; Hus, Vanessa; Lord, Catherine

2012-10-01

Substantial revisions to the DSM-IV criteria for autism spectrum disorders (ASDs) have been proposed in efforts to increase diagnostic sensitivity and specificity. This study evaluated the proposed DSM-5 criteria for the single diagnostic category of autism spectrum disorder in children with DSM-IV diagnoses of pervasive developmental disorders (PDDs) and non-PDD diagnoses. Three data sets included 4,453 children with DSM-IV clinical PDD diagnoses and 690 with non-PDD diagnoses (e.g., language disorder). Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) and clinical observation instrument (Autism Diagnostic Observation Schedule) were matched to DSM-5 criteria and used to evaluate the sensitivity and specificity of the proposed DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses. Based on just parent data, the proposed DSM-5 criteria identified 91% of children with clinical DSM-IV PDD diagnoses. Sensitivity remained high in specific subgroups, including girls and children under 4. The specificity of DSM-5 ASD was 0.53 overall, while the specificity of DSM-IV ranged from 0.24, for clinically diagnosed PDD not otherwise specified (PDD-NOS), to 0.53, for autistic disorder. When data were required from both parent and clinical observation, the specificity of the DSM-5 criteria increased to 0.63. These results suggest that most children with DSM-IV PDD diagnoses would remain eligible for an ASD diagnosis under the proposed DSM-5 criteria. Compared with the DSM-IV criteria for Asperger's disorder and PDD-NOS, the DSM-5 ASD criteria have greater specificity, particularly when abnormalities are evident from both parents and clinical observation.

A Proposal for a Dimensional Classification System Based on the Shared Features of the "DSM-IV" Anxiety and Mood Disorders: Implications for Assessment and Treatment

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Brown, Timothy A.; Barlow, David H.

2009-01-01

A wealth of evidence attests to the extensive current and lifetime diagnostic comorbidity of the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., "DSM-IV") anxiety and mood disorders. Research has shown that the considerable cross-sectional covariation of "DSM-IV" emotional disorders is accounted for by common higher order…

A review of somatoform disorders in DSM-IV and somatic symptom disorders in proposed DSM-V.

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Ghanizadeh, Ahmad; Firoozabadi, Ali

2012-12-01

Psychiatric care providers should be trained to use current changes in the somatoform disorders criteria. New diagnostic criteria for Somatic Symptom disorders in the proposed DSM-V is discussed and compared with its older counterpart in DSM-IV. A new category called Somatic Syndrome Disorders is suggested. It includes new subcategories such as "Complex Somatic Symptom Disorder" (CSSD) and "Simple Somatic Symptom Disorder" (SSSD). Some of the subcategories of DSM-IV derived disorders are included in CSSD. While there are some changes in diagnostic criteria, there are concerns and limitations about the new classification needed to be more discussed before implementation. Functional somatic disturbance, the counterpart of converion disorder in DSM-IV, can be highly dependet on the developmental level of children. However, the role of developmental level needs to be considered.

The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders.

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Ford, Tamsin; Goodman, Robert; Meltzer, Howard

2003-10-01

To describe the prevalence of DSM-IV disorders and comorbidity in a large population-based sample of British children and adolescents. Using a one-phase design, 10,438 children were assessed using the Development and Well-Being Assessment (DAWBA), a structured interview with verbatim reports reviewed by clinicians so that information from parents, teachers, and children was combined in a manner that emulated the clinical process. The authors' analysis examined comorbidity and the influence of teacher reports. The overall prevalence of DSM-IV disorders was 9.5% (95% confidence interval 8.8-10.1%), but 2.1% of children were assigned "not otherwise specified" rather than operationalized diagnoses. After adjusting for the presence of a third disorder, there was no longer significant comorbidity between anxiety and conduct disorder or attention-deficit/hyperactivity disorder (ADHD), or between depression and oppositional defiant disorder. A comparison of the disorders in children with and without teacher reports suggested that the prevalence of conduct disorders and ADHD would be underestimated in the absence of teacher information. Roughly 1 in 10 children have at least one DSM-IV disorder, involving a level of distress or social impairment likely to warrant treatment. Comorbidity reported between some childhood diagnoses may be due to the association of both disorders with a third. Diagnoses of conduct disorder and ADHD may be missed if information is not sought from teachers about children's functioning in school.

Reliability and validity of the DSM-IV-TR and proposed DSM-5 criteria for pedophilia: Implications for the ICD-11 and the next DSM.

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Seto, Michael C; Fedoroff, J Paul; Bradford, John M; Knack, Natasha; Rodrigues, Nicole C; Curry, Susan; Booth, Brad; Gray, Jonathan; Cameron, Colin; Bourget, Dominique; Messina, Sarina; James, Elizabeth; Watson, Diane; Gulati, Sanjiv; Balmaceda, Rufino; Ahmed, Adekunle G

We tested the inter-rater reliability and criterion-related validity of the DSM-IV-TR pedophilia diagnosis and proposed DSM-5 pedohebephilia diagnosis in a sample of 79 men who had committed child pornography offenses, contact sexual offenses against children, or who were referred because of concerns about whether they had a sexual interest in children. Participants were evaluated by two independent psychiatrists with an interview and questionnaire regarding demographic characteristics, sexual history, and self-reported sexual interests; they also completed phallometric and visual reaction time testing. Kappa was .59 for ever meeting DSM-IV-TR criteria for pedophilia and .52 for ever meeting the proposed DSM-5 criteria for pedohebephilia. Ever meeting DSM-IV-TR diagnosis was significantly related to self-reported index of sexual interest in children (highest AUC=.81, 95% CI=.70-.91, pDSM-5 "diagnosis" was similarly related to self-report (AUC=.84, 95% CI=.74-.94, pDSM-5 criteria, we believe these results suggest the revision of DSM-5 and development of ICD-11 could benefit from drawing on the current DSM-5 criteria, which are essentially the same as DSM-IV-TR except for a distinction between having a paraphilia (the interest) and a paraphilic disorder (the paraphilia plus clinically significant distress or impairment). Copyright © 2016. Published by Elsevier Ltd.

Prevalence and severity of eating disorders: A comparison of DSM-IV and DSM-5 among German adolescents.

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Ernst, Verena; Bürger, Arne; Hammerle, Florian

2017-11-01

Changes in the DSM-5 eating disorders criteria sought to increase the clarity of the diagnostic categories and to decrease the preponderance of nonspecified eating disorders. The first objective of this study was to analyze how these revisions affect threshold and EDNOS/OSFED eating disorder diagnoses in terms of prevalence, sex ratios, and diagnostic distribution in a student sample. Second, we aimed to compare the impairment levels of participants with a threshold, an EDNOS/OSFED and no diagnosis using both DSM-IV and DSM-5. A sample of 1654 7th and 8th grade students completed self-report questionnaires to determine diagnoses and impairment levels in the context of an eating disorder prevention program in nine German secondary schools. Height and weight were measured. The prevalence of threshold disorders increased from .48% (DSM-IV) to 1.15% (DSM-5). EDNOS disorders increased from 2.90 to 6.23% when using OSFED-categories. A higher proportion of girls was found throughout all the diagnostic categories, and the sex ratios remained stable. The effect sizes of DSM-5 group differences regarding impairment levels were equal to or larger than those of the DSM-IV comparisons, ranging from small to medium. We provide an in-depth overview of changes resulting from the revisions of DSM eating disorder criteria in a German adolescent sample. Despite the overall increase in prevalence estimates, the results suggest that the DSM-5 criteria differentiate participants with threshold disorders and OSFED from those no diagnosis as well as or even more distinctly than the DSM-IV criteria. © 2017 Wiley Periodicals, Inc.

A comparison of DSM-IV pervasive developmental disorder and DSM-5 autism spectrum disorder prevalence in an epidemiologic sample.

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Kim, Young Shin; Fombonne, Eric; Koh, Yun-Joo; Kim, Soo-Jeong; Cheon, Keun-Ah; Leventhal, Bennett L

2014-05-01

Changes in autism diagnostic criteria found in DSM-5 may affect autism spectrum disorder (ASD) prevalence, research findings, diagnostic processes, and eligibility for clinical and other services. Using our published, total-population Korean prevalence data, we compute DSM-5 ASD and social communication disorder (SCD) prevalence and compare them with DSM-IV pervasive developmental disorder (PDD) prevalence estimates. We also describe individuals previously diagnosed with DSM-IV PDD when diagnoses change with DSM-5 criteria. The target population was all children from 7 to 12 years of age in a South Korean community (N = 55,266), those in regular and special education schools, and a disability registry. We used the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of screen-positive children were offered comprehensive assessments using standardized diagnostic procedures, including the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. Best-estimate clinical diagnoses were made using DSM-IV PDD and DSM-5 ASD and SCD criteria. DSM-5 ASD estimated prevalence was 2.20% (95% confidence interval = 1.77-3.64). Combined DSM-5 ASD and SCD prevalence was virtually the same as DSM-IV PDD prevalence (2.64%). Most children with autistic disorder (99%), Asperger disorder (92%), and PDD-NOS (63%) met DSM-5 ASD criteria, whereas 1%, 8%, and 32%, respectively, met SCD criteria. All remaining children (2%) had other psychopathology, principally attention-deficit/hyperactivity disorder and anxiety disorder. Our findings suggest that most individuals with a prior DSM-IV PDD meet DSM-5 diagnostic criteria for ASD and SCD. PDD, ASD or SCD; extant diagnostic criteria identify a large, clinically meaningful group of individuals and families who require evidence-based services. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

A comparison of outcomes according to different diagnostic systems for delirium (DSM-5, DSM-IV, CAM, and DRS-R98).

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Adamis, Dimitrios; Meagher, David; Rooney, Siobhan; Mulligan, Owen; McCarthy, Geraldine

2018-04-01

ABSTRACTStudies indicate that DSM-5 criteria for delirium are relatively restrictive, and identify different cases of delirium compared with previous systems. We evaluate four outcomes of delirium (mortality, length of hospital stay, institutionalization, and cognitive improvement) in relation to delirium defined by different DSM classification systems.Prospective, longitudinal study of patients aged 70+ admitted to medical wards of a general hospital. Participants were assessed up to a maximum of four times during two weeks, using DSM-5 and DSM-IV criteria, DRS-R98 and CAM scales as proxies for DSM III-R and DSM III.Of the 200 assessed patients (mean age 81.1, SD = 6.5; and 50% female) during hospitalization, delirium was identified in 41 (20.5%) using DSM-5, 45 (22.5%) according to DSM-IV, 46 (23%) with CAM positive, and 37 (18.5%) with DRS-R98 severity score >15. Mortality was significantly associated with delirium according to any classification system, but those identified with DSM-5 were at greater risk. Length of stay was significantly longer for those with DSM-IV delirium. Discharge to a care home was associated only with DRS-R98 defined delirium. Cognitive improvement was only associated with CAM and DSM-IV. Different classification systems for delirium identify populations with different outcomes.

[DSM-5: neurodevelopmental disorders

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Zinkstok, J.; Buitelaar, J.K.

2014-01-01

BACKGROUND: The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published in May, 2013. AIM: To review the changes in the diagnostic criteria for autism spectrum disorder (ASD) and ADHD in DSM-5, compared to DSM-IV. METHOD: The diagnostic criteria for ASD and ADHD

National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using DSM-IV and DSM-5 Criteria

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Kilpatrick, Dean G.; Resnick, Heidi S.; Milanak, Melissa E.; Miller, Mark W.; Keyes, Katherine M.; Friedman, Matthew J.

2014-01-01

Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association’s Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom. PMID:24151000

DSM-IV and DSM-5 Prevalence of Social Anxiety Disorder in a Population Sample of Older People.

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Karlsson, Björn; Sigström, Robert; Östling, Svante; Waern, Margda; Börjesson-Hanson, Anne; Skoog, Ingmar

2016-12-01

To examine the prevalence of social anxiety disorders (SAD) with (DSM-IV) and without (DSM-5) the person's own assessment that the fear was unreasonable, in a population sample of older adults. Further, to determine whether clinical and sociodemographic correlates of SAD differ depending on the criteria applied. Cross-sectional. General population in Gothenburg, Sweden. A random population-based sample of 75- and 85-year olds (N = 1200) without dementia. Psychiatric research nurses carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. DSM-IV SAD was diagnosed with the Mini International Neuropsychiatric Interview. SAD was diagnosed according to DSM-IV and DSM-5 criteria. The 6-month duration criterion in DSM-5 was not applied because of lack of information. Other assessments included the Global Assessment of Functioning (GAF), the Brief Scale for Anxiety (BSA), and the Montgomery Åsberg Depression Rating Scale (MADRS). The 1-month prevalence of SAD was 2.5% (N = 30) when the unreasonable fear criterion was defined in accordance with DSM-IV and 5.1% (N = 61) when the DSM-5 criterion was applied. Clinical correlates (GAF, MADRS, and BSA) were worse in SAD cases identified by either procedure compared with all others, and ratings for those reporting unreasonable fear suggested greater (albeit nonsignificant) overall psychopathology. Shifting the judgment of how reasonable the fear was, from the individual to the clinician, doubled the prevalence of SAD. This indicates that the DSM-5 version might increase prevalence rates of SAD in the general population. Further studies strictly applying all DSM-5 criteria are needed in order to confirm these findings. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

Science.gov (United States)

2012-01-01

Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population). PMID:23267678

Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

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Adornetto Carmen

2012-12-01

Full Text Available Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD, specific phobia, social phobia, and generalized anxiety disorder (GAD. Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9 than with the adult section (F4 of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population is not identical with the population examined using the ICD (clinical population.

An Item Response Theory Analysis of DSM-IV Conduct Disorder

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Gelhorn, Heather; Hartman, Christie; Sakai, Joseph; Mikulich-Gilbertson, Susan; Stallings, Michael; Young, Susan; Rhee, Soo; Corley, Robin; Hewitt, John; Hopfer, Christian; Crowley, Thomas

2009-01-01

Interviews with over 3,000 adolescents were made to evaluate the extent to which DSM-IV criteria characterizes the range of severity of adolescent antisocial behavior within and across sex. The DSM-IV conduct disorder (CD) criteria are a useful indicator of severe adolescent antisocial behavior but some CD criteria display sex bias.

Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V.

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Andrews, Gavin; Hobbs, Megan J; Borkovec, Thomas D; Beesdo, Katja; Craske, Michelle G; Heimberg, Richard G; Rapee, Ronald M; Ruscio, Ayelet Meron; Stanley, Melinda A

2010-02-01

Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM-III. The majority of these revisions have been in response to its poor inter-rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM-IV GAD criteria for DSM-V. First, searches were conducted to identify the evidence that previous DSM Work Groups relied upon when revising the DSM-III-R GAD and the overanxious disorder classifications. Second, the literature pertaining to the DSM-IV criteria for GAD was examined. The review presents a number of options to be considered for DSM-V. One option is for GAD to be re-labeled in DSM-V as generalized worry disorder. This would reflect its hallmark feature. Proposed revisions would result in a disorder that is characterized by excessive anxiety and worry generalized to a number of events or activities for 3 months or more. Worry acts as a cognitive coping strategy that manifests in avoidant behaviors. The reliability and validity of the proposed changes could be investigated in DSM-V validity tests and field trials.

Hoarding Disorder Trough Three Case, A New Mental Disorder in DSM-5

Directory of Open Access Journals (Sweden)

Süheyla DODAN BULUT

2014-03-01

Full Text Available Compulsive hoarding is a problem characterized with excessive collection and accumulation, failure to discard the excess amount of collected items. Although it is considered to be a symptom of obsessive-compulsive disorder in DSMIV- TR (Diagnostic and statistical manual of mental disorders fourth edition text revision, it is thought that compulsive hoarding and OCD may have different biological, cognitive and behavioral mechanisms and compulsive hoarding may be associated with many other psychological illnesses. For these reasons, in DSM-5 (Diagnostic and statistical manual of mental disorders fifth edition hoarding disorder diagnosis is located under the classification of obsessive-compulsive and related disorders. In this case report, three cases classified in different diagnostic categories according to DSM-IV-TR will be mentioned and hoarding disorder will be discussed.

Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using "DSM-IV-TR" and "DSM-5" Criteria

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Harstad, Elizabeth B.; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J.

2015-01-01

Controversy exists regarding the "DSM-5" criteria for ASD. This study tested the psychometric properties of the "DSM-5" model and determined how well it performed across different gender, IQ, and "DSM-IV-TR" sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70).…

"Diagnostic shift" from eating disorder not otherwise specified to bulimia nervosa using DSM-5 criteria: a clinical comparison with DSM-IV bulimia.

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MacDonald, Danielle E; McFarlane, Traci L; Olmsted, Marion P

2014-01-01

In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic threshold for binging and compensation in bulimia nervosa (BN) decreased from twice to once weekly for 3 months. This study investigates the validity of this change by examining whether BN patients and those whose diagnoses "shift" to BN with DSM-5 are similar in their psychological functioning. EDNOS patients whose symptoms met DSM-5 BN criteria (n=25) were compared to DSM-IV BN patients (n=146) on clinically relevant variables. No differences were found on: BMI; weight-based self-evaluation; perfectionism; depression and anxiety symptoms; or readiness for change. Differences were found on one Eating Disorder Inventory subscale (i.e., bulimia), with the BN group reporting higher scores, consistent with group definitions. These findings support the modified criteria, suggesting that psychopathology both directly and indirectly related to eating disorders is comparable between those with once weekly versus more frequent bulimic episodes. © 2013.

From CBCL to DSM: A Comparison of Two Methods to Screen for DSM–IV Diagnoses Using CBCL Data

NARCIS (Netherlands)

Krol, N.P.C.M.; Bruyn, E.E.J. De; Coolen, J.C.; Aarle, E.J.M. van

2006-01-01

The screening efficiency of 2 methods to convert Child Behavior Checklist (CBCL) assessment data into Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses was compared. The Machine-Aided Diagnosis (MAD) method converts CBCL input

Comparison of DSM-IV-TR and DSM-5 Criteria in Diagnosing Autism Spectrum Disorders in Singapore.

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Sung, Min; Goh, Tze Jui; Tan, Bei Lin Joelene; Chan, Jialei Stephanie; Liew, Hwee Sen Alvin

2018-04-28

Our study examines the Diagnostic and Statistical Manual-Fifth Edition (DSM-5) and Diagnostic and Statistical Manual-Fourth Edition, Text Revision (DSM-IV-TR) when applied concurrently against the best estimate clinical diagnoses for 110 children (5.1-19.6 years old) referred for diagnostic assessments of Autism Spectrum Disorder (ASD) in a Singaporean outpatient speciality clinic. DSM-IV-TR performed slightly better, yielding sensitivity of 0.946 and specificity of 0.889, compared to DSM-5 (sensitivity = 0.837; specificity = 0.833). When considering the ASD sub-categories, sensitivity ranged from 0.667 to 0.933, and specificity ranged from 0.900 to 0.975. More participants with a PDD-NOS best estimate clinical diagnosis (40%) were misclassified on DSM-5. Merits and weaknesses to both classification systems, and implications for access to services and policy changes are discussed.

DSM-IV hypochondriasis in primary care.

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Escobar, J I; Gara, M; Waitzkin, H; Silver, R C; Holman, A; Compton, W

1998-05-01

The object of this study was to assess the prevalence and correlates of the DSM-IV diagnosis of hypochondriasis in a primary care setting. A large sample (N = 1456) of primary care users was given a structured interview to make diagnoses of mood, anxiety, and somatoform disorders and estimate levels of disability. The prevalence of hypochondriasis (DSM-IV) was about 3%. Patients with this disorder had higher levels of medically unexplained symptoms (abridged somatization) and were more impaired in their physical functioning than patients without the disorder. Of the various psychopathologies examined, major depressive syndromes were the most frequent among patients with hypochondriasis. Interestingly, unlike somatization disorder, hypochondriasis was not related to any demographic factor. Hypochondriasis is a relatively rare condition in primary care that is largely separable from somatization disorder but seems closely intertwined with the more severe depressive syndromes.

Dimensions of personality pathology in adolescents: Relations to DSM-IV personality disorder symptoms

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Tromp, N.B.; Koot, H.M.

2009-01-01

The aim of the present study was to relate and compare two approaches to personality pathology in adolescents. Dimensions of personality pathology, assessed by the Dimensional Assessment of Personality Pathology-Basic Questionnaire for Adolescents (DAPP-BQ-A; Tromp & Koot, 2008), were related to DSM-IV personality disorder (PD) symptoms in 168 adolescents referred for mental health services. Correlational analyses revealed that the DAPP-BQ-A higher- and lower-order dimensions were related to ...

DSM-IV versus DSM-5 Autism Spectrum Disorder and Social Anxiety Disorder in childhood: Similarities and differences

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van Steensel, F.J.A.; Bögels, S.M.; de Bruin, E.I.

2015-01-01

Within the light of the DSM-5, the current study examined (1) how many and which children with a DSM-IV classification of autism spectrum disorder (ASD) fulfill the DSM-5 symptom-criteria, and (2) whether children who did and did not meet DSM-5 symptom-criteria and children with social anxiety

DSM-5 en cultuur

NARCIS (Netherlands)

de Jong, J.T.V.M.

2012-01-01

Achtergrond: Binnen de geestelijke gezondheidszorg is het diagnostische classificatie-systeem van de Diagnostic and Statistical Manual of Mental Disorders (vierde editie, dsm-iv) toonaangevend. Waarschijnlijk komt in 2013 de volgende versie, de dsm-5, uit. In de nieuwe versie probeert men rekening

National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses with Clinical Reassessments

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Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.

2009-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…

Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

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Schaal, Susanne; Koebach, Anke; Hinkel, Harald; Elbert, Thomas

2015-01-01

Background Compared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD) have been modified in DSM-5. Objective The first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events. Method Ninety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed. Results The DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47), whereas the DSM-IV symptom criteria were met by 44% (n=42). If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8%) than false positives (3%). A minority of participants (19%, n=18) indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R 2=0.40) showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD. Conclusions The findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts. PMID:25720994

Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

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Susanne Schaal

2015-02-01

Full Text Available Background: Compared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD have been modified in DSM-5. Objective: The first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events. Method: Ninety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed. Results: The DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47, whereas the DSM-IV symptom criteria were met by 44% (n=42. If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8% than false positives (3%. A minority of participants (19%, n=18 indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R 2=0.40 showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD. Conclusions: The findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts.

DSM-5 under-Identifies PDDNOS: Diagnostic Agreement between the DSM-5, DSM-IV, and Checklist for Autism Spectrum Disorder

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Mayes, Susan Dickerson; Black, Amanda; Tierney, Cheryl D.

2013-01-01

Agreement between the DSM-5, DSM-IV, and Checklist for Autism Spectrum Disorder was assessed in 125 children with autism spectrum disorder (ASD), which included high and low functioning autism (HFA and LFA) and pervasive developmental disorder not otherwise specified (PDDNOS), and children with other clinical disorders (e.g., ADHD, mental…

The Relationship Between the Childhood Autism Rating Scale: Second Edition and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5.

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Dawkins, Tamara; Meyer, Allison T; Van Bourgondien, Mary E

2016-10-01

The Childhood Autism Rating Scale, Second Edition (CARS2; 2010) includes two rating scales; the CARS2-Standard Version (CARS2-ST) and the newly developed CARS2-High Functioning Version (CARS2-HF). To assess the diagnostic agreement between the CARS2 and DSM-IV-TR versus DSM-5 criteria for Autism Spectrum Disorder (ASD), clinicians at community based centers of the University of North Carolina TEACCH Autism Program rated participants seen for a diagnostic evaluation on symptoms of autism using both the DSM-IV-TR and DSM-5 criteria and either the CARS2-HF or the CARS2-ST. Findings suggest that overall, the diagnostic agreement of the CARS2 remains high across DSM-IV and DSM-5 criteria for autism.

The DSM-IV nosology of chronic pain: a comparison of pain disorder and multiple somatization syndrome.

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Hiller, W; Heuser, J; Fichter, M M

2000-01-01

This study evaluates the classification of pain from the perspective of the DSM-IV system. Of 60 in-patients with long-standing and disabling pain syndromes, 29 with pain disorder (PD) and 31 with pain as part of a multiple somatization syndrome (MSS) were compared before and after a structured cognitive-behavioral treatment. It was hypothesized that MSS patients show more psychological distress, are more severely disabled, and respond less to the treatment. Both groups were similar with respect to sociodemographic status, history of pain symptomatology and comorbidity with DSM-IV mental disorders. The results show that MSS patients had higher levels of affective and sensoric pain sensations as well as more pain-related disabilities. They were also less successful during treatment to reduce their pain-related depression and anxiety. Psychosocial functioning was improved only by PD patients, but remained almost unchanged in the MSS group. However, there were no group differences concerning general depression and hypochondriasis, dysfunctional attitudes towards body and health, and use of pain coping strategies. It is concluded that the DSM-IV distinction between 'pure' pain disorder and syndromes involving pain plus multiple somatoform symptoms cannot generally be confirmed, but further studies of validation are needed. Copyright 2000 European Federation of Chapters of the International Association for the Study of Pain.

An empirical operationalization study of DSM-IV diagnostic criteria for premature ejaculation

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Waldinger, M. D.; Hengeveld, M. W.; Zwinderman, A. H.; Olivier, B.

1998-01-01

The DSM-IV diagnostic criteria for premature ejaculation remain to be investigated by a clinical study. A prospective study was therefore conducted to investigate the DSM-IV definition and to provide an empirical operationalization of premature ejaculation. In this study 140 men suffering from

A comparison of the capacity of DSM-IV and DSM-5 acute stress disorder definitions to predict posttraumatic stress disorder and related disorders.

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Bryant, Richard A; Creamer, Mark; O'Donnell, Meaghan; Silove, Derrick; McFarlane, Alexander C; Forbes, David

2015-04-01

This study addresses the extent to which DSM-IV and DSM-5 definitions of acute stress disorder (ASD) predict subsequent posttraumatic stress disorder (PTSD) and related psychiatric disorders following trauma. Patients with randomized admissions to 5 hospitals across Australia (N = 596) were assessed in hospital and reassessed for PTSD at 3 (n = 508), 12 (n = 426), 24 (n = 439), and 72 (n = 314) months using the Clinician-Administered PTSD Scale; DSM-IV definition of PTSD was used at each assessment, and DSM-5 definition was used at 72 months. The Mini-International Neuropsychiatric Interview (MINI) was used at each assessment to assess anxiety, mood, and substance use disorders. Forty-five patients (8%) met DSM-IV criteria, and 80 patients (14%) met DSM-5 criteria for ASD. PTSD was diagnosed in 93 patients (9%) at 3, 82 patients (10%) at 12, 100 patients (12%) at 24, and 26 patients (8%) at 72 months; 19 patients (6%) met DSM-5 criteria for PTSD at 72 months. Comparable proportions of those diagnosed with ASD developed PTSD using DSM-IV (3 months = 46%, 12 months = 39%, 24 months = 32%, and 72 months = 25%) and DSM-5 (43%, 42%, 33%, and 24%) ASD definitions. Sensitivity was improved for DSM-5 relative to DSM-IV for depression (0.18 vs 0.30), panic disorder (0.19 vs 0.41), agoraphobia (0.14 vs 0.40), social phobia (0.12 vs 0.44), specific phobia (0.24 vs 0.58), obsessive-compulsive disorder (0.17 vs 0.47), and generalized anxiety disorder (0.20 vs 0.47). More than half of participants with DSM-5-defined ASD had a subsequent disorder. The DSM-5 criteria for ASD results in better identification of people who will subsequently develop PTSD or another psychiatric disorder relative to the DSM-IV criteria. Although prediction is modest, it suggests that the new ASD diagnosis can serve a useful function in acute trauma settings for triaging those who can benefit from either early intervention or subsequent monitoring. © Copyright 2015 Physicians Postgraduate Press, Inc.

Clinical value of DSM IV and DSM 5 criteria for diagnosing the most prevalent somatoform disorders in patients with medically unexplained physical symptoms (MUPS).

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van Dessel, Nikki Claassen-; van der Wouden, Johannes C; Dekker, Joost; van der Horst, Henriette E

2016-03-01

This study aimed (1) to describe frequencies of DSM IV somatisation disorder, undifferentiated somatoform disorder and pain disorder versus DSM 5 somatic symptom disorder (SSD) in a multi-setting population of patients with medically unexplained physical symptoms (MUPS), (2) to investigate differences in sociodemographic and (psycho)pathological characteristics between these diagnostic groups and (3) to explore the clinical relevance of the distinction between mild and moderate DSM 5 SSD. We used baseline data of a cohort of 325 MUPS patients. Measurements included questionnaires about symptom severity, physical functioning, anxiety, depression, health anxiety and illness perceptions. These questionnaires were used as proxy measures for operationalization of DSM IV and DSM 5 diagnostic criteria. 92.9% of participants fulfilled criteria of a DSM IV somatoform disorder, while 45.5% fulfilled criteria of DSM 5 SSD. Participants fulfilling criteria of DSM 5 SSD suffered from more severe symptoms than those only fulfilling criteria of a DSM IV somatoform disorder(mean PHQ-15 score of 13.98 (SD 5.17) versus 11.23 (SD 4.71), P-valuephysical functioning was significantly lower. Compared to patients with mild SSD, patients with moderate SSD suffered from significantly lower physical functioning and higher levels of depression. Within a population of MUPS patients DSM 5 SSD criteria are more restrictive than DSM IV criteria for somatoform disorders. They are associated with higher symptom severity and lower physical functioning. However, further specification of the positive psychological criteria of DSM 5 SSD may improve utility in research and practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Agreement between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the proposed DSM-V attention deficit hyperactivity disorder diagnostic criteria: an exploratory study.

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Ghanizadeh, Ahmad

2013-01-01

There is no empirical literature about the American Psychiatry Association proposed new diagnostic criteria for attention deficit hyperactivity disorder (ADHD). This study examined the agreement between ADHD diagnosis derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and DSM-V diagnostic criteria. It also reports sensitivity, specificity, and agreement for ADHD diagnosis. A clinical sample of 246 children and adolescents were interviewed face to face using both ADHD diagnostic criteria for DSM-V and DSM-IV by interviewing clinician. Comorbid psychiatric disorders were screened using DSM-IV criteria. The rate of ADHD diagnosis using DSM-V was significantly higher than the rate detected by using DSM-IV diagnostic criteria. The sensitivity of DSM-V diagnostic criteria was 100%, while its specificity was 71.1%. The kappa agreement between DSM-IV and DSM-V was 0.75. In addition, positive predictive value was 85.1%. All the four newly added symptoms to ADHD diagnostic criteria are statistically more common in the children with ADHD than those in the comparison group. However, these symptoms are also very common in the children without ADHD. It is expected that the rate of ADHD would increase using the proposed ADHD DSM-V criteria. Moreover, the newly added symptoms have a low specificity for ADHD diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

Use of the TAT in the assessment of DSM-IV cluster B personality disorders.

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Ackerman, S J; Clemence, A J; Weatherill, R; Hilsenroth, M J

1999-12-01

The Social Cognition and Object Relations Scale (SCORS), developed by Western, Lohr, Silk, Kerber, and Goodrich (1985), is a diagnostic instrument used to assess an array of psychological functioning by using clinical narratives such as the Thematic Apperception Test (TAT; Murray, 1943) stories. This study investigated the utility of the SCORS to differentiate between Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) antisocial personality disorder (ANPD), borderline personality disorder (BPD), narcissistic personality disorder (NPD), and Cluster C personality disorder (CPD). A sample of 58 patients was separated into four groups: ANPD (n = 9), BPD (n = 21; 18 with a primary BPD diagnosis and 3 with prominent borderline traits who met 4 of the 5 DSM-IV criteria necessary for a BPD diagnosis), NPD (n = 16; 8 with a primary NPD diagnosis and 8 with prominent narcissistic traits who met 4 of the 5 DSM-IV criteria necessary for a NPD diagnosis), and CPD (n = 12). These groups were then compared on the 8 SCORS variables by using 5 TAT cards (1, 2, 3BM, 4, and 13MF). Spearman-Brown correction for 2-way mixed effects model of reliability for the 8 SCORS variables ranged from .70 to .95. The results of categorical and dimensional analyses indicate that (a) SCORS variables can be used to differentiate ANPD, BPD, and NPD; (b) the BPD group scored significantly lower (greater maladjustment) than did the CPD group on certain variables; (c) the BPD group scored significantly lower (greater maladjustment) than did the NPD group on all 8 SCORS variables; (d) the ANPD group scored significantly lower than did the NPD group on certain variables; (e) certain variables were found to be empirically related to the total number of DSM-IV ANPD, BPD, and NPD criteria; and (f) certain variables were found to be empirically related to Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen

Endorsement of DSM-IV dependence criteria among caffeine users.

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Hughes, J R; Oliveto, A H; Liguori, A; Carpenter, J; Howard, T

1998-10-01

The purpose of this article is to determine whether some caffeine users endorse clinical indicators of dependence and abuse. We asked 162 randomly-selected caffeine users generic DSM-IV criteria for dependence, abuse, intoxication and withdrawal pertaining to their caffeine use in the last year via a structured telephone interview. The prevalence of endorsement of dependence items was 56% for strong desire or unsuccessful attempt to stop use, 50% for spending a great deal of time with the drug, 28% for using more than intended, 18% for withdrawal, 14% for using despite knowledge of harm, 8% for tolerance and 1% for foregoing activities to use. Seven percent of users met DSM-IV criteria for caffeine intoxication and, among those who had tried to stop caffeine permanently, 24% met DSM-IV research criteria for caffeine withdrawal. Test-retest interviews for dependency agreed in 29/30 cases (97%). Eight expert substance abuse clinicians agreed with self-endorsed caffeine dependence 91% of the time. Our results replicate earlier work and suggest that a substantial proportion of caffeine users exhibit dependence-like behaviors. Further studies are needed to determine whether such users exhibit a clinically significant syndrome of drug dependence.

Overview and Analysis of the Behaviourist Criticism of the "Diagnostic and Statistical Manual of Mental Disorders (DSM)"

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Andersson, Gerhard; Ghaderi, Ata

2006-01-01

While a majority of cognitive behavioural researchers and clinicians adhere to the classification system provided in the "Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)," strong objections have been voiced among behaviourists who find the dichotomous allocation of patients into psychiatric diagnoses incompatible with the philosophy…

Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an Adult Autism Spectrum Disorder Diagnostic Clinic

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Wilson, C. Ellie; Gillan, Nicola; Spain, Deborah; Robertson, Dene; Roberts, Gedeon; Murphy, Clodagh M.; Maltezos, Stefanos; Zinkstok, Janneke; Johnston, Katie; Dardani, Christina; Ohlsen, Chris; Deeley, P. Quinton; Craig, Michael; Mendez, Maria A.; Happé, Francesca; Murphy, Declan G. M.

2013-01-01

An Autism Spectrum Disorder (ASD) diagnosis is often used to access services. We investigated whether ASD diagnostic outcome varied when DSM-5 was used compared to ICD-10R and DSM-IV-TR in a clinical sample of 150 intellectually able adults. Of those diagnosed with an ASD using ICD-10R, 56% met DSM-5 ASD criteria. A further 19% met DSM-5 (draft)…

Adolescents and substance-related disorders: research agenda to guide decisions on Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V).

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Crowley, Thomas J

2006-09-01

Since the publication of the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV), many studies have addressed substance use disorders (SUD) in adolescents. Based on that adolescent literature, this paper suggests further research to help guide decisions about revising for DSM-V the SUD criteria in DSM-IV. The author has reviewed the 'Substance Related Disorders' section of DSM-IV-TR, recalled his experience in helping to draft that section, accessed relevant articles in PubMed and reviewed his own extensive file of literature citations. This paper suggests six questions for adolescent research to help guide the framers of DSM-V's 'Substance Related Disorders' section: (a) DSM-IV did not provide a diagnosis of cannabis withdrawal; should DSM-V continue that position? (b) Should SUD be included or referenced among 'Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence'? (c) Can inter-rater reliability of the substance abuse (SA) criteria be improved with altered example situations, text descriptions or phrasing of the current criteria? (d) Between ages 14 and 18 years is earlier onset of SUD a severity marker that could be incorporated into DSM-V as a predictor of worse course? (e) In DSM-V could a phenotypic descriptor of pathological multi-substance involvement document severity and predict course of SUD? (f) Could clinicians and patients benefit from DSM-V-related postpublication procedures for classifying emerging new drugs into DSM-V's categories? Without substantive changes in SA or substance dependence diagnostic criteria, research may improve the usefulness of those criteria for adolescents.

Validity of DSM-IV attention–deficit/hyperactivity disorder symptom dimensions and subtypes

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Willcutt, Erik G.; Nigg, Joel T.; Pennington, Bruce F.; Solanto, Mary V.; Rohde, Luis A.; Tannock, Rosemary; Loo, Sandra K.; Carlson, Caryn L.; McBurnett, Keith; Lahey, Benjamin B.

2013-01-01

DSM-IV criteria for ADHD specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C). To aid decision-making for DSM-5 and other future diagnostic systems, a comprehensive literature review and meta-analysis of 546 studies was completed to evaluate the validity of the DSM-IV model of ADHD. Results indicated that DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled. Available data overwhelmingly support the concurrent, predictive, and discriminant validity of the distinction between inattention and hyperactivity-impulsivity symptoms, and indicate that nearly all differences among the nominal subtypes are consistent with the relative levels of inattention and hyperactivity-impulsivity symptoms that define the subtypes. In contrast, the validity of the DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response, and the marked longitudinal instability of all three subtypes. Overall, it is concluded that the DSM-IV ADHD subtypes provide a convenient clinical shorthand to describe the functional and behavioral correlates of current levels of inattention and hyperactivity-impulsivity symptoms, but do not identify discrete subgroups with sufficient long-term stability to justify the classification of distinct forms of the disorder. Empirical support is stronger for an alternative model that would replace the subtypes with dimensional modifiers that reflect the number of inattention and hyperactivity-impulsivity symptoms at the

Prevalence of DSM-IV disorders in a population-based sample of 5- to 8-year-old children : the impact of impairment criteria

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Rijlaarsdam, Jolien; Stevens, Gonneke W J M; van der Ende, Jan; Hofman, Albert; Jaddoe, Vincent W V; Verhulst, Frank C.; Tiemeier, Henning

2015-01-01

This study determined the impact of impairment criteria on the prevalence and patterns of comorbidity of child DSM-IV disorders. The validity of these impairment criteria was tested against different measures of mental health care referral and utilization. We interviewed parents of 1,154 children

Prevalence of DSM-IV disorders in a population-based sample of 5- to 8-year-old children: the impact of impairment criteria

NARCIS (Netherlands)

J. Rijlaarsdam (Jolien); G. Stevens (Gonneke); J. van der Ende (Jan); A. Hofman (Albert); V.W.V. Jaddoe (Vincent); F.C. Verhulst (Frank); H.W. Tiemeier (Henning)

2015-01-01

textabstractThis study determined the impact of impairment criteria on the prevalence and patterns of comorbidity of child DSM-IV disorders. The validity of these impairment criteria was tested against different measures of mental health care referral and utilization. We interviewed parents of 1,154

The 10/66 Dementia Research Group's fully operationalised DSM-IV dementia computerized diagnostic algorithm, compared with the 10/66 dementia algorithm and a clinician diagnosis: a population validation study

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Krishnamoorthy ES

2008-06-01

Full Text Available Abstract Background The criterion for dementia implicit in DSM-IV is widely used in research but not fully operationalised. The 10/66 Dementia Research Group sought to do this using assessments from their one phase dementia diagnostic research interview, and to validate the resulting algorithm in a population-based study in Cuba. Methods The criterion was operationalised as a computerised algorithm, applying clinical principles, based upon the 10/66 cognitive tests, clinical interview and informant reports; the Community Screening Instrument for Dementia, the CERAD 10 word list learning and animal naming tests, the Geriatric Mental State, and the History and Aetiology Schedule – Dementia Diagnosis and Subtype. This was validated in Cuba against a local clinician DSM-IV diagnosis and the 10/66 dementia diagnosis (originally calibrated probabilistically against clinician DSM-IV diagnoses in the 10/66 pilot study. Results The DSM-IV sub-criteria were plausibly distributed among clinically diagnosed dementia cases and controls. The clinician diagnoses agreed better with 10/66 dementia diagnosis than with the more conservative computerized DSM-IV algorithm. The DSM-IV algorithm was particularly likely to miss less severe dementia cases. Those with a 10/66 dementia diagnosis who did not meet the DSM-IV criterion were less cognitively and functionally impaired compared with the DSMIV confirmed cases, but still grossly impaired compared with those free of dementia. Conclusion The DSM-IV criterion, strictly applied, defines a narrow category of unambiguous dementia characterized by marked impairment. It may be specific but incompletely sensitive to clinically relevant cases. The 10/66 dementia diagnosis defines a broader category that may be more sensitive, identifying genuine cases beyond those defined by our DSM-IV algorithm, with relevance to the estimation of the population burden of this disorder.

DSM-IV antisocial personality disorder and conduct disorder: evidence for taxonic structures among individuals with and without substance use disorders in the general population.

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Kerridge, Bradley T; Saha, Tulshi D; Hasin, Deborah S

2014-05-01

The categorical-dimensional status of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) conduct disorder (CD) and antisocial personality disorder (ASPD) is a source of controversy. This study examined whether the underlying structure of DSM-IV CD and ASPD was dimensional or categorical (taxonic) among individuals with and without substance use disorders. Using a national large representative survey of U.S. adults (n = 43,093), taxometric analyses of DSM-IV CD and ASPD diagnostic criteria were conducted on the total sample and among those with and without substance use disorders. Results of three taxometric procedures were consistent in showing that the structures underlying DSM-IV CD and ASPD were clearly taxonic in the total sample and among individuals with and without substance use disorders. Comparison curve fit indices exceeded 0.57 for each model. Taxonic findings of the present study were in contrast to the dimensional results of prior taxometric research among incarcerated samples with substantial comorbidity of antisocial syndromes and substance use disorders. Results supported the categorical representation and diagnostic thresholds of ASPD and CD as defined in DSM-IV and DSM-5. That the structure of ASPD and CD may be taxonic suggests that further research on these disorders use group comparative designs in which samples with and without these disorders are compared in terms of sociodemographic and clinical correlates, comorbidity, and treatment utilization. The taxonic structure of ASPD and CD may contribute to future research on causal processes through which these antisocial syndromes develop.

DSM-IV Antisocial Personality Disorder and Conduct Disorder: Evidence for Taxonic Structures Among Individuals With and Without Substance Use Disorders in the General Population

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Kerridge, Bradley T; Saha, Tulshi D; Hasin, Deborah S

2014-01-01

Objective: The categorical-dimensional status of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) conduct disorder (CD) and antisocial personality disorder (ASPD) is a source of controversy. This study examined whether the underlying structure of DSM-IV CD and ASPD was dimensional or categorical (taxonic) among individuals with and without substance use disorders. Method: Using a national large representative survey of U.S. adults (n = 43,093), taxometric analyses of DSM-IV CD and ASPD diagnostic criteria were conducted on the total sample and among those with and without substance use disorders. Results: Results of three taxometric procedures were consistent in showing that the structures underlying DSM-IV CD and ASPD were clearly taxonic in the total sample and among individuals with and without substance use disorders. Comparison curve fit indices exceeded 0.57 for each model. Conclusions: Taxonic findings of the present study were in contrast to the dimensional results of prior taxometric research among incarcerated samples with substantial comorbidity of antisocial syndromes and substance use disorders. Results supported the categorical representation and diagnostic thresholds of ASPD and CD as defined in DSM-IV and DSM-5. That the structure of ASPD and CD may be taxonic suggests that further research on these disorders use group comparative designs in which samples with and without these disorders are compared in terms of sociodemographic and clinical correlates, comorbidity, and treatment utilization. The taxonic structure of ASPD and CD may contribute to future research on causal processes through which these antisocial syndromes develop. PMID:24766762

Mismatch of Posttraumatic Stress Disorder (PTSD) Symptoms and DSM-IV Symptom Clusters in a Cancer Sample: Exploratory Factor Analysis of the PTSD Checklist-Civilian Version

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Shelby, Rebecca A.; Golden-Kreutz, Deanna M.; Andersen, Barbara L.

2007-01-01

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms. PMID:16281232

DSM-IV defined conduct disorder and oppositional defiant disorder: an investigation of shared liability in female twins.

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Knopik, V S; Bidwell, L C; Flessner, C; Nugent, N; Swenson, L; Bucholz, K K; Madden, P A F; Heath, A C

2014-04-01

DSM-IV specifies a hierarchal diagnostic structure such that an oppositional defiant disorder (ODD) diagnosis is applied only if criteria are not met for conduct disorder (CD). Genetic studies of ODD and CD support a combination of shared genetic and environmental influences but largely ignore the imposed diagnostic structure. We examined whether ODD and CD share an underlying etiology while accounting for DSM-IV diagnostic specifications. Data from 1446 female twin pairs, aged 11-19 years, were fitted to two-stage models adhering to the DSM-IV diagnostic hierarchy. The models suggested that DSM-IV ODD-CD covariation is attributed largely to shared genetic influences. This is the first study, to our knowledge, to examine genetic and environmental overlap among these disorders while maintaining a DSM-IV hierarchical structure. The findings reflect primarily shared genetic influences and specific (i.e. uncorrelated) shared/familial environmental effects on these DSM-IV-defined behaviors. These results have implications for how best to define CD and ODD for future genetically informed analyses.

Diagnostic crossover and outcome predictors in eating disorders according to DSM-IV and DSM-V proposed criteria: a 6-year follow-up study.

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Castellini, Giovanni; Lo Sauro, Carolina; Mannucci, Edoardo; Ravaldi, Claudia; Rotella, Carlo Maria; Faravelli, Carlo; Ricca, Valdo

2011-04-01

To evaluate in a 6-year follow-up study the course of a large clinical sample of patients with eating disorders (EDs) who were treated with individual cognitive behavior therapy. The diagnostic crossover, recovery, and relapses were assessed, applying both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the DSM-V proposed criteria. Patients with EDs move in and out of illness states over time, display frequent relapses, show a relevant lifetime psychiatric comorbidity, and migrate between different diagnoses. A total of 793 patients (including anorexia nervosa, bulimia nervosa, binge eating disorder, and EDs not otherwise specified) were evaluated on the first day of admission, at the end of treatment, 3 years after the end of treatment, and 3 years after the first follow-up. Clinical data were collected through a face-to-face interview; diagnosis was performed by means of the Structured Clinical Interview for DSM-IV and the Eating Disorder Examination Questionnaire was applied. A consistent rate of relapse and crossover between the different diagnoses over time was observed. Mood disorders comorbidity has been found to be an important determinant of diagnostic instability, whereas the severity of shape concern represented a relevant outcome modifier. Using the DSM-V proposed criteria, most patients of EDs not otherwise specified were reclassified, so that the large majority of ED patients seeking treatment would be included in full-blown diagnoses. Among EDs, there are different subgroups of patients displaying various courses and outcomes. The diagnostic instability involves the large majority of patients. An integration of categorical and dimensional approaches could improve the psychopathological investigation and the treatment choices.

Panic Disorder and Agoraphobia: Considerations for DSM-V

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Schmidt, Norman B.; Norr, Aaron M.; Korte, Kristina J.

2014-01-01

With the upcoming release of the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-V) there has been a necessary critique of the DSM-IV including questions regarding how to best improve the next iteration of the DSM classification system. The aim of this article is to provide commentary on the probable…

Greater Prevalence of Proposed ICD-11 Alcohol and Cannabis Dependence Compared to ICD-10, DSM-IV, and DSM-5 in Treated Adolescents.

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Chung, Tammy; Cornelius, Jack; Clark, Duncan; Martin, Christopher

2017-09-01

Proposed International Classification of Diseases, 11th edition (ICD-11), criteria for substance use disorder (SUD) radically simplify the algorithm used to diagnose substance dependence. Major differences in case identification across DSM and ICD impact determinations of treatment need and conceptualizations of substance dependence. This study compared the draft algorithm for ICD-11 SUD against DSM-IV, DSM-5, and ICD-10, for alcohol and cannabis. Adolescents (n = 339, ages 14 to 18) admitted to intensive outpatient addictions treatment completed, as part of a research study, a Structured Clinical Interview for DSM SUDs adapted for use with adolescents and which has been used to assess DSM and ICD SUD diagnoses. Analyses examined prevalence across classification systems, diagnostic concordance, and sources of diagnostic disagreement. Prevalence of any past-year proposed ICD-11 alcohol or cannabis use disorder was significantly lower compared to DSM-IV and DSM-5 (ps DSM-5, and ICD-10 (ps DSM-5 SUD diagnoses showed only moderate concordance. For both alcohol and cannabis, youth typically met criteria for an ICD-11 dependence diagnosis by reporting tolerance and much time spent using or recovering from the substance, rather than symptoms indicating impaired control over use. The proposed ICD-11 dependence algorithm appears to "overdiagnose" dependence on alcohol and cannabis relative to DSM-IV and ICD-10 dependence, and DSM-5 moderate/severe use disorder, generating potential "false-positive" cases of dependence. Among youth who met criteria for proposed ICD-11 dependence, few reported impaired control over substance use, highlighting ongoing issues in the conceptualization and diagnosis of SUD. Copyright © 2017 by the Research Society on Alcoholism.

A population-based study on phobic fears and DSM-IV specific phobia in 70-year olds.

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Sigström, Robert; Östling, Svante; Karlsson, Björn; Waern, Margda; Gustafson, Deborah; Skoog, Ingmar

2011-01-01

This population-based study reports on the prevalence and characteristics of specific phobia (SP) and phobic fears in an elderly population. A representative population sample of Swedish 70-year-olds without dementia (N = 558) was examined using semi-structured interviews. Phobic fears included fear of animals, natural environment, specific situations, blood-injection-injury and 'other'. Mental disorders, including SP, were diagnosed according to DSM-IV. Phobic fears (71.0% vs. 37.9%) and SP (13.8% vs. 4.5%) were more common in women than in men. Among those with phobic fears, more than 80% reported onset before age 21. Of those with SP, 35.7% had another DSM-IV diagnosis compared to 8.5% of those reporting no fear. Fear of specific situations and 'other' fears were related to SP and other anxiety disorders. SP was related to lower global functioning. We conclude that specific phobia in the elderly should receive attention from health professionals as it is common and associated with a decrease in global functioning. Copyright © 2010 Elsevier Ltd. All rights reserved.

The performance of the K10, K6 and GHQ-12 to screen for present state DSM-IV disorders among disability claimants

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Cornelius Bert LR

2013-02-01

Full Text Available Abstract Background Screening for mental disorders among disability claimants is important, since mental disorders seem to be seriously under-recognized in this population. However, performance of potentially suitable scales is unknown. We aimed to evaluate the psychometric properties of three scales, the 10- and 6-item Kessler Psychological Distress Scale (K10, K6 and the 12-item General Health Questionnaire (GHQ-12, to predict present state mental disorders, classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4thEdition (DSM-IV among disability claimants. Methods All scales were completed by a representative sample of persons claiming disability benefit after two years sickness absence (n=293. All diagnoses, both somatic and mental, were included. The gold standard was the Composite International Diagnostic Interview (CIDI 3.0 to diagnose present state DSM-IV disorder. Cronbach’s α, sensitivity, specificity, positive (PPV and negative predictive values (NPV, and the areas under the Receiver Operating Characteristic curve (AUC were calculated. Results Cronbach’s alpha’s were 0.919 (K10, 0.882 (K6 and 0.906 (GHQ-12. The optimal cut-off scores were 24 (K10, 14 ( K6 and 20 (GHQ-12. The PPV and the NPV for the optimal cut point of the K10 was 0.53 and 0.89, for the K6 0.51 and 0.87, and for the GHQ-12 0.50 and 0.82. The AUC’s for 30-day cases were 0.806 (K10; 95% CI 0.749-0.862, 0.796 (K6; 95% CI 0.737-0.854 and 0.695 (GHQ-12; 95% CI 0.626-0.765. Conclusions The K10 and K6 are reliable and valid scales to screen for present state DSM-IV mental disorder. The optimal cut-off scores are 24 (K10 and 14 (K6. The GHQ-12 (optimal cut-off score: 20 is outperformed by the K10 and K6, which are to be preferred above the GHQ-12. The scores on separate items of the K10 and K6 can be used in disability assessment settings as an agenda for an in-depth follow-up clinical interview to ascertain the presence of present state

The Social Responsiveness Scale in relation to DSM IV and DSM5 ASD in Korean Children

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Cheon, Keun-Ah; Park, Jee-In; Koh, Yun-Joo; Song, Jungeun; Hong, Hyun-Joo; Kim, Young-Kee; Lim, Eun-Chung; Kwon, Hojang; Ha, Mina; Lim, Myung-Ho; Paik, Ki-Chung; Constantino, John N.; Leventhal, Bennett; Kim, Young Shin

2017-01-01

LAY ABSTRACT The Social Responsiveness Scale(SRS) is an autism rating scales in widespread use, with over 20 official foreign language translations. It has proven highly feasible for quantitative ascertainment of autistic social impairment in public health settings, however, little is known about the validity of the reinforcement in Asia populations or in references to DSM5. The current study aims to evaluate psychometric properties and cross-cultural aspects of the SRS-Korean version (K-SRS). Our results indicate that the K-SRS exhibits adequate reliability and validity for measuring Autism Spectrum Disorder (ASD) symptoms in Korean children with DSM IV PDD and DSM5 ASD. Our findings further suggest that it is difficult to distinguish Social Communication Disorder (SCD) from other child psychiatric conditions using the K-SRS. This is the first study to examine the relationship between the SRS subscales and DSM5 based clinical diagnosis. This study provides cross-cultural confirmation of the factor structure of ASD symptoms and traits measured by the SRS. SCIENTIFIC ABSTRACT The Social Responsiveness Scale(SRS) is an autism rating scales in widespread use, with over 20 official foreign language translations. It has proven highly feasible for quantitative ascertainment of autistic social impairment in public health settings, however, little is known about the validity of the reinforcement in Asia populations or in references to DSM5. The current study aims to evaluate psychometric properties and cross-cultural aspects of the SRS-Korean version(K-SRS). The study subjects were ascertained from three samples: a general sample from 3 regular education elementary schools(n=790), a clinical sample(n=154) of 6–12-year-olds from four psychiatric clinics, and an epidemiological sample of children with ASD, diagnosed using both DSM IV PDD, DSM5 ASD and SCD criteria(n=151). Their parents completed the K-SRS and the Autism Spectrum Screening Questionnaire(ASSQ). Descriptive

Validation of the Portuguese DSM-IV-MR-J.

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Calado, Filipa; Alexandre, Joana; Griffiths, Mark D

2016-01-01

Youth problem gambling is viewed as an emergent public health issue in many countries, and is also an emerging area of public concern in Portugal. However, there is currently no Portuguese instrument that focuses specifically on the measurement of problem gambling among young people. Consequently, the present study aimed to validate the DSM-IV-MR-J for use among Portuguese adolescents and to examine its' psychometric properties. A cross-cultural adaption of this instrument to the Portuguese language was performed using the translation and back translation method. The final version of the instrument was administered to 753 Portuguese high school and first year college students. The findings revealed an acceptable internal reliability and replicated the one-factor structure of this scale. Based on these findings, the Portuguese DSM-IV-MR-J appears to be a valid and reliable instrument, and provides a much needed psychometric tool for the development of more research on youth gambling in Portugal.

DSM-IV-defined anxiety disorder symptoms in a middle-childhood-aged group of Malaysian children using the Spence Children's Anxiety Scale

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Atefeh Ahmadi; Mohamed Sharif Mustaffa; Amirmudin Udin; AliAkbar Haghdoost

2016-01-01

Introduction Pediatric anxiety disorders are the most common mental health disorders in the middle-childhood age group. The purpose of this study is to assess anxiety disorder symptoms, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), in a large community sample of low socioeconomic level rural children and to investigate some of the psychometric properties (internal consistency, construct and convergent validity and items rated as often or always...

A Taxometric Investigation of "DSM-IV" Major Depression in a Large Outpatient Sample: Interpretable Structural Results Depend on the Mode of Assessment

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Ruscio, John; Brown, Timothy A.; Ruscio, Ayelet Meron

2009-01-01

Most taxometric studies of depressive constructs have drawn indicators from self-report instruments that do not bear directly on the "Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)" diagnostic construct of major depressive disorder (MDD). The present study examined the latent structure of MDD using indicator sets…

The General Assessment of Personality Disorder (GAPD): factor structure, incremental validity of self-pathology, and relations to DSM-IV personality disorders.

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Hentschel, Annett G; Livesley, W John

2013-01-01

Recent developments in the classification of personality disorder, especially moves toward more dimensional systems, create the need to assess general personality disorder apart from individual differences in personality pathology. The General Assessment of Personality Disorder (GAPD) is a self-report questionnaire designed to evaluate general personality disorder. The measure evaluates 2 major components of disordered personality: self or identity problems and interpersonal dysfunction. This study explores whether there is a single factor reflecting general personality pathology as proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), whether self-pathology has incremental validity over interpersonal pathology as measured by GAPD, and whether GAPD scales relate significantly to Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]) personality disorders. Based on responses from a German psychiatric sample of 149 participants, parallel analysis yielded a 1-factor model. Self Pathology scales of the GAPD increased the predictive validity of the Interpersonal Pathology scales of the GAPD. The GAPD scales showed a moderate to high correlation for 9 of 12 DSM-IV personality disorders.

A importância e as limitações do uso do DSM-IV na prática clínica La importancia y los límites del uso del DSM-IV en la práctica clínica Importance and constraints of the DSM-IV use in the clinical practice

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Evandro Gomes de Matos

2005-12-01

Full Text Available INTRODUÇÃO: O DSM-IV é um sistema diagnóstico e estatístico de classificação dos transtornos mentais, segundo o modelo categorial, destinado à prática clínica e à pesquisa em psiquiatria. O objetivo do presente estudo foi apresentar as vantagens do uso deste instrumento e suas limitações. METODOLOGIA: Os autores realizaram uma ampla revisão bibliográfica e apresentaram a relevância do tema, como está no momento configurado. Foram apontadas algumas mudanças prováveis, que ocorrerão nas próximas edições, e a discussão entre os modelos diagnósticos - dimensional e categorial. O artigo inclui os seguintes tópicos: histórico, conceito, vantagens e desvantagens da utilização, discussão e conclusão. Apresenta, também, um projeto que será desenvolvido no Núcleo de Atendimento dos Transtornos de Ansiedade (NATA, do Departamento de Psiquiatria da FCM/UNICAMP, aplicando um novo instrumento diagnóstico para o espectro do pânico agorafóbico, segundo o modelo dimensional.INTRODUCCIÓN: El DSM-IV es un sistema diagnóstico y estadístico de clasificación de los trastornos mentales, conforme al modelo categorial, destinado a la práctica clínica y a la investigación en psiquiatría. El objetivo del presente estudio fue presentar las ventajas del uso de este instrumento, así como sus límites. METODOLOGIA: Los autores realizaron una amplia revisión bibliográfica y presentaron la relevancia del tema, tal como se configura en el momento. Señalaron algunos cambios probables, que ocurrirán en las próximas ediciones, y la discusión entre los modelos diagnósticos - dimensional y categorial. El artículo incluye los siguientes tópicos: histórico, concepto, ventajas y desventajas de la utilización, discusión y conclusión. Presenta, además, un proyecto que será desarrollado en el Núcleo de Atendimento dos Transtornos de Ansiedade (NATA, del Departamento de Psiquiatría de la FCM/UNICAMP, aplicando un nuevo

"DSM IV," "DSM-5," and the Five-Factor Model: the Diagnosis of Personality Disorder with Intellectual and Developmental Disabilities

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Lindsay, William R.; Steptoe, Lesley; McVicker, Ronnie; Haut, Fabian; Robertson, Colette

2018-01-01

In "DSM-5" there has been a move to dimensional personality disorder (PD) diagnosis, incorporating personality theory in the form of the five-factor model (FFM). It proposes an alternative assessment system based on diagnostic indicators and the FFM, while retaining "DSM-IV" categorical criteria. Four individuals with…

[Dissociative disorders: from Janet to DSM-IV].

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Nakatani, Y

2000-01-01

I reviewed the literature on dissociation and dissociative disorders from Pierre Janet to DSM-IV, and examined the current trends in research. Janet's theory on hysteria is multifaceted, and is based on three psychological models. Based on a hierarchical model, Janet related hysteric symptoms to the activities within the lower strata of mental hierarchy (automatisms psychologiques), which were demonstrably shown in somnambulism. A second model was based on the concept of a psychological system, which was hypothetically composed of ideas, images, feelings, sensations, and movements. According to this model, dissociation of psychological functions was fundamental to the mechanism of hysteria: loss of integration was thought to engender fixed ideas (ideas fixes) and to lead to the development of a system totally isolated from the whole personality system. Janet also attempted to explain various mental disorders using an economic model. He referred to a loss of equilibration between psychological force and psychological tension. Thus, an unexpected emotional experience was conceived to cause a consumption of reserved psychological force, which was in turn followed by exhaustion associated with hysteric symptoms. Whereas most current researchers regard Janet as the first to study psychological trauma as a principal cause of dissociation, I feel it is important to note that he also emphasized the role of stigmata, i.e., permanent traits of hysteric patients, which were represented as a suggestibility and a tendency toward a narrowing of the consciousness field. Discussion about dissociation and its relation to trauma all but disappeared after Janet. However, during the Second World War and post-war period, some psychiatrists began to pay attention to two emerging phenomena: a high incidence of dissociative symptoms such as fugue and amnesia among combatants, and traumatic neurosis frequently observed among ex-inmates of concentration camps. In the 1970s, interest in

[Neurocognitive disorders in DSM-5: pervasive changes in the diagnostics of dementia].

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Maier, W; Barnikol, U B

2014-05-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes an innovative chapter on neurocognitive disorders (NCD) as a substitute for the dementia, delirium and amnestic disorders chapter in DSM-IV. This NCD chapter promotes a most innovative change compared to DSM-IV. While the term delirium is preserved, the commonly used term dementia does not occur as a diagnostic entity. Neurocognitive disorders are more inclusive than dementias; they also cover early prodromal stages of dementias below the DSM-IV threshold. The diagnosis of NCDs requires essentially neuropsychological testing preferentially with standardized instruments. Special focus is given to etiological subtyping taking former diagnostic consensus processes by expert groups into consideration. The subsequent more extensive concept of NCD also allows the diagnosis of etiological-specific prodromal states of cognitive impairments. The changes from DSM-IV to DSM-5 are critically discussed.

Health services utilization by school going Omani adolescents and youths with DSM IV mental disorders and barriers to service use

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Morsi Magdi M

2009-09-01

Full Text Available Abstract Background Recent corpus of research suggests that psychiatric disorders amongst adolescents and youths are an emerging global challenge, but there is paucity of studies exploring health services utilization by this age group in Arab region. Aim This study focus on the health services utilization and the barriers among school going adolescents and youths with DSM IV disorders in the country Oman, whose population is predominantly youthful. Methods Representative sample of secondary school Omani adolescents and youths were concurrently interviewed for the (i presence of DSM IV mental disorders using the face-to-face interview, World Mental Health-Composite International Diagnostic Interview (WMH-CIDI, (ii tendency for health care utilization and (iii predictors of utilization with clinical and demographic background. Results The proportions of lifetime cases having ever made treatment contact are low, being 5.2% for any anxiety disorder and 13.2% for any mood disorder category. None of these anxiety cases made treatment contact in the year of onset of the disorder, and the median delay when they eventually made treatment contact is about 14 years. In any mood disorders category only 3.6% made contact within the 1st year of onset with the median delay in initial treatment contact is two years for the Bipolar disorder (broad, four years for Any Mood disorder and nine years for the Major Depressive Disorder group. Male gender is significantly associated with less likelihood of making treatment contact when suffering from Social phobia (p = 0.000, Major Depressive Disorder (p = 0.000 and Bipolar Disorder (p = 0.000. The younger cohorts of 14-16 years and 17-18 years of Social phobic made significantly less lifetime any treatment contact (p = 0.000. The 14-16 year olds were significantly less likely to make lifetime any treatment contact for Bipolar Mood disorder (p = 0.000, while the 17-18 group were 1.5 times more likely to do so. Over past

Proportion of patients without mental disorders being treated in mental health services worldwide

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Bruffaerts, Ronny; Posada-Villa, Jose; Al-Hamzawi, Ali Obaid; Gureje, Oye; Huang, Yueqin; Hu, Chiyi; Bromet, Evelyn J.; Viana, Maria Carmen; Hinkov, Hristo Ruskov; Karam, Elie G.; Borges, Guilherme; Florescu, Silvia E.; Williams, David R.; Demyttenaere, Koen; Kovess-Masfety, Viviane; Matschinger, Herbert; Levinson, Daphna; de Girolamo, Giovanni; Ono, Yutaka; de Graaf, Ron; Browne, Mark Oakley; Bunting, Brendan; Xavier, Miguel; Haro, Josep Maria; Kessler, Ronald C.

2015-01-01

Background Previous research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’. Aims To examine the association of past-year mental health treatment with DSM-IV disorders. Method The World Health Organization’s World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs. Results Roughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose-response associations were found between number of indicators of need and treatment. Conclusions The vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment. PMID:25395690

Diagnóstico diferencial e direção do tratamento na atualidade: do DSM-IV à psicanálise

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Claudia Henschel de Lima

2010-01-01

Full Text Available The objective of this paper is to analyze the relevance of the psychoanalysis in the context of an era dominated by the biopolitical model as reference for diagnosis and for direction of the treatment of mental disorders. The DSM-IV uses generic category of disorder to classify the symptoms, reducing them to a behavioral dimension and converting them into monosymptoms. Hence, from the approach of the diagnostic difficulties faced by Freud in the conduction of the case of the Wolf Man, this paper question the current relevance of structural diagnosis in psychoanalysis, showing that the DSM-IV: (i reduces the diagnostic difficulty to the syndrome of the panic; (ii establish the direction of treatment through the monosymptmatic model, suppressing structural elements of the psychosis. Alternatively, the orientation of the diagnosis in the last Lacan to the Wolf Man case will be an ordinary psychosis.

Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders: reduction of eating disorder not otherwise specified and validity.

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Keel, Pamela K; Brown, Tiffany A; Holm-Denoma, Jill; Bodell, Lindsay P

2011-09-01

Revised Eating Disorder (ED) diagnostic criteria have been proposed for the Diagnostic and Statistical Manual (DSM)-5 to reduce the preponderance of eating disorder not otherwise specified (EDNOS) and increase the validity of diagnostic groups. This article compares DSM-IV and proposed DSM-5 diagnostic criteria on number of EDNOS cases and validity. Participants (N = 397; 91% female) completed structured clinical interviews in a two-stage epidemiological study of EDs. Interviewers did not follow standard skip rules, making it possible to evaluate alternative ED diagnostic criteria. Using DSM-IV versus DSM-5 criteria, 34 (14%) versus 48 (20%) had anorexia nervosa, 43 (18%) versus 44 (18%) had bulimia nervosa, and 163 (68%) had EDNOS versus 20 (8%) had binge eating disorder (BED), and 128 (53%) had EDNOS, respectively, reflecting a significant decrease in EDNOS. Validation analyses supported significant differences among groups with some improvement associated with delineation of BED. Proposed revisions to EDs in the DSM-5 significantly reduced reliance on EDNOS without loss of information. Copyright © 2011 Wiley Periodicals, Inc.

Are symptoms of spirit possessed patients covered by the DSM-IV or DSM-5 criteria for possession trance disorder? A mixed-method explorative study in Uganda.

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van Duijl, Marjolein; Kleijn, Wim; de Jong, Joop

2013-09-01

As in many cultures, spirit possession is a common idiom of distress in Uganda. The DSM-IV contains experimental research criteria for dissociative and possession trance disorder (DTD and PTD), which are under review for the DSM-5. In the current proposed categories of the DSM-5, PTD is subsumed under dissociative identity disorder (DID) and DTD under dissociative disorders not elsewhere classified. Evaluation of these criteria is currently urgently required. This study explores the match between local symptoms of spirit possession in Uganda and experimental research criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. A mixed-method approach was used combining qualitative and quantitative research methods. Local symptoms were explored of 119 spirit possessed patients, using illness narratives and a cultural dissociative symptoms' checklist. Possible meaningful clusters of symptoms were inventoried through multiple correspondence analysis. Finally, local symptoms were compared with experimental criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. Illness narratives revealed different phases of spirit possession, with passive-influence experiences preceding the actual possession states. Multiple correspondence analysis of symptoms revealed two dimensions: 'passive' and 'active' symptoms. Local symptoms, such as changes in consciousness, shaking movements, and talking in a voice attributed to spirits, match with DSM-IV-PTD and DSM-5-DID criteria. Passive-influence experiences, such as feeling influenced or held by powers from outside, strange dreams, and hearing voices, deserve to be more explicitly described in the proposed criteria for DID in the DSM-5. The suggested incorporation of PTD in DID in the DSM-5 and the envisioned separation of DTD and PTD in two distinctive categories have disputable aspects.

Redefining Autism Spectrum Disorder Using DSM-5: The Implications of the Proposed DSM-5 Criteria for Autism Spectrum Disorders

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Young, Robyn L.; Rodi, Melissa L.

2014-01-01

A number of changes were made to pervasive developmental disorders (PDDs) in the recently released diagnostic and statistical manual of mental disorders (APA, "Diagnostic and statistical manual of mental disorders," American Psychiatric Publishing, Arlington, VA, 2013). Of the 210 participants in the present study who met DSM-IV-TR…

The relationship between the Five-Factor Model and latent DSM-IV personality disorder dimensions

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Nestadt, Gerald; Costa, Paul T.; Hsu, Fang-Chi; Samuels, Jack; Bienvenu, O. Joseph; Eaton, William W.

2007-01-01

This study compared the latent structure of the DSM-IV personality disorders to the Five-Factor Model (FFM) of general personality dimensions. The subjects in the study were 742 community-residing individuals who participated in the Hopkins Epidemiology of Personality Disorder Study. DSM-IV personality disorder traits were assessed by psychologists using the International Personality Disorder Examination, and personality disorder dimensions were derived previously using dichotomous factor ana...

Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V.

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Craske, Michelle G; Kircanski, Katharina; Epstein, Alyssa; Wittchen, Hans-Ulrich; Pine, Danny S; Lewis-Fernández, Roberto; Hinton, Devon

2010-02-01

This review covers the literature since the publication of DSM-IV on the diagnostic criteria for panic attacks (PAs) and panic disorder (PD). Specific recommendations are made based on the evidence available. In particular, slight changes are proposed for the wording of the diagnostic criteria for PAs to ease the differentiation between panic and surrounding anxiety; simplification and clarification of the operationalization of types of PAs (expected vs. unexpected) is proposed; and consideration is given to the value of PAs as a specifier for all DSM diagnoses and to the cultural validity of certain symptom profiles. In addition, slight changes are proposed for the wording of the diagnostic criteria to increase clarity and parsimony of the criteria. Finally, based on the available evidence, no changes are proposed with regard to the developmental expression of PAs or PD. This review presents a number of options and preliminary recommendations to be considered for DSM-V.

An Examination of a Proposed DSM-IV Pathological Gambling Hierarchy in a Treatment Seeking Population: Similarities with Substance Dependence and Evidence for Three Classification Systems.

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Christensen, Darren R; Jackson, Alun C; Dowling, Nicki A; Volberg, Rachel A; Thomas, Shane A

2015-09-01

Toce-Gerstein et al. (Addiction 98:1661-1672, 2003) investigated the distribution of Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV) pathological gambling criteria endorsement in a U.S. community sample for those people endorsing a least one of the DSM-IV criteria (n = 399). They proposed a hierarchy of gambling disorders where endorsement of 1-2 criteria were deemed 'At-Risk', 3-4 'Problem gamblers', 5-7 'Low Pathological', and 8-10 'High Pathological' gamblers. This article examines these claims in a larger Australian treatment seeking population. Data from 4,349 clients attending specialist problem gambling services were assessed for meeting the ten DSM-IV pathological gambling criteria. Results found higher overall criteria endorsement frequencies, three components, a direct relationship between criteria endorsement and gambling severity, clustering of criteria similar to the Toce-Gerstein et al. taxonomy, high accuracy scores for numerical and criteria specific taxonomies, and also high accuracy scores for dichotomous pathological gambling diagnoses. These results suggest significant complexities in the frequencies of criteria reports and relationships between criteria.

Racial/ethnic variation in the reliability of DSM-IV pathological gambling disorder.

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Cunningham-Williams, Renee M; Ostmann, Emily L; Spitznagel, Edward L; Books, Samantha J

2007-07-01

Racial/ethnic disparities in mental disorders, including pathological gambling disorder (PGD), may be either real or artifacts of how they are conceptualized and measured. We aimed to assess racial/ethnic variation in the reliability of self-reported lifetime PGD determined by meeting > or = 5 criteria of the Diagnostic and Statistical Manual of Mental Disorders. Using community advertising, we recruited 15-85-year-old Caucasians (n = 225) and African (American/other minorities (n = 87), who had gambled more than 5 times lifetime), for 2 interviews, held 1 week apart, about gambling and associated behaviors. Results indicate substantial to almost-perfect DSM-IV PGD reliability for Caucasians (kappa = 0.82) and African Americans/other minorities (kappa = 0.68). Reliability for symptoms and for game-specific disorders was fair to almost perfect (kappa = 0.37-0.90). After adjusting results for confounding variables and multiple comparisons, racial/ethnic variation in PGD and game-specific reliability failed to persist. Implications exist for increased attention to screening and prevention efforts critical to reducing racial/ethnic disparities in PGD prevalence.

Distress, sexual dysfunctions, and DSM: Dialogue at cross purposes?

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Hendrickx, Lies; Gijs, Luk; Enzlin, Paul

2013-01-01

Introduction. A distress criterion was added to the diagnostic criteria of sexual dysfunctions in Diagnostic and Statistical Manual of Mental Disorders, 4th Edition DSM-IV; 1994). This decision was neither based on empirical evidence, nor on an open, academic, or public debate about its necessity. As a result, this decision has been disputed ever since the publication of DSM-IV. Aim. In this article, the necessity to include or exclude the distress criterion from the diagnostic criteria of...

Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V.

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LeBeau, Richard T; Glenn, Daniel; Liao, Betty; Wittchen, Hans-Ulrich; Beesdo-Baum, Katja; Ollendick, Thomas; Craske, Michelle G

2010-02-01

The present review was conducted in order to evaluate the current diagnostic criteria for specific phobia (SP) in light of the empirical evidence gathered since DSM-IV and to propose changes to DSM-V where change is clearly and reliably indicated by the evidence. In response to questions put forth by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group, four primary areas were determined for this review: the accuracy and utility of the current SP type classification system, the validity of test anxiety as a type of SP, the boundary between agoraphobia and SP, and the reliability and utility of the diagnostic criteria for SP. Developmental issues are addressed within each area. Literature reviews examining academic findings published between 1994 and 2009 were carried out and the results are included herein. The review presents a number of options and preliminary recommendations to be considered for DSM-V. All of these recommendations should be considered tentative as they await the field trials and expert consensus necessary prior to their inclusion in the DSM-V. The present review also reveals a great need for future research in the area of SP and directions for such research is provided.

The DSM-5: Classification and criteria changes.

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Regier, Darrel A; Kuhl, Emily A; Kupfer, David J

2013-06-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) marks the first significant revision of the publication since the DSM-IV in 1994. Changes to the DSM were largely informed by advancements in neuroscience, clinical and public health need, and identified problems with the classification system and criteria put forth in the DSM-IV. Much of the decision-making was also driven by a desire to ensure better alignment with the International Classification of Diseases and its upcoming 11th edition (ICD-11). In this paper, we describe select revisions in the DSM-5, with an emphasis on changes projected to have the greatest clinical impact and those that demonstrate efforts to enhance international compatibility, including integration of cultural context with diagnostic criteria and changes that facilitate DSM-ICD harmonization. It is anticipated that this collaborative spirit between the American Psychiatric Association (APA) and the World Health Organization (WHO) will continue as the DSM-5 is updated further, bringing the field of psychiatry even closer to a singular, cohesive nosology. Copyright © 2013 World Psychiatric Association.

Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98

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Meagher, David J; Morandi, Alessandro; Inouye, Sharon K; Ely, Wes; Adamis, Dimitrios; Maclullich, Alasdair J; Rudolph, James L; Neufeld, Karin; Leonard, Maeve; Bellelli, Giuseppe; Davis, Daniel; Teodorczuk, Andrew; Kriesel, Stefan; Thomas, Christine; Hasemann, Wolfgang

2014-01-01

peer-reviewed Background: The Diagnostic and Statistical Manual fifth edition (DSM-5) provides new criteria for delirium diagnosis. We examined delirium diagnosis using these new criteria compared with the Diagnostic and Statistical Manual fourth edition (DSM-IV) in a large dataset of patients assessed for delirium and related presentations. Methods: Patient data (n = 768) from six prospectively collected cohorts, clinically assessed using DSM-IV and the Delirium Rating Scale-R...

Binge Eating Disorder: A Review of a New "DSM" Diagnosis

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Myers, Laura L.; Wiman, Allison M.

2014-01-01

In 1994, binge eating disorder (BED) was introduced as a disorder requiring further study in the "American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders", fourth edition ("DSM-IV"). It is now listed as a distinct eating disorder in the "DSM-5", along with bulimia nervosa and anorexia…

Reassessment of patients with Eating Disorders after moving from DSM-IV towards DSM-5: a retrospective study in a clinical sample.

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Gualandi, Malvina; Simoni, Marzia; Manzato, Emilia; Scanelli, Giovanni

2016-12-01

To compare the relative prevalence of eating disorders moving from DSM-IV to DSM-5, and to reassess the overall medical impairment in the revised diagnostic classes. We applied DSM-5 to 206 patients (age 15-56 years) previously studied and classified according to DSM-IV. Medical impairment was classified as low, medium, or high, based on a cumulative score of clinical severity (SCS), computed as the sum of specific weights assigned to different pathological conditions and their ascertained prognostic impact. Application of DSM-5 produced a decrease in Eating Disorders Not Otherwise Specified (EDNOS) by 17 %, an increase in anorexia (AN) by 14 % and bulimia (BN) by 2.4 %; 44.6 % of EDNOS migrated to AN, 8 % to BN, and 30.8 % was reclassified as Other Specified Feeding and Eating Disorders (OSFED). Mean SCS was higher in AN than in other diagnoses independent of classification. Differently from EDNOS, no high score was found in OSFED. BMI (OR 0.74, 95 % CI 0.56-0.98) and duration of amenorrhea >1 year (OR 6.63, 95 % CI 1.29-34.16) resulted significantly associated with the risk for medium-high SCS level in AN classified with DSM-5. The results confirmed that DSM-5 reduces the number of EDNOS. DSM-5 seems to better represent the clinical picture in OSFED than in EDNOS. The clinical relevance of BMI and duration of amenorrhea should be considered even more now that they are no longer used as diagnostic hallmarks of AN.

Eating disorders in adolescents: how does the DSM-5 change the diagnosis?

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Fisher, Martin; Gonzalez, Marisol; Malizio, Joan

2015-11-01

This study aimed to determine the changes in diagnosis that occur in making the transition from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in an adolescent medicine eating disorder program. During the months of September 2011 through December 2012, a data sheet was completed at the end of each new outpatient eating disorder evaluation listing the patient's gender, age, ethnicity, weight, height, DSM-IV diagnosis, and proposed DSM-5 diagnosis. Distributions were calculated using the Mann-Whitney and Wilcoxon rank sum analyses to determine differences between diagnostic groups. There were 309 patients evaluated during the 16-month period. DSM-IV diagnoses were as follows: anorexia nervosa, 81 patients (26.2%); bulimia nervosa, 29 patients (9.4%); binge eating disorder, 1 patient (0.3%); and eating disorder not otherwise specified (EDNOS), 198 patients (64.6%). By contrast, DSM-5 diagnoses were as follows: anorexia nervosa, 100 patients; atypical anorexia nervosa, 93 patients; avoidant/restrictive food intake disorder, 60 patients; bulimia nervosa, 29 patients; purging disorder, 18 patients; unspecified feeding or eating disorder, 4 patients; subthreshold bulimia nervosa, 2 patients; subthreshold binge eating disorder, 2 patients; and binge eating disorder, 1 patient. Almost two thirds (64.6%) of the 309 patients had a diagnosis of EDNOS based on the DSM-IV criteria. By contrast, only four patients had a diagnosis of unspecified feeding or eating disorder based on the DSM-5 criteria. These data demonstrate that the goal of providing more specific diagnoses for patients with eating disorders has been accomplished very successfully by the new DSM-5 criteria.

Implications of "DSM"-IV to "DSM"-5 Substance Use Disorder Diagnostic Changes in Adolescents Enrolled in a School-Based Intervention

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Stewart, David G.; Arlt, Virginia K.; Siebert, Erin C.; Chapman, Meredith K.; Hu, Emily M.

2016-01-01

This study aimed to examine (a) the impact of the change in the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") from a categorical to dimensional classification of substance use diagnoses, (b) the elimination of the legal criterion, and (c) the inclusion of a craving criterion in the "DSM"-5.…

The epistemological significance of possession entering the DSM.

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Stephenson, Craig

2015-09-01

The discourse of the American Psychiatric Association's DSM reflects the inherently dialogic or contradictory nature of its stated mandate to demonstrate both 'nosological completeness' and cultural 'inclusiveness'. Psychiatry employs the dialogic discourse of the DSM in a one-sided, positivistic manner by identifying what it considers universal mental disease entities stripped of their cultural context. In 1992 the editors of the Diagnostic and Statistical Manual of Mental Disorders proposed to introduce possession into their revisions. A survey of the discussions about introducing 'possession' as a dissociative disorder to be listed in the DSM-IV indicates a missed epistemological break. Subsequently the editors of the DSM-5 politically 'recuperated' possession into its official discourse, without acknowledging the anarchic challenges that possession presents to psychiatry as a cultural practice. © The Author(s) 2015.

Symptoms associated with the DSM IV diagnosis of depression in pregnancy and post partum.

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Kammerer, Martin; Marks, Maureen N; Pinard, Claudia; Taylor, Alyx; von Castelberg, Brida; Künzli, Hansjörg; Glover, Vivette

2009-06-01

Pregnancy and the postpartum may affect symptoms of depression. However it has not yet been tested how the symptoms used for the DSM IV diagnosis of depression discriminate depressed from non depressed women perinatally. A modified version of the Structured Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all associated DSM IV symptoms of depression with depressed and non depressed women in pregnancy and the postpartum period. Loss of appetite was not associated with depression either ante or postnatally. The antenatal symptom pattern was different from the postnatal. The sensitivity of the symptoms ranged from 0.7% to 51.6%, and specificity from 61.3% to 99.1%. The best discriminating symptoms were motor retardation/agitation and concentration antenatally, and motor retardation/agitation, concentration and fatigue postnatally. Depression in pregnancy and postpartum depression show significantly different symptom profiles. Appetite is not suitable for the diagnosis of depression in the perinatal period.

Mental health professionals' natural taxonomies of mental disorders: implications for the clinical utility of the ICD-11 and the DSM-5.

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Reed, Geoffrey M; Roberts, Michael C; Keeley, Jared; Hooppell, Catherine; Matsumoto, Chihiro; Sharan, Pratap; Robles, Rebeca; Carvalho, Hudson; Wu, Chunyan; Gureje, Oye; Leal-Leturia, Itzear; Flanagan, Elizabeth H; Correia, João Mendonça; Maruta, Toshimasa; Ayuso-Mateos, José Luís; de Jesus Mari, Jair; Xiao, Zeping; Evans, Spencer C; Saxena, Shekhar; Medina-Mora, María Elena

2013-12-01

To examine the conceptualizations held by psychiatrists and psychologists around the world of the relationships among mental disorders in order to inform decisions about the structure of the classification of mental and behavioral disorders in World Health Organization's International Classification of Diseases and Related Health Problems 11th Revision (ICD-11). 517 mental health professionals in 8 countries sorted 60 cards containing the names of mental disorders into groups of similar disorders, and then formed a hierarchical structure by aggregating and disaggregating these groupings. Distance matrices were created from the sorting data and used in cluster and correlation analyses. Clinicians' taxonomies were rational, interpretable, and extremely stable across countries, diagnostic system used, and profession. Clinicians' consensus classification structure was different from ICD-10 and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV), but in many respects consistent with ICD-11 proposals. The clinical utility of the ICD-11 may be improved by making its structure more compatible with the common conceptual organization of mental disorders observed across diverse global clinicians. © 2013 Wiley Periodicals, Inc.

Implications of DSM-5 for Health Care Organizations and Mental Health Policy.

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Castillo, Richard J; Guo, Kristina L

2016-01-01

The American Psychiatric Association (APA) has made major changes in the way mental illness is conceptualized, assessed, and diagnosed in its new diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, and has far reaching implications for health care organizations and mental health policy. This paper reviews the four new principles in DSM-5: 1) A spectrum (also called "dimensional") approach to the definition of mental illness; 2) recognition of the role played by environmental risk factors related to stress and trauma in predisposing, precipitating, and perpetuating mental illness; 3) cultural relativism in diagnosis and treatment of mental illness; and 4) recognizing the adverse effects of psychiatric medications on patients. Each of these four principles will be addressed in detail. In addition, four major implications for health care organizations and mental health policy are identified as: 1) prevention; 2) client-centered psychiatry; 3) mental health workers retraining; and 4) medical insurance reform. We conclude that DSM- 5's new approach to diagnosis and treatment of mental illness will have profound implications for health care organizations and mental health policy, indicating a greater emphasis on prevention and cure rather than long-term management of symptoms.

Understanding the DSM-5: stasis and change.

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Cooper, Rachel

2018-03-01

This paper aims to understand the DSM-5 through situating it within the context of the historical development of the DSM series. When one looks at the sets of diagnostic criteria, the DSM-5 is strikingly similar to the DSM-IV. I argue that at this level the DSM has become 'locked-in' and difficult to change. At the same time, at the structural, or conceptual, level there have been radical changes, for example in the definition of 'mental disorder', in the role of theory and of values, and in the abandonment of the multiaxial approach to diagnosis. The way that the DSM-5 was constructed means that the overall conceptual framework of the classification only barely constrains the sets of diagnostic criteria it contains.

Examining the Stability of "DSM-IV" and Empirically Derived Eating Disorder Classification: Implications for "DSM-5"

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Peterson, Carol B.; Crow, Scott J.; Swanson, Sonja A.; Crosby, Ross D.; Wonderlich, Stephen A.; Mitchell, James E.; Agras, W. Stewart; Halmi, Katherine A.

2011-01-01

Objective: The purpose of this investigation was to derive an empirical classification of eating disorder symptoms in a heterogeneous eating disorder sample using latent class analysis (LCA) and to examine the longitudinal stability of these latent classes (LCs) and the stability of DSM-IV eating disorder (ED) diagnoses. Method: A total of 429…

An examination of the factor structure of DSM-IV Narcissistic Personality Disorder Criteria

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Miller, Joshua D.; Hoffman, Brian J.; Campbell, W. Keith; Pilkonis, Paul A.

2008-01-01

A growing body of research has suggested that narcissistic personality disorder (NPD) contains two factors or types: overt/grandiose and covert/vulnerable. A recent factor analysis of DSM-IV NPD symptoms supported a similar two-factor model. The present research tested this proposed two-factor solution against a one-factor solution (N = 298; 72% patients) using both confirmatory factor analysis (CFA) and an examination of associations between the resultant factors and theoretically relevant criteria (other PDs; depression, anxiety). The results of the CFA supported a one-factor solution. Likewise, the two factors each yielded a similar pattern of correlations with relevant criteria. Together, these results argue against a two-factor structure for the current DSM-IV NPD symptoms. Given the broader research literature suggesting a two-factor structure of narcissism, strategies for assessing both overt/grandiose and covert/vulnerable forms of narcissism in DSM-V are discussed. PMID:18243885

Comorbidity in "DSM" Childhood Mental Disorders: A Functional Perspective

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Cipani, Ennio

2014-01-01

In this article, I address the issue of comorbidity and its prevalence in the prior "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") classification systems. The focus on the topography or form of presenting problems as the venue for determining mental disorders is scrutinized as the possible cause. Addressing the…

[Generalized anxiety disorder, now and the future: a perspective to the DSM-5].

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Otsubo, Tempei

2012-01-01

Generalized, persistent, and free-floating anxiety was first described by Freud in 1894. The diagnostic term generalized anxiety disorder (GAD) was not in classification systems until the publication of the diagnostic and statistical manual for mental disorders, third edition (DSM-III) in 1980. Initially considered as a residual category to be used when no other diagnosis could be made, it is not accepted that GAD represents a distinct diagnostic category yet. Since 1980, revisions to the diagnostic criteria for GAD in the DSM-III-R, DSM-IV and DSM-5 classifications have slightly redefined this disorder. The classification is fluid. The duration criterion has increased to 6 months in DSM-IV, but decreased to 3 months in DSM-5. This article reviews the development of diagnostic criteria for defining GAD from Freud to DSM-5 and compares the DSM-5 criterion with DSM-IV and the tenth revision of the International Classification of Disease. The impact of the changes in diagnostic criteria on research into GAD, and on diagnosis, differential diagnosis, will be discussed.

The use of old and recent DSM definitions of premature ejaculation in observational studies: a contribution to the present debate for a new classification of PE in the DSM-V.

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Waldinger, Marcel D; Schweitzer, Dave H

2008-05-01

The DSM-III definition of premature ejaculation (PE) contains the criterion "control" but not that of "ejaculation time." In contrast, the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) (DSM-IV-TR) contains the criterion "short ejaculation time," while it lacks "control." To review the adequacy and consequent use of all criteria of the DSM-IV-TR definition in previously published PE Internet surveys. Reviewing all published cohort studies on PE from 2004 to 2007. MEDLINE and EMBASE computer bibliographies were used. Definitions of DSM-III, DSM-IV-TR, and International Classification of Diseases. Five papers, of which three are original studies, reported inclusion of men with PE according to DSM-IV-TR definition but omitted to apply the required "short ejaculation time" criterion. These studies, which have defined PE according to subjective criteria such as control, actually referred to the DSM-III definition. Using DSM-III-like definitions in three different studies revealed a highly variable prevalence of PE (32.5%, 27.6%, and 13.0%). In contrast, based on studies using a 1-minute cutoff point, being the time that is required to call ejaculation time "short" or using the criterion "persistent occurrence," PE revealed to be far less prevalent (5-6%). Unacceptable discrepancies of PE definitions according to DSM-III (abandoned but still used) and DSM-IV-TR argue strongly in favor of a multidimensional new classification of PE for the DSM-V.

The Relationship between the "Childhood Autism Rating Scale: Second Edition" and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5

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Dawkins, Tamara; Meyer, Allison T.; Van Bourgondien, Mary E.

2016-01-01

"The Childhood Autism Rating Scale, Second Edition" (CARS2; 2010) includes two rating scales; the CARS2-Standard Version (CARS2-ST) and the newly developed CARS2-High Functioning Version (CARS2-HF). To assess the diagnostic agreement between the CARS2 and DSM-IV-TR versus DSM-5 criteria for Autism Spectrum Disorder (ASD), clinicians at…

Women-specific mental disorders in DSM-V: are we failing again?

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Wittchen, Hans-Ulrich

2010-02-01

Despite a wealth of studies on differences regarding the biobehavioral and social-psychological bases of mental disorders in men and women and repeated calls for increased attention, women-specific issues have so far not been comprehensively addressed in past diagnostic classification systems of mental disorders. There is also increasing evidence that this situation will not change significantly in the upcoming revisions of ICD-11 and DSM-V. This paper explores reasons for this continued failure, highlighting three major barriers: the fragmentation of the field of women's mental health research, lack of emphasis on diagnostic classificatory issues beyond a few selected clinical conditions, and finally, the "current rules of game" used by the current DSM-V Task Forces in the revision process of DSM-V. The paper calls for concerted efforts of researchers, clinicians, and other stakeholders within a more coherent and comprehensive framework aiming at broader coverage of women-specific diagnostic classificatory issues in future diagnostic systems.

Comparison of DSM-IV and proposed ICD-11 formulations of PTSD among civilian survivors of war and war veterans.

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Morina, Nexhmedin; van Emmerik, Arnold A P; Andrews, Bernice; Brewin, Chris R

2014-12-01

The World Health Organization recently proposed a reformulation of posttraumatic stress disorder (PTSD) for the 11(th) edition of the International Classification of Diseases (ICD-11), employing only 6 symptoms. The aim of this study was to investigate the impact of this reformulation of PTSD as compared to criteria according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) on the prevalence of current PTSD as well as comorbid major depressive episode and anxiety disorders other than PTSD. Study 1 involved previously collected interviews with 560 Kosovar civilian war survivors; Study 2 employed a previously collected sample of 142 British war veterans. Results revealed no change in the diagnostic status under the criteria proposed for ICD-11 in 87.5% of civilian war survivors and 91.5% of war veterans. Participants who only met the newly proposed criteria showed lower rates of comorbid major depressive episode than participants who only met DSM-IV criteria (13.6% vs. 43.8% respectively). Rates of comorbid anxiety disorders did not significantly differ between participants who lost or gained a PTSD diagnosis under the proposed criteria. Copyright © 2014 International Society for Traumatic Stress Studies.

Inter-rater agreement of comorbid DSM-IV personality disorders in substance abusers

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Thylstrup Birgitte

2008-05-01

Full Text Available Abstract Background Little is known about the inter-rater agreement of personality disorders in clinical settings. Methods Clinicians rated 75 patients with substance use disorders on the DSM-IV criteria of personality disorders in random order, and on rating scales representing the severity of each. Results Convergent validity agreement was moderate (range for r = 0.55, 0.67 for cluster B disorders rated with DSM-IV criteria, and discriminant validity was moderate for eight of the ten personality disorders. Convergent validity of the rating scales was only moderate for antisocial and narcissistic personality disorder. Discussion Dimensional ratings may be used in research studies and clinical practice with some caution, and may be collected as one of several sources of information to describe the personality of a patient.

The myth of DSM's invention of new categories of disorder: Houts's diagnostic discontinuity thesis disconfirmed.

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Wakefield, J C

2001-05-01

Houts (2001) argues that increases in DSM diagnostic categories are due to the invention of new disorders that are discontinuous with old conceptions of disorder and would not have been previously diagnosed. He maintains that DSM category increases are not comparable in nature to ICD category increases, which are mainly refinements of recognized disorders. I survey categories of disorder introduced after DSM-II and assess whether they are discontinuous with old concepts and categories of disorder. Candidate categories are identified from: Houts and Follette (1998), Mentalism, mechanisms, and medical analogues: Reply to Wakefield. Journal of Consulting and Clinical Psychology; Kutchins and Kirk (1997) Making us crazy: DSM: The psychiatric bible and the creation of mental disorders. New York: Free Press; and my own list. The result is that virtually none of the candidate categories are invented, discontinuous categories. In almost every case, the newly labeled conditions were considered disorders at the time of DSM-II and would have been diagnosed under DSM-II categories. I also reexamine DSM-IV sleep disorder categories, which Houts claims are discontinuous with past diagnostic conceptions. The result is that all DSM-IV sleep disorders were recognized as disorders at the time of DSM-II, and most were recognized as mental disorders. I conclude that DSM category increases are comparable in nature to ICD category increases, and that the invention-of-disorder account cannot explain the vast majority of such increases.

DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11).

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Bromet, E J; Hobbs, M J; Clouston, S A P; Gonzalez, A; Kotov, R; Luft, B J

2016-03-01

Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11-13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.

[Critical evaluation of the first draft of DSM-V].

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Frances, A

2011-02-16

Critical evaluation of DSM-V first draft This is an evaluation of the first DSM-V (Diagnostic and Statistical Manual of Mental Disorders-V) draft from the DSM-IV chairman. First, a brief history of DSM is reported. Then, major reasons for present controversies and the threat they raise to APA leadership in the field are discussed. Third point is careful recollection of the several conflicting aspects of the DSM-V draft, paying attention to drawbacks and their implications for future clinical practice, research and forensic activity. Comment is finally provided about APA (American Psychiatric Association) decisions aimed at reaching more consensus about this basic instrument of American psychiatry.

A Twin Study of Normative Personality and DSM-IV Personality Disorder Criterion Counts: Evidence for Separate Genetic Influences.

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Czajkowski, Nikolai; Aggen, Steven H; Krueger, Robert F; Kendler, Kenneth S; Neale, Michael C; Knudsen, Gun Peggy; Gillespie, Nathan A; Røysamb, Espen; Tambs, Kristian; Reichborn-Kjennerud, Ted

2018-03-21

Both normative personality and DSM-IV personality disorders have been found to be heritable. However, there is limited knowledge about the extent to which the genetic and environmental influences underlying DSM personality disorders are shared with those of normative personality. The aims of this study were to assess the phenotypic similarity between normative and pathological personality and to investigate the extent to which genetic and environmental influences underlying individual differences in normative personality account for symptom variance across DSM-IV personality disorders. A large population-based sample of adult twins was assessed for DSM-IV personality disorder criteria with structured interviews at two waves spanning a 10-year interval. At the second assessment, participants also completed the Big Five Inventory, a self-report instrument assessing the five-factor normative personality model. The proportion of genetic and environmental liabilities unique to the individual personality disorder measures, and hence not shared with the five Big Five Inventory domains, were estimated by means of multivariate Cholesky twin decompositions. The median percentage of genetic liability to the 10 DSM-IV personality disorders assessed at wave 1 that was not shared with the Big Five domains was 64%, whereas for the six personality disorders that were assessed concurrently at wave 2, the median was 39%. Conversely, the median proportions of unique environmental liability in the personality disorders for wave 1 and wave 2 were 97% and 96%, respectively. The results indicate that a moderate-to-sizable proportion of the genetic influence underlying DSM-IV personality disorders is not shared with the domain constructs of the Big Five model of normative personality. Caution should be exercised in assuming that normative personality measures can serve as proxies for DSM personality disorders when investigating the etiology of these disorders.

The Impact of DSM-5 on Eating Disorder Diagnoses.

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Vo, Megen; Accurso, Erin C; Goldschmidt, Andrea B; Le Grange, Daniel

2017-05-01

Eating disorder diagnostic criteria were revised from the fourth to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and -5, respectively). This study examines the impact of these revisions on rates of eating disorder diagnoses in treatment-seeking youth. Participants were 651 youth, ages 7-18 years, presenting to an outpatient eating disorders program who met criteria for a DSM-IV eating disorder diagnosis on intake. Patients completed well-validated semi-structured interviews to assess eating disorder psychopathology and psychiatric comorbidity. Participants were predominantly female (n = 588; 90.3%) with an average age of 15.28 years (SD = 2.21), mean percent of median Body Mass Index (mBMI) of 101.91 (SD = 31.73), and average duration of illness of 16.74 months (SD = 17.63). Cases of DSM-IV Eating Disorder Not Otherwise Specified (EDNOS), now most consistent with DSM-5 Other Specified Feeding or Eating Disorder, decreased from 47.6% to 39.0%, Anorexia Nervosa increased from 29.6% to 33.5%, and Bulimia Nervosa increased from 22.7% to 24.7%. Consistent with previous studies, and in keeping with the aims of the DSM-5 for eating disorders, the revised diagnostic criteria reduced cases of DSM-IV EDNOS and increased cases of specified eating disorders. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:578-581). © 2016 Wiley Periodicals, Inc.

Assessment of documentation of DSM-IV-TR Criteria A for diagnosis of schizophrenia in psychiatric unit, tertiary hospital, Malaysia.

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Maung, K; Ohnmar, H; Than, W; Ramli, M; Najwa Hanim, M R; Ali Sabri, R; Ahmad Zafri, A B

The purposes of this study were to investigate the documentation of the DSM-IV-TR- Criteria A in diagnoses of schizophrenia and to identify the symptoms associated with over diagnosis of schizophrenia. This study involved a retrospective review and analysis of data from case notes. Data of 107 newly diagnosed patients with schizophrenia were keyed in and analyzed using SPSS v 19. The cases were then evaluated for the use of the DSM-IV-TR- Criteria A. Over diagnosis was noted in 37.39% of the patients. Disorganised behaviour (12.5%), affective flattening (12.5%), hallucination (16%) and non-bizarre delusion (18.3%) significantly contributed to the over-diagnosis of schizophrenia. Symptoms such as non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia and were statistically significant with p ≤0.05. There was a significant lack of DSM-IV-TR Criteria A among the data documented to diagnose schizophrenia and non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia. This key problem needs to be addressed. The reliability of a diagnosis is indispensable and achievable with the proper clinical application of DSM-IV-TR Criteria A. The DSM-IV-TR Criteria have been perceived to be useful and reliable and is most widely used throughout the world.

The dimensionality of DSM-IV alcohol use disorders among adolescent and adult drinkers and symptom patterns by age, gender, and race/ethnicity.

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Harford, Thomas C; Yi, Hsiao-ye; Faden, Vivian B; Chen, Chiung M

2009-05-01

There is limited information on the validity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorders (AUD) symptom criteria among adolescents in the general population. The purpose of this study is to assess the DSM-IV AUD symptom criteria as reported by adolescent and adult drinkers in a single representative sample of the U.S. population aged 12 years and older. This design avoids potential confounding due to differences in survey methodology when comparing adolescents and adults from different surveys. A total of 133,231 current drinkers (had at least 1 drink in the past year) aged 12 years and older were drawn from respondents to the 2002 to 2005 National Surveys on Drug Use and Health. DSM-IV AUD criteria were assessed by questions related to specific symptoms occurring during the past 12 months. Factor analytic and item response theory models were applied to the 11 AUD symptom criteria to assess the probabilities of symptom item endorsements across different values of the underlying trait. A 1-factor model provided an adequate and parsimonious interpretation for the 11 AUD criteria for the total sample and for each of the gender-age groups. The MIMIC model exhibited significant indication for item bias among some criteria by gender, age, and race/ethnicity. Symptom criteria for "tolerance,"time spent," and "hazardous use" had lower item thresholds (i.e., lower severity) and low item discrimination, and they were well separated from the other symptoms, especially in the 2 younger age groups (12 to 17 and 18 to 25). "Larger amounts,"cut down,"withdrawal," and "legal problems" had higher item thresholds but generally lower item discrimination, and they tend to exhibit greater dispersion at higher AUD severity, particularly in the youngest age group (12 to 17). Findings from the present study do not provide support for the 2 separate DSM-IV diagnoses of alcohol abuse and dependence among either adolescents or adults

The Impact of DSM-5 A-Criteria Changes on Parent Ratings of ADHD in Adolescents.

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Sibley, Margaret H; Yeguez, Carlos E

2018-01-01

Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) A-criteria for ADHD were expanded to include new descriptors referencing adolescent and adult symptom manifestations. This study examines the effect of these changes on symptom endorsement in a sample of adolescents with ADHD (N = 259; age range = 10.72-16.70). Parent ratings were collected and Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) and DSM-5 endorsement of ADHD symptoms were compared. Under the DSM-5, there were significant increases in reported inattention, but not hyperactivity/impulsivity (H/I) symptoms, with specific elevations for certain symptoms. The average adolescent met criteria for less than one additional symptom under the DSM-5, but the correlation between ADHD symptoms and impairment was attenuated when using the DSM-5 items. Impulsivity items appeared to represent adolescent deficits better than hyperactivity items. Results were not moderated by demographic factors. In a sample of adolescents with well-diagnosed DSM-IV-TR ADHD, developmental symptom descriptors led parents to endorse slightly more symptoms of inattention, but this elevation is unlikely to be clinically meaningful.

The Lay Concept of Childhood Mental Disorder

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Giummarra, Melita J.; Haslam, Nick

2005-01-01

The structure of lay people's concepts of childhood mental disorder was investigated in a questionnaire study and examined for convergence with the Diagnostic and Statistical Manual (DSM-IV). Eighty-four undergraduates who had no formal education in abnormal psychology rated 54 conditions--36 DSM-IV childhood disorders and 18 non-disorders--on…

Antisocial personality disorder in DSM-5: missteps and missed opportunities.

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Lynam, Donald R; Vachon, David D

2012-10-01

This paper evaluates the proposal for antisocial personality disorder (ASPD) in the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5). Some aspects of the proposal are appealing: personality disorders will be assessed using trait criteria, and these criteria are similar to trait descriptions of DSM-IV ASPD. Other aspects of the proposal are less appealing. First, the DSM-5 will depend on a newly constructed personality trait system rather than relying on a well validated, widely studied one. Second, the trait profile of ASPD is incomplete; although this profile reflects the traits included in DSM-IV, it maps poorly onto the full personality profile of ASPD. Third, the DSM Workgroup missed an opportunity to finally unify ASPD and psychopathy; history and research suggest that these disorders have diverged mistakenly. Fourth, the newly proposed criteria of impairments in self- and interpersonal functioning are of questionable derivation and utility. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

School Mental Health Resources and Adolescent Mental Health Service Use

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Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

2014-01-01

Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

Reconceptualising women’s sexual desire and arousal in DSM-5

OpenAIRE

Graham, Cynthia A.

2015-01-01

The publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013 was the culmination of more than a decade of work by the APA DSM-5 task force and Work Groups. From 2007 to 2013, I served as a member of the Sexual Dysfunctions subworkgroup, part of the Sexual and Gender Identity Disorders workgroup. In the area of sexual disorders, some of the most significant changes were made in diagnostic categories for female sexual dysfunction. The DSM-IV ...

Are symptoms of spirit possessed patients covered by the DSM-IV or DSM-5 criteria for possession trance disorder? A mixed-method explorative study in Uganda

NARCIS (Netherlands)

van Duijl, M.; Kleyn, W.; de Jong, J.

2013-01-01

Introduction and aims As in many cultures, spirit possession is a common idiom of distress in Uganda. The DSM-IV contains experimental research criteria for dissociative and possession trance disorder (DTD and PTD), which are under review for the DSM-5. In the current proposed categories of the

Posttraumatic Stress Disorder in the DSM-5: Controversy, Change, and Conceptual Considerations

OpenAIRE

Pai, Anushka; Suris, Alina M.; North, Carol S.

2017-01-01

The criteria for posttraumatic stress disorder PTSD have changed considerably with the newest edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Changes to the diagnostic criteria from the DSM-IV to DSM-5 include: the relocation of PTSD from the anxiety disorders category to a new diagnostic category named “Trauma and Stressor-related Disorders”, the elimination of the subjective component to the definition of trauma, the exp...

Continuity Between DSM-5 Section II and III Personality Disorders in a Dutch Clinical Sample.

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Orbons, Irene M J; Rossi, Gina; Verheul, Roel; Schoutrop, Mirjam J A; Derksen, Jan L L; Segal, Daniel L; van Alphen, Sebastiaan P J

2018-05-14

The goal of this study was to evaluate the continuity across the Section II personality disorders (PDs) and the proposed Section III model of PDs in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013a ). More specifically, we analyzed association between the DSM-5 Section III pathological trait facets and Section II PDs among 110 Dutch adults (M age = 35.8 years, range = 19-60 years) receiving mental health care. We administered the Structured Clinical Interview for DSM-IV Axis II Disorders to all participants. Participants also completed the self-report Personality Inventory for DSM-5 (PID-5) as a measure of pathological trait facets. The distributions underlying the dependent variable were modeled as criterion counts, using negative binomial regression. The results provided some support for the validity of the PID-5 and the DSM-5 Section III Alternative Model, although analyses did not show a perfect match. Both at the trait level and the domain level, analyses showed mixed evidence of significant relationships between the PID-5 trait facets and domains with the traditional DSM-IV PDs.

Validity of "DSM-IV" Syndromes in Preschoolers with Autism Spectrum Disorders

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Lecavalier, Luc; Gadow, Kenneth D.; Devincent, Carla J.; Houts, Carrie R.; Edwards, Michael C.

2011-01-01

Behavior and emotional problems are often present in very young children with autism spectrum disorders (ASDs) but their nosology has been the object of scant empirical attention. The objective of this study was to assess the construct validity of select "Diagnostic and Statistical Manual of Mental Disorders" ("DSM)"--defined…

Classification of mood disorders in DSM-V and DSM-VI.

Science.gov (United States)

Joyce, Peter R

2008-10-01

For any diagnostic system to be clinically useful, and go beyond description, it must provide an understanding that informs about aetiology and/or outcome. DSM-III and DSM-IV have provided reliability; the challenge for DSM-V and DSM-VI will be to provide validity. For DSM-V this will not be achieved. Believers in DSM-III and DSM-IV have impeded progress towards a valid classification system, so DSM-V needs to retain continuity with its predecessors to retain reliability and enhance research, but position itself to inform a valid diagnostic system by DSM-VI. This review examines the features of a diagnostic system and summarizes what is really known about mood disorders. The review also questions whether what are called mood disorders are primarily disorders of mood. Finally, it provides suggestions for DSM-VI.

Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98

NARCIS (Netherlands)

Meagher, David J.; Morandi, Alessandro; Inouye, Sharon K.; Ely, Wes; Adamis, Dimitrios; Maclullich, Alasdair J.; Rudolph, James L.; Neufeld, Karin; Leonard, Maeve; Bellelli, Giuseppe; Davis, Daniel; Teodorczuk, Andrew; Kreisel, Stefan; Thomas, Christine; Hasemann, Wolfgang; Timmons, Suzanne; O'Regan, Niamh; Grover, Sandeep; Jabbar, Faiza; Cullen, Walter; Dunne, Colum; Kamholz, Barbara; van Munster, Barbara C.; de Rooij, Sophia E.; de Jonghe, Jos; Trzepacz, Paula T.

2014-01-01

The Diagnostic and Statistical Manual fifth edition (DSM-5) provides new criteria for delirium diagnosis. We examined delirium diagnosis using these new criteria compared with the Diagnostic and Statistical Manual fourth edition (DSM-IV) in a large dataset of patients assessed for delirium and

Validity of proposed DSM-5 diagnostic criteria for nicotine use disorder: results from 734 Israeli lifetime smokers

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Shmulewitz, D.; Wall, M.M.; Aharonovich, E.; Spivak, B.; Weizman, A.; Frisch, A.; Grant, B. F.; Hasin, D.

2013-01-01

Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes aligning nicotine use disorder (NUD) criteria with those for other substances, by including the current DSM fourth edition (DSM-IV) nicotine dependence (ND) criteria, three abuse criteria (neglect roles, hazardous use, interpersonal problems) and craving. Although NUD criteria indicate one latent trait, evidence is lacking on: (1) validity of each criterion; (2) validity of the criteria as a set; (3) comparative validity between DSM-5 NUD and DSM-IV ND criterion sets; and (4) NUD prevalence. Method Nicotine criteria (DSM-IV ND, abuse and craving) and external validators (e.g. smoking soon after awakening, number of cigarettes per day) were assessed with a structured interview in 734 lifetime smokers from an Israeli household sample. Regression analysis evaluated the association between validators and each criterion. Receiver operating characteristic analysis assessed the association of the validators with the DSM-5 NUD set (number of criteria endorsed) and tested whether DSM-5 or DSM-IV provided the most discriminating criterion set. Changes in prevalence were examined. Results Each DSM-5 NUD criterion was significantly associated with the validators, with strength of associations similar across the criteria. As a set, DSM-5 criteria were significantly associated with the validators, were significantly more discriminating than DSM-IV ND criteria, and led to increased prevalence of binary NUD (two or more criteria) over ND. Conclusions All findings address previous concerns about the DSM-IV nicotine diagnosis and its criteria and support the proposed changes for DSM-5 NUD, which should result in improved diagnosis of nicotine disorders. PMID:23312475

Bulimia nerviosa ¿Mas allá del DSM-IV?

OpenAIRE

Sánchez-Carracedo, David; Mora, Marisol; Raich, Rosa; Torras, Joan

1999-01-01

En el articulo se discuten diversos estudios recientes sobre cada uno de los criterios diagnósticos del DSM-IV sobre la bulimia nerviosa. Se ha puesto una atención especial a aquellos síntomas que pueden formar parte de otro diagnóstico pero que en el marco de la Bulimia Nerviosa pueden presentar una muyor gravedad. También se analizan las posibles repercusiones diagnósticas y terapéuticas que comportarían cambios en las exigencias de algunos criterios.

Assessment of DSM-IV personality disorders in obsessive-compulsive disorder: comparison of clinical diagnosis, self-report questionnaire, and semi-structured interview

NARCIS (Netherlands)

Tenney, Nienke H.; Schotte, Chris K. W.; Denys, Damiaan A. J. P.; van Megen, Harold J. G. M.; Westenberg, Herman G. M.

2003-01-01

In patients with obsessive-compulsive disorder, personality disorders are not many times assessed according to DSM-IV criteria. The purpose of the present study is to examine the prevalence of personality disorders diagnosed according to the DSM-IV in a severely disordered OCD population (n=65) with

Genetic and Environmental Structure of DSM-IV Criteria for Antisocial Personality Disorder: A Twin Study.

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Rosenström, Tom; Ystrom, Eivind; Torvik, Fartein Ask; Czajkowski, Nikolai Olavi; Gillespie, Nathan A; Aggen, Steven H; Krueger, Robert F; Kendler, Kenneth S; Reichborn-Kjennerud, Ted

2017-05-01

Results from previous studies on DSM-IV and DSM-5 Antisocial Personality Disorder (ASPD) have suggested that the construct is etiologically multidimensional. To our knowledge, however, the structure of genetic and environmental influences in ASPD has not been examined using an appropriate range of biometric models and diagnostic interviews. The 7 ASPD criteria (section A) were assessed in a population-based sample of 2794 Norwegian twins by a structured interview for DSM-IV personality disorders. Exploratory analyses were conducted at the phenotypic level. Multivariate biometric models, including both independent and common pathways, were compared. A single phenotypic factor was found, and the best-fitting biometric model was a single-factor common pathway model, with common-factor heritability of 51% (95% CI 40-67%). In other words, both genetic and environmental correlations between the ASPD criteria could be accounted for by a single common latent variable. The findings support the validity of ASPD as a unidimensional diagnostic construct.

How should we revise diagnostic criteria for substance use disorders in the DSM-V?

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Martin, Christopher S; Chung, Tammy; Langenbucher, James W

2008-08-01

This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. Copyright (c) 2008 APA, all rights reserved.

What is hypomania? Tetrachoric factor analysis and kernel estimation of DSM-IV hypomanic symptoms.

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Benazzi, Franco

2009-11-01

The DSM-IV definition of hypomania, which relies on clinical consensus and historical tradition, includes several "nonspecific" symptoms. The aim of this study was to identify the core symptoms of DSM-IV hypomania. In an outpatient private practice, 266 bipolar II disorder (BP-II) and 138 major depressive disorder (MDD) remitted patients were interviewed by a bipolar-trained psychiatrist, for different study goals. Patients were questioned, using the Structured Clinical Interview for DSM-IV, about the most common symptoms and duration of recent threshold and subthreshold hypomanic episodes. Data were recorded between 2002 and 2006. Four different samples, assessed with the same methodology, were pooled for the present analyses. Tetrachoric factor analysis was used to identify core hypomanic symptoms. Distribution of symptoms by kernel estimation was inspected for bimodality. Validity of core hypomania was tested by receiver operating characteristic (ROC) analysis. The distribution of subthreshold and threshold hypomanic episodes did not show bimodality. Tetrachoric factor analysis found 2 uncorrelated factors: factor 1 included the "classic" symptoms elevated mood, inflated self-esteem, decreased need for sleep, talkativeness, and increase in goal-directed activity (overactivity); factor 2 included the "nonspecific" symptoms irritable mood, racing/crowded thoughts, and distractibility. Factor 1 discriminatory accuracy for distinguishing BP-II versus MDD was high (ROC area = 0.94). The distribution of the 5-symptom episodes of factor 1 showed clear-cut bimodality. Similar results were found for episodes limited to 3 behavioral symptoms of factor 1 (decreased need for sleep, talkativeness, and overactivity) and 4 behavioral symptoms of factor 1 (adding elevated mood), with high discriminatory accuracy. A core, categorical DSM-IV hypomania was found that included 3 to 5 symptoms, ie, behavioral symptoms and elevated mood. Behavioral symptoms (overactivity domain

Comorbilidades psiquiátricas en los trastornos del espectro autista: estudio comparativo entre los criterios DSM-IV-TR y DSM-5

Directory of Open Access Journals (Sweden)

Marina Romero

2016-01-01

Full Text Available Antecedentes/Objetivo: Los Trastornos del Espectro Autista (TEA incluyen un grupo heterogéneo en cuanto a su presentación clínica, lo que supone un desafío a nivel de caracterización diagnóstica. Por consiguiente, el objetivo principal de la clasificación DSM-5 debería de ser identificar subgrupos de ASD que incluyan severidad y comorbilidades psiquiátricas. El objetivo principal de este estudio es explorar las comorbilidades diagnósticas que pueden ser relevantes como descriptores de fenotipos autistas así como la severidad de los síntomas de autismo y comparar los resultados de las diferentes criterios de clasificación entre el DSM-IV-TR y el DSM-5. Método: Se realiza un estudio comparati - vo de severidad y comorbilidades psiquiátricas entre una muestra con diagnóstico de Trastorno Generalizado del Desarrollo, según criterios DSM-IV-TR, y una muestra que cumplía también criterios para TEA según la clasificación DSM-5. La muestra fue obtenida en centros educativos ( n =123. Las comorbilidades psiquiátricas y la severidad de los síntomas se evaluaron a través del The Nisonger Child Behavior Rating Form , entrevista clínica y el Inventario de Trastorno del Espectro Autista, respectivamente. Las comorbi - lidades estudiadas fueron ansiedad, alteraciones de la conducta alimentaria, auto-agre - sividad, hetero-agresividad, autolesiones, trastorno obsesivo-compulsivo y déficit de atención e hiperactividad. Resultados: Se encontraron diferencias estadísticamente sig - nificativas entre ambos grupos para trastorno obsesivo-compulsivo , alteraciones de la conducta alimentaria y severidad . Conclusiones: Se apoya la hipótesis de que los indivi - duos que cumplen criterios diagnósticos según DSM-5 tienen mayor severidad sintomáti - ca, no sólo con respecto a los síntomas autistas centrales, sino también en relación con comorbilidades psiquiátricas.

ADHD Rating Scale-IV: Checklists, Norms, and Clinical Interpretation

Science.gov (United States)

Pappas, Danielle

2006-01-01

This article reviews the "ADHD Rating Scale-IV: Checklist, norms, and clinical interpretation," is a norm-referenced checklist that measures the symptoms of attention deficit/hyperactivity disorder (ADHD) according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric…

Reconceptualizing personality pathology in DSM-5: limitations in evidence for eliminating dependent personality disorder and other DSM-IV syndromes.

Science.gov (United States)

Bornstein, Robert F

2011-04-01

The DSM-5 Personality and Personality Disorders Workgroup proposed that five DSM-IV personality disorders be eliminated as formal diagnostic categories (paranoid, schizoid, histrionic, narcissistic, and dependent), because these syndromes purportedly have low clinical utility and minimal evidence for validity. Scrutiny of studies cited in support of this proposal reveals difficulties in three areas: (1) Inadequate information regarding parameters of the literature search; (2) Mixed empirical support for proposed changes; and (3) Selective attention to certain disorders and not others. Review of validity and clinical utility data related to dependent personality disorder indicates that evidence regarding this syndrome does not differ from that of syndromes proposed for retention in DSM-5. Limitations in the research base cited by the workgroup illuminates gaps in the personality disorder literature, and may serve as a starting point for systematic research on personality pathology so that adequate empirical data are available to decide which syndromes to retain, revise, or remove in future versions of the diagnostic manual.

A multivariate twin study of the DSM-IV criteria for antisocial personality disorder.

Science.gov (United States)

Kendler, Kenneth S; Aggen, Steven H; Patrick, Christopher J

2012-02-01

Many assessment instruments for psychopathy are multidimensional, suggesting that distinguishable factors are needed to effectively capture variation in this personality domain. However, no prior study has examined the factor structure of the DSM-IV criteria for antisocial personality disorder (ASPD). Self-report questionnaire items reflecting all A criteria for DSM-IV ASPD were available from 4291 twins (including both members of 1647 pairs) from the Virginia Adult Study of Psychiatric and Substance Use Disorders. Exploratory factor analysis and twin model fitting were performed using, respectively, Mplus and Mx. Phenotypic factor analysis produced evidence for two correlated factors: aggressive-disregard and disinhibition. The best-fitting multivariate twin model included two genetic and one unique environmental common factor, along with criteria-specific genetic and environmental effects. The two genetic factors closely resembled the phenotypic factors and varied in their prediction of a range of relevant criterion variables. Scores on the genetic aggressive-disregard factor score were more strongly associated with risk for conduct disorder, early and heavy alcohol use, and low educational status, whereas scores on the genetic disinhibition factor score were more strongly associated with younger age, novelty seeking, and major depression. From a genetic perspective, the DSM-IV criteria for ASPD do not reflect a single dimension of liability but rather are influenced by two dimensions of genetic risk reflecting aggressive-disregard and disinhibition. The phenotypic structure of the ASPD criteria results largely from genetic and not from environmental influences. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

DSM-5 Gambling Disorder: Prevalence and Characteristics in a Substance Use Disorder Sample

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Rennert, Lior; Denis, Cécile; Peer, Kyle; Lynch, Kevin G.; Gelernter, Joel; Kranzler, Henry R.

2014-01-01

Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) replaced the DSM-IV diagnosis of Pathological Gambling (PG) with Gambling Disorder (GD). GD requires four rather than five criteria for the diagnosis and excludes the “Illegal Acts” criterion. We examined the prevalence of GD and its characteristics and validity in a substance use disorder (SUD) sample. Methods Participants (N=6,613) in genetic studies of substance dependence underwent a semi-structured psychiatric interview. Individuals who reported ever having gambled $10 at least monthly (n = 1,507) were the focus of the analyses. Results Approximately one-third of acknowledged gamblers (n = 563; 8.5% of the total sample) received both PG (DSM-IV) and GD (DSM-5) diagnoses and 678 (10.3% of the total) received a DSM-5 diagnosis, representing an increase of 20.4% relative to DSM-IV. Although the three groups were comparable demographically, the DSM-5-Only group was intermediate between the other two groups on the prevalence of comorbid substance use disorders, the distribution of DSM-IV PG criteria endorsed, and the types of gambling reported. Multinomial logistic regression analysis showed that the DSM-5-Only group was more likely than the No-Diagnosis group and less likely than the Both-Diagnoses group to acknowledge a gambling problem. Conclusion There was a high prevalence of PG in this SUD sample. Analysis of non-DSM variables suggested that the increased sensitivity of the DSM-5 GD diagnosis successfully identifies a broader set of individuals with clinically significant gambling-related problems. Prospective studies of individuals with GD are needed to validate this finding. PMID:24490711

The validity of the DSM-IV diagnostic classification system of non-affective psychoses

NARCIS (Netherlands)

Korver-Nieberg, Nikie; Quee, Piotr J.; Boos, Heleen B.; Simons, Claudia J.; Kahn, René S.; Cahn, Wiepke; Linszen, Don H.; de Haan, Lieuwe; van Os, Jim; Krabbendam, Lydia; Myin-Germeys, Inez; Wiersma, Durk; Bruggeman, Richard; van den Berg, S. E.; Schroeder, C. L. A.; van der Valk, R.; Dekker, N. [=Nienke; Meijer, C. J.; Korver, N.; Boyette, L. N.; Meijer, J.; van Dam, D.; de Rijke, I.; Huinink, S.; de Vries, R. J.; Jansen, M.; Bos, D.; Hoen, W. P.; te West, E. M.; Groeneveld, S. H. J.; Vergunst, E. M.; Swets, M.; Vothknecht, S.; Poleacov, I.; van Dijk, D.; de Metz, S.; Hasty, M. T.; Geertsa, G.; de Baaij, P. M.; Metzger, A.; van Beveren, N. J. M.; Baldini, M.; Grimbergen, F. D.; Boerma, M. A. M.; van der Werf, M.; Habets, P.; Derks, E. M.; van Leeuwen, M.; Verweij, K.; van Wijk, M.

2011-01-01

The schizophrenia and other non-affective disorders categories listed in the DSM-IV, are currently under revision for the development of the fifth edition. The aim of the present study is to demonstrate the validity of these categories by investigating possible differences between diagnostic patient

The validity of the DSM-IV diagnostic classification system of non-affective psychoses

NARCIS (Netherlands)

Korver-Nieberg, Nikie; Quee, Piotr J.; Boos, Heleen B.; Simons, Claudia J.

2011-01-01

Objective: The schizophrenia and other non-affective disorders categories listed in the DSM-IV, are currently under revision for the development of the fifth edition. The aim of the present study is to demonstrate the validity of these categories by investigating possible differences between

Culture and the anxiety disorders: recommendations for DSM-V.

Science.gov (United States)

Lewis-Fernández, Roberto; Hinton, Devon E; Laria, Amaro J; Patterson, Elissa H; Hofmann, Stefan G; Craske, Michelle G; Stein, Dan J; Asnaani, Anu; Liao, Betty

2010-02-01

The anxiety disorders specified in the fourth edition, text revision, of The Diagnostic and Statistical Manual (DSM-IV-TR) are identified universally in human societies, and also show substantial cultural particularities in prevalence and symptomatology. Possible explanations for the observed epidemiological variability include lack of measurement equivalence, true differences in prevalence, and limited validity or precision of diagnostic criteria. One central question is whether, through inadvertent "over-specification" of disorders, the post-DSM-III nosology has missed related but somewhat different presentations of the same disorder because they do not exactly fit specified criteria sets. This review canvases the mental health literature for evidence of cross-cultural limitations in DSM-IV-TR anxiety disorder criteria. Searches were conducted of the mental health literature, particularly since 1994, regarding cultural or race/ethnicity-related factors that might limit the universal applicability of the diagnostic criteria for six anxiety disorders. Possible mismatches between the DSM criteria and the local phenomenology of the disorder in specific cultural contexts were found for three anxiety disorders in particular. These involve the unexpectedness and 10-minute crescendo criteria in Panic Disorder; the definition of social anxiety and social reference group in Social Anxiety Disorder; and the priority given to psychological symptoms of worry in Generalized Anxiety Disorder. Limited evidence was found throughout, particularly in terms of neurobiological markers, genetic risk factors, treatment response, and other DSM-V validators that could help clarify the cross-cultural applicability of criteria. On the basis of the available data, options and preliminary recommendations for DSM-V are put forth that should be further evaluated and tested.

The centrality of DSM and non-DSM depressive symptoms in Han Chinese women with major depression.

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Kendler, Kenneth S; Aggen, Steven H; Flint, Jonathan; Borsboom, Denny; Fried, Eiko I

2018-02-01

We compared DSM-IV criteria for major depression (MD) with clinically selected non-DSM criteria in their ability to represent clinical features of depression. We conducted network analyses of 19 DSM and non-DSM symptoms of MD assessed at personal interview in 5952 Han Chinese women meeting DSM-IV criteria for recurrent MD. We estimated an Ising model (the state-of-the-art network model for binary data), compared the centrality (interconnectedness) of DSM-IV and non-DSM symptoms, and investigated the community structure (symptoms strongly clustered together). The DSM and non-DSM criteria were intermingled within the same symptom network. In both the DSM-IV and non-DSM criteria sets, some symptoms were central (highly interconnected) while others were more peripheral. The mean centrality of the DSM and non-DSM criteria sets did not significantly differ. In at least two cases, non-DSM criteria were more central than symptomatically related DSM criteria: lowered libido vs. sleep and appetite changes, and hopelessness versus worthlessness. The overall network had three sub-clusters reflecting neurovegetative/mood symptoms, cognitive changes and anxiety/irritability. The sample were severely ill Han Chinese females limiting generalizability. Consistent with prior historical reviews, our results suggest that the DSM-IV criteria for MD reflect one possible sub-set of a larger pool of plausible depressive symptoms and signs. While the DSM criteria on average perform well, they are not unique and may not be optimal in their ability to describe the depressive syndrome. Copyright © 2017. Published by Elsevier B.V.

DSM-5

DEFF Research Database (Denmark)

Arendt, Mikkel; Jónsson, Hjalti; Hougaard, Esben

2013-01-01

I maj måned i år udkom den længe ventede opdatering af diagnoselisten DSM-IV. Her følger en gennemgang af indholdet......I maj måned i år udkom den længe ventede opdatering af diagnoselisten DSM-IV. Her følger en gennemgang af indholdet...

Screening for PTSD among detained adolescents: Implications of the changes in the DSM-5.

Science.gov (United States)

Modrowski, Crosby A; Bennett, Diana C; Chaplo, Shannon D; Kerig, Patricia K

2017-01-01

Screening for posttraumatic stress disorder (PTSD) is highly relevant for youth involved in the juvenile justice system given their high rates of trauma exposure and posttraumatic stress symptoms. However, to date, no studies have investigated the implications of the recent revisions to the Diagnostic and Statistical Manual for Mental Disorders (5th ed., DSM-5; American Psychiatric Association [APA], 2013) diagnostic criteria for PTSD for screening in this population. To this end, the present study compared PTSD screening rates using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; APA, 2013) versus DSM-5 criteria in a group of detained adolescents. Participants included 209 youth (60 girls) aged 13-19 (M = 15.97, SD = 1.24). Youth completed measures of lifetime trauma exposure and past-month posttraumatic stress symptoms. Over 95% of youth in the sample reported exposure to at least 1 type of traumatic event. Approximately 19.60% of the sample screened positive for PTSD according to the DSM-5 compared to 17.70% according to the DSM-IV-TR. Girls were more likely than boys to screen positive for PTSD according to the DSM-IV-TR compared to the DSM-5. The main factors accounting for the differences in screening rates across the versions of PTSD criteria involved the removal of Criterion A2 from the DSM-5, the separation of avoidance symptoms (Criterion C) into their own cluster, the addition of a cluster involving negative alterations in cognitions and mood (Criterion D), and revisions to the cluster of arousal symptoms (Criterion E). Future research should continue to investigate gender differences in PTSD symptoms in youth and consider the implications of these diagnostic changes for the accurate diagnosis and referral to treatment of adolescents who demonstrate posttraumatic stress reactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Classification of body dysmorphic disorder - what is the advantage of the new DSM-5 criteria?

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Schieber, Katharina; Kollei, Ines; de Zwaan, Martina; Martin, Alexandra

2015-03-01

In DSM-5 the diagnosis of body dysmorphic disorder (BDD) has been subjected to two important changes: Firstly, BDD has been assigned to the category of obsessive-compulsive and related disorders. Secondly, a new criterion has been defined requiring the presence of repetitive behaviors or mental acts in response to appearance concerns. The aims of this study were to report the prevalence rates of BDD based on a DSM-5 diagnosis, and to evaluate the impact of the recently introduced DSM-5 criteria for BDD by comparing the prevalence rates (DSM-5 vs. BDD-criteria (DSM-IV/DSM-5), dysmorphic concerns, and depressive symptoms, were assessed in a representative sample of the German general population (N=2129, aged 18-65years). The association between BDD case identification based on DSM-IV and DSM-5 was strong (Phi=.95, p<.001), although point prevalence of BDD according to DSM-5 was slightly lower (2.9%, n=62 vs. 3.2%, n=68). Approximately one third of the identified BDD (DSM-5) cases reported time-consuming behavioral acts in response to appearance concerns. In detail, 0.8% of the German general population fulfilled the BDD criteria and reported repetitive acts of at least one hour/day. The revised criteria of BDD in DSM-5 do not seem to have an impact on prevalence rates. However, the recently added B-criterion reflects more precisely the clinical symptoms of BDD, and may be useful for distinguishing between various severity levels related to repetitive behaviors/mental acts. Copyright © 2015 Elsevier Inc. All rights reserved.

Delusional versus nondelusional body dysmorphic disorder: recommendations for DSM-5

Science.gov (United States)

Phillips, Katharine A.; Hart, Ashley S.; Simpson, Helen Blair; Stein, Dan J.

2016-01-01

The core feature of body dysmorphic disorder (BDD) is distressing or impairing preoccupation with nonexistent or slight defects in one’s physical appearance. BDD beliefs are characterized by varying degrees of insight, ranging from good (ie, recognition that one’s BDD beliefs are not true) through “absent insight/delusional” beliefs (ie, complete conviction that one’s BDD beliefs are true). The Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. (DSM-III-R) and The Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) classified BDD’s nondelusional form in the somatoform section of the manual and its delusional form in the psychosis section, as a type of delusional disorder, somatic type (although DSM-IV allowed double-coding of delusional BDD as both a psychotic disorder and BDD). However, little or no evidence on this issue was available when these editions were published. In this article, we review the classification of BDD’s delusional and nondelusional variants in earlier editions of DSM and the limitations of their approaches. We then review empirical evidence on this topic, which has become available since DSM-IV was developed. Available evidence indicates that across a range of validators, BDD’s delusional and nondelusional variants have many more similarities than differences, including response to pharmacotherapy. Based on these data, we propose that BDD’s delusional and nondelusional forms be classified as the same disorder and that BDD’s diagnostic criteria include an insight specifier that spans a range of insight, including absent insight/delusional BDD beliefs. We hope that this recommendation will improve care for patients with this common and often-severe disorder. This increased understanding of BDD may also have implications for other disorders that have an “absent insight/delusional” form. PMID:23659348

Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples.

Science.gov (United States)

Stammel, Nadine; Abbing, Eva M; Heeke, Carina; Knaevelsrud, Christine

2015-01-01

The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11). The present study investigated the impact of these changes in two different post-conflict samples. Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.

Diagnostic Distribution of eating disorders: Comparison between DSMIV- TR and DSM-5.

Science.gov (United States)

Serrano-Troncoso, Eduardo; Cañas, Laura; Carbonell, Xavier; Carulla, Marta; Palma, Carolina; Matalí, Josep; Dolz, Montse

2017-01-01

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a significant revision of Eating Disorders (ED). The objective of this study is to compare the distribution of diagnosis of ED in adolescents according to DSM-VI-TR and DSM-5 criteria. A second objective is to study the psychopathological differences between patients with ED (based on DSM-IV-TR) and those whose diagnosis changed by applying DSM-5 criteria. One hundred and one adolescents diagnosed with ED (mean: 14.68 years; SD: 1.46) were evaluated with clinical interviews and scales for eating psychopathology, perfectionism, anxiety, and depression. Applying the DSM-5 criteria led to a significant decrease in the diagnosed cases of Eating Disorders Not Otherwise Specified (EDNOS) (from 34.7% to 23.8%; p<0.001) and to a significant increase in those of anorexia nervosa (AN) (from 58.4% to 66.3%; p<0.001) and of bulimia nervosa (BN) (from 6.9% to 8.9%; p<0.001). No significant psychopathological differences were found between patients diagnosed with AN and BN based on DSM-IV-TR criteria and those newly diagnosed with AN and BN based on DSM-5 criteria. Using DSM-5 criteria for adolescents with ED leads to a significant decrease in the frequency of an EDNOS diagnosis. As similar psychopathological characteristics were observed between ED patients diagnosed based on DSM-IV-TR and those who were switched from EDNOS to AN or BN based on DSM-5, we conclude that the new criteria for ED in DSM-5 are valid for an adolescent population.

Substance dependence and non-dependence in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD): can an identical conceptualization be achieved?

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Saunders, John B

2006-09-01

This review summarizes the history of the development of diagnostic constructs that apply to repetitive substance use, and compares and contrasts the nature, psychometric performance and utility of the major diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) diagnostic systems. The available literature was reviewed with a particular focus on diagnostic concepts that are relevant for clinical and epidemiological practice, and so that research questions could be generated that might inform the development of the next generation of DSM and ICD diagnoses. The substance dependence syndrome is a psychometrically robust and clinically useful construct, which applies to a range of psychoactive substances. The differences between the DSM fourth edition (DSM-IV) and the ICD tenth edition (ICD-10) versions are minimal and could be resolved. DSM-IV substance abuse performs moderately well but, being defined essentially by social criteria, may be culture-dependent. ICD-10 harmful substance use performs poorly as a diagnostic entity. There are good prospects for resolving many of the differences between the DSM and ICD systems. A new non-dependence diagnosis is required. There would also be advantages in a subthreshold diagnosis of hazardous or risky substance use being incorporated into the two systems. Biomedical research can be drawn upon to define a psychophysiological 'driving force' which could underpin a broad spectrum of substance use disorders.

[Panic disorders and agoraphobia: Freudian concepts and DSM IV].

Science.gov (United States)

Manfredi de Poderoso, Clelia; Linetzky, Leonardo

2003-01-01

This paper refers to the relationship between panic and agoraphobia, regarding Panic Disorder and Agoraphobia (DSM IV), from two different points of view coming from Psychoanalysis and Psychiatry. Psychoanalysis (S. Freud) considers agoraphobia as a defensive organization to avoid anxiety, not bound to the original conflict, but to substitutive formation. The exposure to space (its unconscious significance) provokes panic attack. The psychiatric approach considers agoraphobia, meaningless by its own, as a consequence of spontaneous panic attacks. The etiology is referred to neurophysiological mechanisms. The authors reviewd D Klein's hypothesis about panic and Freud's theories on anxiety, partiularly Anxiety Neurosis.

The development of a research agenda for substance use disorders diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V).

Science.gov (United States)

Saunders, John B; Schuckit, Marc A

2006-09-01

This paper describes the background to the establishment of the Substance Use Disorders Workgroup, which was charged with developing the research agenda for the development of the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It summarizes 18 articles that were commissioned to inform that process. A preliminary list of research topics, developed at the DSM-V Launch Conference in 2004, led to the identification of subjects that were subject to formal presentations and detailed discussion at the Substance Use Disorders Conference in February 2005. The 18 articles presented in this supplement examine: (1) categorical versus dimensional diagnoses; (2) the neurobiological basis of substance use disorders; (3) social and cultural perspectives; (4) the crosswalk between DSM-IV and the International Classification of Diseases Tenth Revision (ICD-10); (5) comorbidity of substance use disorders and mental health disorders; (6) subtypes of disorders; (7) issues in adolescence; (8) substance-specific criteria; (9) the place of non-substance addictive disorders; and (10) the available research resources. In the final paper a broadly based research agenda for the development of diagnostic concepts and criteria for substance use disorders is presented.

Accuracy of the Composite International Diagnostic Interview (CIDI 2.1 for diagnosis of post-traumatic stress disorder according to DSM-IV criteria Validade do diagnóstico de transtorno de estresse pós-traumático do Composite International Diagnostic Interview (CIDI 2.1 de acordo com os critérios diagnósticos da DSM-IV

Directory of Open Access Journals (Sweden)

Maria Inês Quintana

2012-07-01

Full Text Available The objective was to study the accuracy of the post-traumatic stress disorder (PTSD section of the Composite International Diagnostic Interview (CIDI 2.1 DSM-IV diagnosis, using the Structured Clinical Interview (SCID as gold standard, and compare the ICD-10 and DSM IV classifications for PTSD. The CIDI was applied by trained lay interviewers and the SCID by a psychologist. The subjects were selected from a community and an outpatient program. A total of 67 subjects completed both assessments. Kappa coefficients for the ICD-10 and the DSM IV compared to the SCID diagnosis were 0.67 and 0.46 respectively. Validity for the DSM IV diagnosis was: sensitivity (51.5%, specificity (94.1%, positive predictive value (9.5%, negative predictive value (66.7%, misclassification rate (26.9%. The CIDI 2.1 demonstrated low validity coefficients for the diagnosis of PTSD using DSM IV criteria when compared to the SCID. The main source of discordance in this study was found to be the high probability of false-negative cases with regards to distress and impairment as well as to avoidance symptoms.O objetivo deste artigo foi estudar a validade concorrente da seção de transtorno de estresse pós-traumático do CIDI 2.1 critérios DSM IV, utilizando o Structured Clinical Interview (SCID como padrão-ouro, e comparar o diagnóstico de TEPT entre CID-10 e DSM IV. O CIDI foi aplicado por entrevistadores leigos treinados e o SCID por uma psicóloga. A amostra foi composta por sujeitos da comunidade e de um ambulatório de especialidade psiquiátrica. Sessenta e sete sujeitos completaram ambos os questionários. O coeficiente kappa foi de 0.46 ao comparar DSM IV com a SCID. A validade diagnóstica usando critérios do DSM IV foi de: sensibilidade = 51.5%, especificidade = 94.1%, valor preditivo positivo = 89.5%, valor preditivo negativo = 66.7%, taxa de classificação incorreta = 26.9%. O CIDI 2.1 apresentou valores baixos para os coeficientes de validação de TEPT

Toward DSM-V: An Item Response Theory Analysis of the Diagnostic Process for DSM-IV Alcohol Abuse and Dependence in Adolescents

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Gelhorn, Heather; Hartman, Christie; Sakai, Joseph; Stallings, Michael; Young, Susan; Rhee, So Hyun; Corley, Robin; Hewitt, John; Hopger, Christian; Crowley, Thomas D.

2008-01-01

Clinical interviews of approximately 5,587 adolescents revealed that DSM-IV diagnostic categories were found to be different in terms of the severity of alcohol use disorders (AUDs). However, a substantial inconsistency and overlap was found in severity of AUDs across categories. The need for an alternative diagnostic algorithm which considers all…

Conceptions of narcissism and the DSM-5 pathological personality traits.

Science.gov (United States)

Wright, Aidan G C; Pincus, Aaron L; Thomas, Katherine M; Hopwood, Christopher J; Markon, Kristian E; Krueger, Robert F

2013-06-01

The Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) features two conceptions of Narcissistic Personality Disorder (NPD), one based on the retained DSM-IV's categorical diagnosis and the other based on a model that blends impairments in personality functioning with a specific trait profile intended to recapture DSM-IV NPD. Nevertheless, the broader literature contains a richer array of potential conceptualizations of narcissism, including distinguishable perspectives from psychiatric nosology, clinical observation and theory, and social/personality psychology. This raises questions about the most advantageous pattern of traits to use to reflect various conceptions of narcissistic pathology via the Personality Inventory for the DSM-5 (PID-5). In this study, we examine the associations of the Personality Disorder Questionnaire-Narcissistic Personality Disorder scale, Narcissistic Personality Inventory-16, and the Pathological Narcissism Inventory and the PID-5 dimensions and facets in a large sample (N = 1,653) of undergraduate student participants. Results point to strong associations with PID-5 Antagonism scales across narcissism measures, consistent with the DSM-5's proposed representation of NPD. However, additional notable associations emerged with PID-5 Negative Affectivity and Psychoticism scales when considering more clinically relevant narcissism measures.

DSM-5 field survey

DEFF Research Database (Denmark)

Lochner, Christine; Grant, Jon E; Odlaug, Brian Lawrence

2012-01-01

The aim of this multisite field survey was to examine the DSM-IV-TR criteria, proposed DSM-5 diagnostic criteria, as well as a number of possible additional diagnostic criteria, in patients with hair-pulling disorder (HPD, or trichotillomania).......The aim of this multisite field survey was to examine the DSM-IV-TR criteria, proposed DSM-5 diagnostic criteria, as well as a number of possible additional diagnostic criteria, in patients with hair-pulling disorder (HPD, or trichotillomania)....

Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V): consider the later life context.

Science.gov (United States)

Balsis, Steve; Segal, Daniel L; Donahue, Cailin

2009-10-01

The categorical measurement approach implemented by the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) personality disorder (PD) diagnostic system is theoretically and pragmatically limited. As a result, many prominent psychologists now advocate for a shift away from this approach in favor of more conceptually sound dimensional measurement. This shift is expected to improve the psychometric properties of the personality disorder (PD) diagnostic system and make it more useful for clinicians and researchers. The current article suggests that despite the probable benefits of such a change, several limitations will remain if the new diagnostic system does not closely consider the context of later life. A failure to address the unique challenges associated with the assessment of personality in older adults likely will result in the continued limited validity, reliability, and utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM) system for this growing population. This article discusses these limitations and their possible implications. (c) 2009 APA, all rights reserved.

Diagnostic Utility of the ADI-R and DSM-5 in the Assessment of Latino Children and Adolescents.

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Magaña, Sandy; Vanegas, Sandra B

2017-05-01

Latino children in the US are systematically underdiagnosed with Autism Spectrum Disorder (ASD); therefore, it is important that recent changes to the diagnostic process do not exacerbate this pattern of under-identification. Previous research has found that the Autism Diagnostic Interview-Revised (ADI-R) algorithm, based on the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition, Text Revision (DSM-IV-TR), has limitations with Latino children of Spanish speaking parents. We evaluated whether an ADI-R algorithm based on the new DSM-5 classification for ASD would be more sensitive in identifying Latino children of Spanish speaking parents who have a clinical diagnosis of ASD. Findings suggest that the DSM-5 algorithm shows better sensitivity than the DSM-IV-TR algorithm for Latino children.

Neurodevelopmental disorders: cluster 2 of the proposed meta-structure for DSM-V and ICD-11.

Science.gov (United States)

Andrews, G; Pine, D S; Hobbs, M J; Anderson, T M; Sunderland, M

2009-12-01

DSM-IV and ICD-10 are atheoretical and largely descriptive. Although this achieves good reliability, the validity of diagnoses can be increased by an understanding of risk factors and other clinical features. In an effort to group mental disorders on this basis, five clusters have been proposed. We now consider the second cluster, namely neurodevelopmental disorders. We reviewed the literature in relation to 11 validating criteria proposed by a DSM-V Task Force Study Group. This cluster reflects disorders of neurodevelopment rather than a 'childhood' disorders cluster. It comprises disorders subcategorized in DSM-IV and ICD-10 as Mental Retardation; Learning, Motor, and Communication Disorders; and Pervasive Developmental Disorders. Although these disorders seem to be heterogeneous, they share similarities on some risk and clinical factors. There is evidence of a neurodevelopmental genetic phenotype, the disorders have an early emerging and continuing course, and all have salient cognitive symptoms. Within-cluster co-morbidity also supports grouping these disorders together. Other childhood disorders currently listed in DSM-IV share similarities with the Externalizing and Emotional clusters. These include Conduct Disorder, Attention Deficit Hyperactivity Disorder and Separation Anxiety Disorder. The Tic, Eating/Feeding and Elimination disorders, and Selective Mutisms were allocated to the 'Not Yet Assigned' group. Neurodevelopmental disorders meet some of the salient criteria proposed by the American Psychiatric Association (APA) to suggest a classification cluster.

Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples

Directory of Open Access Journals (Sweden)

Nadine Stammel

2015-05-01

Full Text Available Background: The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11. Objective: The present study investigated the impact of these changes in two different post-conflict samples. Method: Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV. Results: Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample. Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. Conclusions: The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.

Intergenerational Childhood Maltreatment in Persons with DSM-IV Pathological Gambling and Their First-Degree Relatives.

Science.gov (United States)

Shultz, Samuel K; Shaw, Martha; McCormick, Brett; Allen, Jeff; Black, Donald W

2016-09-01

This study investigates the characteristics of individuals with DSM-IV pathological gambling (PG) who experienced childhood maltreatment and rates of maltreatment occurring in their first-degree relatives (FDRs). 94 subjects with DSM-IV PG, 91 controls, and 312 FDRs were assessed for childhood maltreatment as part of a family study of PG. Maltreatment was evaluated using the Revised Childhood Experiences Questionnaire. The Family Assessment Device was used to evaluate the functionality of the PG subject's (or control's) family of origin. Data were analyzed using logistic regression by the method of generalized estimating equations. Rates of maltreatment were significantly higher in subjects with PG than controls (61 vs. 25 %, P childhood maltreatment in persons with PG is common and intergenerational. Rates of maltreatment in FDRs of PG subjects are high, particularly among those who experienced abuse. The implications of the findings are discussed.

Similarities and differences between excessive exercising anorexia nervosa patients compared with DSM-IV defined anorexia nervosa subtypes.

Science.gov (United States)

Kiezebrink, K; Campbell, D; Mann, E; Blundell, J

2009-12-01

This study describes anorexia nervosa (AN) patients who use excessive exercise for weight management and how this behaviour relates to the classical Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) sub-grouping of AN. The study compared 428 clinical AN patients with 119 age and gender-matched controls. The AN cases were initially dichotomised according to DSM-IV subtype criteria into restricting (RAN; N=198) and binge-purge (BPAN; N=230) anorexia. The psychometric instruments were chosen to reflect key features concerning the diagnosis of eating disorders and characteristics of eating and food behaviour and included the 26-item Eating Attitude Test (EAT-26), Three Factor Eating Questionnaire (TFEQ), Dutch Eating Behaviour Questionnaire (DEBQ), Eysenck Personality Inventory (EPI) and Rosenberg Self-Esteem scale (RSE). Structured clinical interviews (1) were carried out in order to identify the subgroup of patients who use excessive exercise in order to facilitate weight control (EAN). The three groups (RAN, BPAN, EAN) did not differ in measures of current age, current body mass index, age of onset of AN and measures of restrained eating. However, significant differences were observed on EAT-26, DEBQ emotional and external factors, TFEQ disinhibition and hunger factors, EPI extraversion and neuroticism, and self-esteem. The EAN were similar to the RAN on the majority of variables but showed significant differences on extraversion, neuroticism, self-esteem and disease pathology (EAT-26). Compared with BPAN, EAN had lower disease pathology (EAT-26 scores), scored higher on the EPI extraversion scale, lower on the neuroticism scale and had greater self-esteem. The EAN also displayed significantly lower emotional and external eating (DEBQ) than BPAN and significantly lower disinhibition and hunger scores (TFEQ). These data suggest that EAN group display a mixed profile of characteristics resembling both BPAN and RAN. When EAN are defined as

Mapping the manuals of madness : Comparing the ICD-10 and DSM-IV-TR using a network approach

NARCIS (Netherlands)

Tio, P.; Epskamp, S.; Noordhof, A.; Borsboom, D.

2016-01-01

The International Classification of Diseases and Related Health Problems (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) represent dominant approaches to diagnosis of mental disorders. However, it is unclear how these alternative systems relate to each other when taking

Mapping the manuals of madness : Comparing the ICD-10 and DSM-IV-TR using a network approach

NARCIS (Netherlands)

Tio, P.; Epskamp, S.; Noordhof, A.; Borsboom, D.

2017-01-01

The International Classification of Diseases and Related Health Problems (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) represent dominant approaches to diagnosis of mental disorders. However, it is unclear how these alternative systems relate to each other when taking

On the road to DSM-V and ICD-11.

Science.gov (United States)

Kupfer, David J; Regier, Darrel A; Kuhl, Emily A

2008-11-01

Development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has been ongoing since 1994, though official release will not occur for another 4 years. Potential revisions are being derived from multiple sources, including building on perceived limitations of DSM-IV; broad-based literature reviews; secondary and primary data analyses; and discussions between global members of the mental health community. The current focus on aligning DSM with the International Classification of Diseases-11 (ICD-11) speaks to the importance of creating a unified text that embraces cross-cutting issues of diagnostics, such as developmental, age-related, and cultural phenomena. International discourse is vital to this process and has been fostered by a National Institutes of Health-sponsored conference series on diagnosis-specific topics. From this series, the DSM-V Task Force developed the following set of revision principals to guide the efforts of the DSM-V Work Groups: grounding recommendations in empirical evidence; maintaining continuity with previous editions of DSM; removing a priori limitations on the amount of changes DSM-V may incur; and maintaining DSM's status as a living document. With work group formation complete, members are currently carrying out the research and revision recommendations proposed during the conference series. Ongoing activities include adding specialized advisors to each work group; completing literature reviews and planning data analyses; and forming study groups to discuss integration of cross-cutting issues (e.g., developmental lifespan factors; formation of diagnostic spectra). The road to DSM-V and ICD-11 has been challenging, but members continue to work diligently in their goal of constructing the most harmonious, scientifically sound, and clinically relevant DSM to date.

38 CFR 4.125 - Diagnosis of mental disorders.

Science.gov (United States)

2010-07-01

... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the... substantiate the diagnosis. (b) If the diagnosis of a mental disorder is changed, the rating agency shall...

A proposal for including nomophobia in the new DSM-V.

Science.gov (United States)

Bragazzi, Nicola Luigi; Del Puente, Giovanni

2014-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.

Factor structure of the Psychiatric Diagnostic Screening Questionnaire (PDSQ), a screening questionnaire for DSM-IV axis I disorders.

Science.gov (United States)

Sheeran, T; Zimmerman, M

2004-03-01

We examined the factor structure of the Psychiatric Diagnostic Screening Questionnaire (PDSQ), a 125-item self-report scale that screens for 15 of the most common Axis I psychiatric disorders for which patients seek treatment in outpatient settings. The sample consisted of 2440 psychiatric outpatients. Thirteen factors were extracted. Ten mapped directly onto the DSM-IV diagnosis for which they were designed and one represented suicidal ideation. The remaining two factors reflected closely related disorders: Panic Disorder/Agoraphobia, and Somatization/Hypochondriasis. A psychosis factor was not extracted. Overall, the factor structure of the PDSQ was consistent with the DSM-IV nosology upon which it was developed.

Alcoholgerelateerde cognitieve stoornissen in de DSM-5

NARCIS (Netherlands)

Walvoort, S.J.W.; Wester, A.J.; Doorakkers, M.C.; Kessels, R.P.C.; Egger, J.I.M.

2016-01-01

Achtergrond: Binnen de dsm-iv-tr zijn alcoholgerelateerde cognitieve stoornissen moeilijk onder te brengen, met als gevolg dat deze neurocognitieve stoornissen vaak over het hoofd worden gezien. De komst van de dsm-5 zou hierin uitkomst kunnen bieden. Doel: De dsm-5 vergelijken met de dsm-iv-tr

Short-Term Persistence of "DSM-IV" ADHD Diagnoses: Influence of Context, Age, and Gender

Science.gov (United States)

Bauermeister, Jose J.; Bird, Hector R.; Shrout, Patrick E.; Chavez, Ligia; Ramirez, Rafael; Canino, Glorisa

2011-01-01

Objective: Little is known about the effect of social context and gender on persistence of "attention-deficit/hyperactivity disorder" (ADHD) in children of early and middle school years. The study compared persistence of "DSM-IV" ADHD and ADHD not otherwise specified (NOS) over 2 years in two groups of Puerto Rican children.…

The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5.

Science.gov (United States)

Hinton, Devon E; Lewis-Fernández, Roberto

2011-09-01

There is considerable debate about the cross-cultural applicability of the posttraumatic stress disorder (PTSD) category as currently specified. Concerns include the possible status of PTSD as a Western culture-bound disorder and the validity of individual items and criteria thresholds. This review examines various types of cross-cultural validity of the PTSD criteria as defined in DSM-IV-TR, and presents options and preliminary recommendations to be considered for DSM-5. Searches were conducted of the mental health literature, particularly since 1994, regarding cultural-, race-, or ethnicity-related factors that might limit the universal applicability of the diagnostic criteria of PTSD in DSM-IV-TR and the possible criteria for DSM-5. Substantial evidence of the cross-cultural validity of PTSD was found. However, evidence of cross-cultural variability in certain areas suggests the need for further research: the relative salience of avoidance/numbing symptoms, the role of the interpretation of trauma-caused symptoms in shaping symptomatology, and the prevalence of somatic symptoms. This review also indicates the need to modify certain criteria, such as the items on distressing dreams and on foreshortened future, to increase their cross-cultural applicability. Text additions are suggested to increase the applicability of the manual across cultural contexts: specifying that cultural syndromes-such as those indicated in the DSM-IV-TR Glossary-may be a prominent part of the trauma response in certain cultures, and that those syndromes may influence PTSD symptom salience and comorbidity. The DSM-IV-TR PTSD category demonstrates various types of validity. Criteria modification and textual clarifications are suggested to further improve its cross-cultural applicability. © 2010 Wiley-Liss, Inc.

How Voting and Consensus Created the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).

Science.gov (United States)

Davies, James

2017-04-01

This paper examines how Task Force votes were central to the development of Diagnostic and Statistical Manual of Mental Disorders (DSM-III and DSM-III-R). Data were obtained through a literature review, investigation of DSM archival material housed at the American Psychiatric Association (APA), and interviews with key Task Force members of DSM-III and DSM-III-R. Such data indicate that Task Force votes played a central role in the making of DSM-III, from establishing diagnostic criteria and diagnostic definitions to settling questions about the inclusion or removal of diagnostic categories. The paper concludes that while the APA represented DSM-III, and the return to descriptive psychiatry it inaugurated, as a triumph of empirically based decision-making, the evidence presented here fails to support that view. Since the DSM is a cumulative project, and as DSM-III lives on through subsequent editions, this paper calls for a more socio-historically informed understanding of DSM's construction to be deployed in how the DSM is taught and implemented in training and clinical settings.

Factor structure of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder.

Science.gov (United States)

Grilo, C M

2004-01-01

To examine the factor structure of DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive out-patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. The eight criteria for the OCPD diagnosis were examined with reliability and correlational analyses. Exploratory factor analysis was performed to identify potential components. Cronbach's coefficient alpha for the OCPD criteria was 0.77. Principal components factor analysis with varimax rotation revealed a three-factor solution (rigidity, perfectionism, and miserliness), which accounted for 65% of variance. The DSM-IV criteria for OCPD showed good internal consistency. Exploratory factor analysis, however, revealed three components that may reflect distinct interpersonal, intrapersonal (cognitive), and behavioral features.

Schizoaffective Disorder in the DSM-5.

Science.gov (United States)

Malaspina, Dolores; Owen, Michael J; Heckers, Stephan; Tandon, Rajiv; Bustillo, Juan; Schultz, Susan; Barch, Deanna M; Gaebel, Wolfgang; Gur, Raquel E; Tsuang, Ming; Van Os, Jim; Carpenter, William

2013-10-01

Characterization of patients with both psychotic and mood symptoms, either concurrently or at different points during their illness, has always posed a nosological challenge and this is reflected in the poor reliability, low diagnostic stability, and questionable validity of DSM-IV Schizoaffective Disorder. The clinical reality of the frequent co-occurrence of psychosis and Mood Episodes has also resulted in over-utilization of a diagnostic category that was originally intended to only rarely be needed. In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, an effort is made to improve reliability of this condition by providing more specific criteria and the concept of Schizoaffective Disorder shifts from an episode diagnosis in DSM-IV to a life-course of the illness in DSM-5. When psychotic symptoms occur exclusively during a Mood Episode, DSM-5 indicates that the diagnosis is the appropriate Mood Disorder with Psychotic Features, but when such a psychotic condition includes at least a two-week period of psychosis without prominent mood symptoms, the diagnosis may be either Schizoaffective Disorder or Schizophrenia. In the DSM-5, the diagnosis of Schizoaffective Disorder can be made only if full Mood Disorder episodes have been present for the majority of the total active and residual course of illness, from the onset of psychotic symptoms up until the current diagnosis. In earlier DSM versions the boundary between Schizophrenia and Schizoaffective Disorder was only qualitatively defined, leading to poor reliability. This change will provide a clearer separation between Schizophrenia with mood symptoms from Schizoaffective Disorder and will also likely reduce rates of diagnosis of Schizoaffective Disorder while increasing the stability of this diagnosis once made. Copyright © 2013 Elsevier B.V. All rights reserved.

A diagnostic and statistical manual of mental disorders history of premenstrual dysphoric disorder.

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Zachar, Peter; Kendler, Kenneth S

2014-04-01

The proposals to include a menstruation-related mood disorder in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R), and DSM-IV led to intense public and behind-the-scenes controversy. Although the controversies surrounding the DSM-5 revision were greater in number than the controversies of the earlier revisions, the DSM-5 proposal to include a menstruation-related mood disorder was not among them. Premenstrual dysphoric disorder was made an official disorder in the DSM-5 with no significant protest. To understand the factors that led to this change, we interviewed those psychiatrists and psychologists who were most involved in the DSM-IV revision. On the basis of these interviews, we offer a list of empirical and nonempirical considerations that led to the DSM-IV compromise and explore how key alterations in these considerations led to a different outcome for the DSM-5.

How does relaxing the algorithm for autism affect DSM-V prevalence rates?

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Matson, Johnny L; Hattier, Megan A; Williams, Lindsey W

2012-08-01

Although it is still unclear what causes autism spectrum disorders (ASDs), over time researchers and clinicians have become more precise with detecting and diagnosing ASD. Many diagnoses, however, are based on the criteria established within the Diagnostic and Statistical Manual of Mental Disorders (DSM); thus, any change in these diagnostic criteria can have a great effect upon children with ASD and their families. It is predicted that the prevalence of ASD diagnoses will dramatically decrease with the adoption of the proposed DSM-5 criteria in 2013. The aim of this current study was to inspect the changes in prevalence first using a diagnostic criteria set which was modified slightly from the DSM-5 criteria (Modified-1 criteria) and again using a set of criteria which was relaxed even a bit more (Modified-2 criteria). Modified-1 resulted in 33.77 % fewer toddlers being diagnosed with ASD compared to the DSM-IV, while Modified-2 resulted in only a 17.98 % decrease in ASD diagnoses. Children diagnosed with the DSM-5 criteria exhibited the greatest levels of autism symptomatology, but the Mod-1, Mod-2, and DSM-IV groups still demonstrated significant impairments. Implications of these findings are discussed.

Neurocognitive disorders: cluster 1 of the proposed meta-structure for DSM-V and ICD-11.

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Sachdev, P; Andrews, G; Hobbs, M J; Sunderland, M; Anderson, T M

2009-12-01

In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. In this paper, we consider the validity of the first cluster, neurocognitive disorders, within this proposal. These disorders are categorized as 'Dementia, Delirium, and Amnestic and Other Cognitive Disorders' in DSM-IV and 'Organic, including Symptomatic Mental Disorders' in ICD-10. We reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force as applied to the cluster of neurocognitive disorders. 'Neurocognitive' replaces the previous terms 'cognitive' and 'organic' used in DSM-IV and ICD-10 respectively as the descriptor for disorders in this cluster. Although cognitive/organic problems are present in other disorders, this cluster distinguishes itself by the demonstrable neural substrate abnormalities and the salience of cognitive symptoms and deficits. Shared biomarkers, co-morbidity and course offer less persuasive evidence for a valid cluster of neurocognitive disorders. The occurrence of these disorders subsequent to normal brain development sets this cluster apart from neurodevelopmental disorders. The aetiology of the disorders is varied, but the neurobiological underpinnings are better understood than for mental disorders in any other cluster. Neurocognitive disorders meet some of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster. Further developments in the aetiopathogenesis of these disorders will enhance the clinical utility of this cluster.

[A version of DSM-IV criteria adapted for adolescents and applied to young smokers].

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Clemente Jiménez, M L; Pérez Trullén, A; Rubio Aranda, E; Marrón Tundidor, R; Rodríguez Ibáñez, M L; Herrero Labarga, I

2003-07-01

To evaluate nicotine dependence in adolescent smokers using a version of DSM-IV criteria for nicotine dependence adapted for adolescents (DSM-IVa). To establish its usefulness and the most relevant items for diagnosing adolescent smokers. Two thousand six hundred forty-seven schoolchildren between 10 and 17 years old were surveyed. A sample size was calculated for each year of age, using the finite population equation with the addition of 10% so that the absolute error would not increase at the end of the study if questionnaires were withdrawn. The sample was stratified by sex and type of school for each age group, with allocation to each stratum proportional to the number of individuals. Schools and students were selected using random number tables. The questionnaire collected the most significant personal data and information related to DSM-IVa criteria. Smokers made up 23.1% of the sample, and 63.5% of them smoked daily. According to the DSM-IVa criteria, 70.7% of the smokers were nicotine dependent. The DSM-IVa had a kappa value of 1 and internal consistency was good (Cronbach's alpha: 0.5598). The DSM-IVa is useful in the studied population, although not perfect. According to the criteria, 70.7% of those interviewed were already nicotine dependent. The key questions were those that referred to the presence of nicotine withdrawal syndrome symptoms and the need to spend a large amount of free time obtaining or smoking cigarettes.

The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans.

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Weathers, Frank W; Bovin, Michelle J; Lee, Daniel J; Sloan, Denise M; Schnurr, Paula P; Kaloupek, Danny G; Keane, Terence M; Marx, Brian P

2018-03-01

The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The mental health impact of AIDS-related mortality in South Africa: a national study

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Myer, L; Seedat, S; Stein, D J; Moomal, H; Williams, D R

2011-01-01

Background Few data exist on how the HIV/AIDS epidemic may influence population mental health. The associations were examined between knowing someone who died of HIV/AIDS and common mental disorders among South African adults. Methods Between 2002 and 2004, a nationally representative sample of 4351 adults were interviewed about personally knowing someone who died of HIV/AIDS, and the World Health Organization Composite International Diagnostic Interview was used to generate psychiatric diagnoses for depression, anxiety and substance abuse disorders during the preceding 12 months based on the Diagnostic and Statistical Manual, 4th edition (DSM-IV). Results Overall, 42.2% of the sample knew someone who died of HIV/AIDS, and 16.5% met the criteria for at least one DSM-IV diagnosis. Individuals who knew someone who died of HIV/AIDS were significantly more likely to have any DSM-IV defined disorder, including any depressive, anxiety or substance-related disorder (pdrug dependence or abuse. Based on these results, it is estimated that up to 15% of 12-month DSM-IV disorders in the South African adult population may be related to knowing someone who died of HIV/AIDS. Conclusion These novel data suggest that AIDS-related mortality may contribute substantially to the burden of mental disorders in settings of high HIV prevalence. While this finding requires further investigation, these data suggest the need to strengthen mental health services in communities where HIV/AIDS is prevalent. PMID:19074926

Application of the Chinese Version of the Whiteley Index-7 for Detecting DSM-5 Somatic Symptom and Related Disorders.

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Tu, Chao-Ying; Liao, Shih-Cheng; Liu, Chao-Yu; Chen, Tzu-Ting; Chen, I-Ming; Lin, Kuan-Fu; Huang, Wei-Lieh

2016-01-01

The Whiteley Index-7 (WI-7) is frequently used for evaluating patients with suspected hypochondriasis. However, information about its use on somatic symptom and related disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is still lacking. This study investigated the psychometric properties of the Mandarin Chinese version of the WI-7 and its application to evaluation of somatic symptom and related disorders. Participants completed the WI-7 and received diagnostic interview based on both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-5 criteria. Exploratory factor analysis was performed, and the test-retest reliability and the internal consistency of the WI-7 were assessed. Receiver Operating Characteristic curves were established, and the area under the curve was calculated to determine the cutoff point to distinguish DSM-IV somatoform disorders and DSM-5 somatic symptom and related disorders, respectively. A total of 471 subjects were recruited for this study. The exploratory factor analysis of the WI-7 identified a single factor. The internal consistency and test-retest reliability of the WI-7 were 0.829 and 0.836, respectively. The area under Receiver Operating Characteristic curve using WI-7 to distinguish DSM-5 somatic symptom and related disorders is 0.660, higher than that when applying to distinguish DSM-IV somatoform disorders. The sensitivity and specificity at an optimal cutoff point of 0/1 are 0.645 and 0.675, respectively. The Mandarin Chinese version of the WI-7 is a potentially useful tool to detect individuals with DSM-5 somatic symptom and related disorders. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Using the Internet to assess perceptions of patients with borderline personality disorder: what do patients want in the DSM-V?

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Kalapatapu, Raj K; Patil, Uday; Goodman, Marianne S

2010-10-01

This study was an anonymous Internet survey of individuals currently diagnosed with borderline personality disorder (BPD), where participants gave opinions about BPD criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV-TR), and suggested modifications for BPD criteria to appear in the DSM-V (5th edition). Survey links were posted on 24 websites/Internet blogs that offered advice, education, or treatment of BPD. Demographic and clinical data pertaining to each participant were collected. Free-text responses were analyzed by frequencies of keywords and key phrases. A total of 1,832 responses were downloaded between March 7 and June 6, 2009, and 646 responses were analyzable. Results indicated that the majority of the DSM-IV-TR criteria appeared to capture what participants were experiencing, even though a significant percentage of participants felt that something was missing from the current criteria. A significant percentage of participants felt that BPD should be renamed in the DSM-V; some combination of "emotion(al)" and "(dys)regulation" was most commonly suggested to include in an alternative name. This Internet study highlighted the enthusiasm of individuals diagnosed with BPD to share their opinions on the DSM criteria with mental-health professionals. A significant percentage of participants in this study felt that BPD should be renamed in the DSM-V. Patient involvement during the DSM-V revision process remains controversial.

The cross-national epidemiology of DSM-IV intermittent explosive disorder.

Science.gov (United States)

Scott, K M; Lim, C C W; Hwang, I; Adamowski, T; Al-Hamzawi, A; Bromet, E; Bunting, B; Ferrand, M P; Florescu, S; Gureje, O; Hinkov, H; Hu, C; Karam, E; Lee, S; Posada-Villa, J; Stein, D; Tachimori, H; Viana, M C; Xavier, M; Kessler, R C

2016-11-01

This is the first cross-national study of intermittent explosive disorder (IED). A total of 17 face-to-face cross-sectional household surveys of adults were conducted in 16 countries (n = 88 063) as part of the World Mental Health Surveys initiative. The World Health Organization Composite International Diagnostic Interview (CIDI 3.0) assessed DSM-IV IED, using a conservative definition. Lifetime prevalence of IED ranged across countries from 0.1 to 2.7% with a weighted average of 0.8%; 0.4 and 0.3% met criteria for 12-month and 30-day prevalence, respectively. Sociodemographic correlates of lifetime risk of IED were being male, young, unemployed, divorced or separated, and having less education. The median age of onset of IED was 17 years with an interquartile range across countries of 13-23 years. The vast majority (81.7%) of those with lifetime IED met criteria for at least one other lifetime disorder; co-morbidity was highest with alcohol abuse and depression. Of those with 12-month IED, 39% reported severe impairment in at least one domain, most commonly social or relationship functioning. Prior traumatic experiences involving physical (non-combat) or sexual violence were associated with increased risk of IED onset. Conservatively defined, IED is a low prevalence disorder but this belies the true societal costs of IED in terms of the effects of explosive anger attacks on families and relationships. IED is more common among males, the young, the socially disadvantaged and among those with prior exposure to violence, especially in childhood.

[Specific learning disabilities - from DSM-IV to DSM-5].

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Schulte-Körne, Gerd

2014-09-01

The publication of the DSM-5 means changes in the classification and recommendations for diagnosis of specific learning disabilities. Dyslexia and dyscalculia have been reintroduced into the DSM. Three specific learning disorders - impairment in reading, impairment in the written expression, and impairment in mathematics, described by subskills - are now part of the DSM-5. Three subcomponents of the reading disorder are expressly differentiated: word reading accuracy, reading rate, and fluency and reading comprehension. Impaired subskills of the specific learning disorder with impairment in written expression are spelling accuracy, grammar and punctuation accuracy, and clarity and organization of written expression. Four subskills are found in the mathematics disorder: number sense, memorization of arithmetic facts, accurate or fluent calculation, and accurate math reasoning. Each impaired academic domain and subskill should be recorded. A description of the severity degree was also included. The diagnosis is based on a variety of methods, including medical history, clinical interview, school report, teacher evaluation, rating scales, and psychometric tests. The IQ discrepancy criterion was abandoned, though that of age or class discrepancy criterion was retained. The application of a discrepancy is recommended by 1 to 2.5 SD. All three specific developmental disorders are common (prevalence 5 %-15 %), occur early during the first years of formal schooling, and persist into adulthood.

Under-recognition and under-treatment of DSM-IV classified mood and anxiety disorders among disability claimants

NARCIS (Netherlands)

Cornelius, Lammert; van der Klink, Jac J. L.; Brouwer, Sandra; Groothoff, Johan W.

2014-01-01

Purpose: This study aimed to examine under-recognition, under-treatment and severity of under-treated DSM-IV mood and anxiety disorders among disability claimants. Methods: In a representative sample of Dutch disability claimants (n = 346), registry codes certified according to the International

Evaluating Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents.

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Mikolajewski, Amy J; Scheeringa, Michael S; Weems, Carl F

2017-05-01

Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7-18-year olds. PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7-12) were examined separately from adolescents (ages 13-18) to assess for potential developmental differences. A significantly higher proportion of 7-12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13-18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7-12-year-old (but not 13-18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV. These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7-12-year-old children, but not for adolescents. Using the very young children criteria for 7-12-year-old children may further increase prevalence, but capture children with less severe psychopathology.

[Conversion disorder: from DSM IV to DSM 5 or from a psychiatric to a neurological diagnosis].

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Vermeulen, M; Willems, M H A

2015-01-01

According to one of the diagnostic criteria of the dsm iv for conversion disorder there has to be a temporal relationship between psychological factors and the onset, or the worsening, of the symptoms. This criterion has been omitted in the dsm-5. Another criterion, namely that the symptoms are not produced intentionally, has also been abandoned. A new recommendation is that therapists should look for neurological symptoms that support the diagnosis. To investigate whether studies support the changes in the criteria. We searched literature using PubMed. When the symptoms first appear, trauma or stress in 37% of patients is of a physical rather than a psychological nature. Different forms of stress were found in equal proportions (20%) in patients with or without conversion disorder. There are no specific stressors, except possibly in patients with dysphonia. The percentages of childhood abuse vary widely, namely from 0 to 85%. The characteristic phenomenon of 'la belle indifference' occurs in only 3% of patients with conversion disorder versus only 2% of controls. Most of the 'positive' clinical tests for partial paralysis and sensory and gait disorders are highly specific. There are no reliable tests for distinguishing conversion disorder from simulation. The changes of the criteria are supported by recent studies.

Characterizing psychopathy using DSM-5 personality traits.

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Strickland, Casey M; Drislane, Laura E; Lucy, Megan; Krueger, Robert F; Patrick, Christopher J

2013-06-01

Despite its importance historically and contemporarily, psychopathy is not recognized in the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR). Its closest counterpart, antisocial personality disorder, includes strong representation of behavioral deviance symptoms but weak representation of affective-interpersonal features considered central to psychopathy. The current study evaluated the extent to which psychopathy and its distinctive facets, indexed by the Triarchic Psychopathy Measure, can be assessed effectively using traits from the dimensional model of personality pathology developed for DSM-5, operationalized by the Personality Inventory for DSM-5 (PID-5). Results indicate that (a) facets of psychopathy entailing impulsive externalization and callous aggression are well-represented by traits from the PID-5 considered relevant to antisocial personality disorder, and (b) the boldness facet of psychopathy can be effectively captured using additional PID-5 traits. These findings provide evidence that the dimensional model of personality pathology embodied in the PID-5 provides effective trait-based coverage of psychopathy and its facets.

Tourette's: syndrome, disorder or spectrum? Classificatory challenges and an appraisal of the DSM criteria.

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Robertson, Mary May; Eapen, Valsamma

2014-10-01

The fifth version of the Diagnostic and statistical manual of mental disorders (DSM-5) was released in May 2013 after 14 years of development and almost two decades after the last edition DSM-IV was published in 1994. We review the DSM journey with regards to Tourette Syndrome from the original publication of DSM 1 in 1952 till date. In terms of changes in DSM 5, the major shift has come in the placement of Tourette Syndrome under the 'Neurodevelopmental Disorders' alongside other disorders with a developmental origin. This review provides an overview of the changes in DSM-5 highlighting key points for clinical practice and research along with a snap shot of the current use of DSM as a classificatory system in different parts of the world and suggestions for improving the subtyping and the diagnostic confidence. Copyright © 2014 Elsevier B.V. All rights reserved.

Predictive validity of childhood oppositional defiant disorder and conduct disorder: implications for the DSM-V.

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Burke, Jeffrey D; Waldman, Irwin; Lahey, Benjamin B

2010-11-01

Data are presented from 3 studies of children and adolescents to evaluate the predictive validity of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) and the International Classification of Diseases, Version 10 (ICD-10; World Health Organization, 1992). The present analyses strongly support the predictive validity of these diagnoses by showing that they predict both future psychopathology and enduring functional impairment. Furthermore, the present findings generally support the hierarchical developmental hypothesis in DSM-IV that some children with ODD progress to childhood-onset CD, and some youth with CD progress to antisocial personality disorder (APD). Nonetheless, they reveal that CD does not always co-occur with ODD, particularly during adolescence. Importantly, the present findings suggest that ICD-10 diagnostic criteria for ODD, which treat CD symptoms as ODD symptoms when diagnostic criteria for CD are not met, identify more functionally impaired children than the more restrictive DSM-IV definition of ODD. Filling this "hole" in the DSM-IV criteria for ODD should be a priority for the DSM-V. In addition, the present findings suggest that although the psychopathic trait of interpersonal callousness in childhood independently predicts future APD, these findings do not confirm the hypothesis that callousness distinguishes a subset of children with CD with an elevated risk for APD. PsycINFO Database Record (c) 2010 APA, all rights reserved

The prevalence of DSM-IV personality pathology among individuals with bulimia nervosa, binge eating disorder and obesity

NARCIS (Netherlands)

De Jonge, PV; Van Furth, EF; Lacey, JH; Waller, G

2003-01-01

Background. There are numerous reports of personality disorder pathology in different eating disorders. However, few studies have directly compared personality pathology in bulimia nervosa, binge eating disorder and obesity. The present study examines group differences in DSM-IV personality

Mental health service use among South Africans for mood, anxiety ...

African Journals Online (AJOL)

Background. Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. Design. A nationally representative survey of 4 351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) ...

Brief Report: Comparability of DSM-IV and DSM-5 ASD Research Samples

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Mazefsky, C. A.; McPartland, J. C.; Gastgeb, H. Z.; Minshew, N. J.

2013-01-01

Diagnostic and Statistical Manual (DSM-5) criteria for ASD have been criticized for being too restrictive, especially for more cognitively-able individuals. It is unclear, however, if high-functioning individuals deemed eligible for research via standardized diagnostic assessments would meet DSM-5 criteria. This study investigated the impact of…

Validating the proposed diagnostic and statistical manual of mental disorders, 5th edition, severity indicator for personality disorder.

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Morey, Leslie C; Bender, Donna S; Skodol, Andrew E

2013-09-01

The authors sought to determine whether a 5-point global rating of personality dysfunction on the Level of Personality Functioning Scale proposed as a severity index for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), would be related to DSM-IV personality disorder diagnosis as well as to other key clinical judgments. Data were collected from a national sample of 337 mental health clinicians who provided complete diagnostic information relevant to DSM-IV and proposed DSM-5 personality disorder diagnoses, as well as demographic information and other clinical judgments, on one of their patients. Of the 337 patients described, 248 met criteria for 1 of the 10 specific DSM-IV personality disorders. A "moderate" or greater rating of impairment in personality functioning on the Level Scale demonstrated 84.6% sensitivity and 72.7% specificity for identifying patients meeting criteria for a specific DSM-IV personality disorder. The Level of Personality Functioning Scale had significant and substantial validity correlations with other measures of personality pathology and with clinical judgments regarding functioning, risk, prognosis, and optimal treatment intensity. Furthermore, the single-item Level of Personality Functioning rating was viewed as being as clinically useful as the 10 DSM-IV categories for treatment planning and patient description and was a better predictor of clinician ratings of broad psychosocial functioning than were the 10 DSM-IV categories combined. These results confirm hypotheses that the single-item Level of Personality Functioning Scale rating provides an indication of severity of personality pathology that predicts both assignment of personality disorder diagnosis and clinician appraisals of functioning, risk, prognosis, and needed treatment intensity.

The three year course of alcohol use disorders in the general population: DSM-IV, ICD-10 and the Craving Withdrawal Model

NARCIS (Netherlands)

de Bruijn, Carla; van den Brink, Wim; de Graaf, Ron; Vollebergh, Wilma A. M.

2006-01-01

AIMS: To determine the course of alcohol use disorders (AUD) in a prospective general population study using three different classification systems: Diagnostic and Statistical Manual version IV (DSM-IV), International Classification of Diseases version 10 (ICD-10) and the craving withdrawal model

The relations between DISC-IV DSM diagnoses of ADHD and multi-informant CBCL-AP syndrome scores

NARCIS (Netherlands)

Derks, Eske M.; Hudziak, Jim J.; Dolan, Conor V.; Ferdinand, Robert F.; Boomsma, Dorret I.

2006-01-01

Previous studies have examined the relation between attention problems (APs) obtained with the Child Behavior Checklist (CBCL) and attention deficit hyperactivity disorder (ADHD) assessed with the Diagnostic and Statistical Manual of Mental Disorders (DSM). We will examine this relation across sex

Scientific Forum on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)-An Invitation.

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Aboraya, Ahmed

2010-11-01

The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is anticipated in May 2013 with many new additions and changes. In this article, the author summarizes the phases of psychiatric classification from the turn of the 20th century until today. Psychiatry 2010 offers a DSM-V Scientific Forum and invites readers to submit comments, recommendations, and articles to Psychiatry 2010 and DSM-V Task Force.

Food Addiction in the Light of DSM-5

Directory of Open Access Journals (Sweden)

Adrian Meule

2014-09-01

Full Text Available The idea that specific kind of foods may have an addiction potential and that some forms of overeating may represent an addicted behavior has been discussed for decades. In recent years, the interest in food addiction is growing and research on this topic lead to more precise definitions and assessment methods. For example, the Yale Food Addiction Scale has been developed for the measurement of addiction-like eating behavior based on the diagnostic criteria for substance dependence of the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV. In 2013, diagnostic criteria for substance abuse and—dependence were merged, thereby increasing the number of symptoms for substance use disorders (SUDs in the DSM-5. Moreover, gambling disorder is now included along SUDs as a behavioral addiction. Although a plethora of review articles exist that discuss the applicability of the DSM-IV substance dependence criteria to eating behavior, the transferability of the newly added criteria to eating is unknown. Thus, the current article discusses if and how these new criteria may be translated to overeating. Furthermore, it is examined if the new SUD criteria will impact future research on food addiction, for example, if “diagnosing” food addiction should also be adapted by considering all of the new symptoms. Given the critical response to the revisions in DSM-5, we also discuss if the recent approach of Research Domain Criteria can be helpful in evaluating the concept of food addiction.

Posttraumatic Stress Disorder in the DSM-5: Controversy, Change, and Conceptual Considerations

Directory of Open Access Journals (Sweden)

Anushka Pai

2017-02-01

Full Text Available The criteria for posttraumatic stress disorder PTSD have changed considerably with the newest edition of the American Psychiatric Association’s (APA Diagnostic and Statistical Manual of Mental Disorders (DSM-5. Changes to the diagnostic criteria from the DSM-IV to DSM-5 include: the relocation of PTSD from the anxiety disorders category to a new diagnostic category named “Trauma and Stressor-related Disorders”, the elimination of the subjective component to the definition of trauma, the explication and tightening of the definitions of trauma and exposure to it, the increase and rearrangement of the symptoms criteria, and changes in additional criteria and specifiers. This article will explore the nosology of the current diagnosis of PTSD by reviewing the changes made to the diagnostic criteria for PTSD in the DSM-5 and discuss how these changes influence the conceptualization of PTSD.

The centrality of DSM and non-DSM depressive symptoms in Han Chinese women with major depression

NARCIS (Netherlands)

Kendler, K.S.; Aggen, S.H.; Flint, J.; Borsboom, D.; Fried, E.I.

Introduction: We compared DSM-IV criteria for major depression (MD) with clinically selected non-DSM criteria in their ability to represent clinical features of depression. Method: We conducted network analyses of 19 DSM and non-DSM symptoms of MD assessed at personal interview in 5952 Han Chinese

Culture and Context in Mental Health Diagnosing: Scrutinizing the DSM-5 Revision.

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Bredström, Anna

2017-12-28

This article examines the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and its claim of incorporating a "greater cultural sensitivity." The analysis reveals that the manual conveys mixed messages as it explicitly addresses the critique of being ethnocentric and having a static notion of culture yet continues in a similar fashion when culture is applied in diagnostic criteria. The analysis also relates to current trends in psychiatric nosology that emphasize neurobiology and decontextualize distress and points to how the DSM-5 risks serving as an ethnic dividing line in psychiatry by making sociocultural context relevant only for some patients.

Estimated Risk of Developing Selected DSM-IV Disorders among 5-Year-Old Children with Prenatal Cocaine Exposure

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Morrow, Connie E.; Accornero, Veronica H.; Xue, Lihua; Manjunath, Sudha; Culbertson, Jan L.; Anthony, James C.; Bandstra, Emmalee S.

2009-01-01

We estimated childhood risk of developing selected DSM-IV Disorders, including Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Separation Anxiety Disorder (SAD), in children with prenatal cocaine exposure (PCE). Children were enrolled prospectively at birth (n = 476) with prenatal drug exposures documented…

Recent advances in autism research as reflected in DSM-5 criteria for autism spectrum disorder.

Science.gov (United States)

Lord, Catherine; Bishop, Somer L

2015-01-01

This article provides a selective review of advances in scientific knowledge about autism spectrum disorder (ASD), using DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) diagnostic criteria as a framework for the discussion. We review literature that prompted changes to the organization of ASD symptoms and diagnostic subtypes in DSM-IV, and we examine the rationale for new DSM-5 specifiers, modifiers, and severity ratings as well as the introduction of the diagnosis of social (pragmatic) communication disorder. Our goal is to summarize and critically consider the contribution of clinical psychology research, along with that of other disciplines, to the current conceptualization of ASD.

Evaluating Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents

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Scheeringa, Michael S.; Weems, Carl F.

2017-01-01

Abstract Objectives: Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7–18-year olds. Methods: PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7–12) were examined separately from adolescents (ages 13–18) to assess for potential developmental differences. Results: A significantly higher proportion of 7–12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13–18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7–12-year-old (but not 13–18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV. Conclusion: These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7–12-year-old children, but not for adolescents. Using the very young children criteria for 7–12-year-old children may further increase prevalence, but capture children with less severe psychopathology. PMID:28170306

[Clinical usefulness of IDEA and CARS: concordance with DSM-IV-TR in children and adolescents with suspicion of PDD].

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García-López, C; Narbona, J

2014-02-01

Observational scales are useful to estimate the severity of symptoms in PDD as well as to monitor their evolution. a) To analyze the concordance between diagnoses based on the Autism Spectrum Inventory (Inventario del Espectro Autista, IDEA)) and the Childhood Autism Rating Scale (CARS), compared to DSM-IV-TR criteria, in subjects with a suspicion of pervasive developmental disorders (PDD), and b) to study the discrimination power of both scales to differentiate between a clinical diagnosis situated in the autism spectrum. Fifty-six children and adolescents, between 2 and 20 years-old, who attended our Neuropediatric Unit due to suspicion of PDD. Independently, two clinicians evaluated the presence of PDD symptoms; one of them according to DSM-IV-TR criteria and the other one based on the application of IDEA and CARS. The concordance of IDEA and CARS when compared to DSM-IV-TR classification was 73 and 82%, respectively, with a sensitivity of 1 and 0,83 and a specificity of 0,61 and 0,82, respectively. Both scales correctly discriminated between autistic disorder and other clinical diagnoses. Both IDEA and CARS are useful instruments to detect and monitor autism symptoms in the context of routine clinical practice. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Examination of the Section III DSM-5 diagnostic system for personality disorders in an outpatient clinical sample

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Few, Lauren R.; Miller, Joshua D.; Rothbaum, Alex; Meller, Suzanne; Maples, Jessica; Terry, Douglas P.; Collins, Brittany; MacKillop, James

2014-01-01

The DSM-5 includes a novel approach to the diagnosis of personality disorders (PDs) in Section III, in order to stimulate further research with the possibility that this proposal will be included more formally in future DSM iterations. The current study provides the first test of this proposal in a clinical sample by simultaneously examining its two primary components: a system for rating personality impairment and a newly developed dimensional model of pathological personality traits. Participants were community adults currently receiving outpatient mental health treatment who completed a semi-structured interview for DSM-IV PDs and were then rated in terms of personality impairment and pathological traits. Data on the pathological traits were also collected via self-reports using the Personality Inventory for DSM-5 (PID-5). Both sets of trait scores were compared to self-report measures of general personality traits, internalizing symptoms, and externalizing behaviors. Inter-rater reliabilities for the clinicians’ ratings of impairment and the pathological traits were fair. The impairment ratings manifested substantial correlations with symptoms of depression and anxiety, DSM-5 PDs, and DSM-5 pathological traits. The clinician and self-reported personality trait scores demonstrated good convergence with one another, both accounted for substantial variance in DSM-IV PD constructs, and both manifested expected relations with the external criteria. The traits but not the impairment ratings demonstrated incremental validity in the prediction of the DSM-IV PDs. Overall, the current results support the general validity of several of the components of this new PD diagnostic system and point to areas that may require further modification. PMID:24364607

The latent factor structure of acute stress disorder following bank robbery: testing alternative models in light of the pending DSM-5.

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Hansen, Maj; Lasgaard, Mathias; Elklit, Ask

2013-03-01

Acute stress disorder (ASD) was introduced into the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) to identify posttraumatic stress reactions occurring within the first month after a trauma and thus help to identify victims at risk of developing posttraumatic stress disorder (PTSD). Since its introduction, research into ASD has focused on the prediction of PTSD, whereas only a few studies have investigated the latent structure of ASD. Results of the latter have been mixed. In light of the current proposal for the ASD diagnosis in the pending DSM-5, there is a profound need for empirical studies that investigate the latent structure of ASD prior to the DSM-5 being finalized. Based on previous factor analytic research, the DSM-IV, and the proposed DSM-5 formulation of ASD, four different models of the latent structure of ASD were specified and estimated. The analyses were based on a national study of bank robbery victims (N = 450) using the acute stress disorder scale. The results of the confirmatory factor analyses showed that the DSM-IV model provided the best fit to the data. Thus, the present study suggests that the latent structure of ASD may best be characterized according to the four-factor DSM-IV model of ASD (i.e., dissociation, re-experiencing, avoidance, and arousal) following exposure to bank robbery. The results are pertinent in light of the pending DSM-5 and add to the debate about the conceptualization of ASD. . © 2012 The British Psychological Society.

Teaching about mental health and illness through the history of the DSM.

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Clegg, Joshua W

2012-11-01

Most students enter introductory or abnormal psychology courses with a naively realist concept of what constitutes mental illness, and most textbooks do little to complicate this understanding. The tendency to reify the various diagnostic categories of the mental health disciplines into stable and independent illnesses is ever present. However, a critical review of the development of successive versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) can help instructors demonstrate the evolving ways in which mental health and illness are conceptualized and can reveal the cultural, political, and economic forces that shape this process. This article provides a brief general review of this history, along with useful pedagogical questions and suggestions for integrating this material into the classroom. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Two Sides of the Same Coin: Cannabis Dependence and Mental Health Problems in Help-Seeking Adolescent and Young Adult Outpatients

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Norberg, Melissa M.; Battisti, Robert A.; Copeland, Jan; Hermens, Daniel F.; Hickie, Ian B.

2012-01-01

The aim of the current study was to delineate the psychiatric profile of cannabis dependent young people (14-29 years old) with mental health problems (N = 36) seeking treatment via a research study. To do so, the Structured Clinical Interview for DSM-IV-TR Axis I Disorders and the Structured Clinical Interview for DSM-IV Childhood Diagnoses were…

Scientific Forum on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)—An Invitation

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Aboraya, Ahmed

2010-01-01

The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is anticipated in May 2013 with many new additions and changes. In this article, the author summarizes the phases of psychiatric classification from the turn of the 20th century until today. Psychiatry 2010 offers a DSM-V Scientific Forum and invites readers to submit comments, recommendations, and articles to Psychiatry 2010 and DSM-V Task Force.

The effect of draft DSM-V criteria on posttraumatic stress disorder prevalence.

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Calhoun, Patrick S; Hertzberg, Jeffrey S; Kirby, Angela C; Dennis, Michelle F; Hair, Lauren P; Dedert, Eric A; Beckham, Jean C

2012-12-01

This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence. The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD. Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E. Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest. © 2012 Wiley Periodicals, Inc.

The Effect of Draft DSM-5 Criteria on Posttraumatic Stress Disorder Prevalence

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Calhoun, Patrick S.; Hertzberg, Jeffrey S.; Kirby, Angela C.; Dennis, Michelle F.; Hair, Lauren P.; Dedert, Eric A.; Beckham, Jean C.

2012-01-01

Background This study was designed to examine the concordance of proposed DSM-5 posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-5 PTSD criteria on prevalence. Method The sample (N=185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-5 classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-5 PTSD. Results Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-5. Results examining concordance between DSM-IV and DSM-5 algorithms indicated that several of the algorithms had AUCs above .90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = .93; Kappa = .86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E. Conclusions Despite several significant changes to the diagnostic criteria for PTSD for DSM-5, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-5 decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest. PMID:23109002

A dimensional approach to assessing personality functioning: examining personality trait domains utilizing DSM-IV personality disorder criteria.

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Christopher Fowler, J; Sharp, Carla; Kalpakci, Allison; Madan, Alok; Clapp, Joshua; Allen, Jon G; Christopher Frueh, B; Oldham, John M

2015-01-01

This study compared a dimensional, trait domain approach to characterizing personality pathology with the traditional polythetic approach with respect to their associations with interpersonal functioning and personality traits from the five factor model. Psychiatric inpatients (N=1476) were administered the Structured Clinical Interview for DSM-IV Axis II personality disorders. Dimensional representations of trait domains were derived from reorganizing DSM-IV criteria into personality trait domains from DSM-5 Alternative Model. Dimensional scores and personality disorder (PD) total criterion scores served as independent variables in predicting interpersonal profile clusters, as well as extraversion, agreeableness conscientiousness, neuroticism and openness from the five factor model traits. Trait domain scores and PD criteria totals were significantly correlated with submissive interpersonal style yet none proved significant in regression analyses. Avoidant and borderline PD total criteria were negatively associated with a normative interpersonal style. Combined trait domain of detachment and avoidant PD total criteria predicted a hostile/withdrawn interpersonal style. The trait domain of detachment was negatively associated with five factor traits of extroversion, whereas borderline PD total criteria were negatively associated with conscientiousness. Avoidant and borderline PD total criteria were positively associated with neuroticism. The cross-cutting dimensional approach provided useful information in predicting a hostile/withdrawn interpersonal style as well as extroversion. Importantly, PD criterion scores and dimensional trait scores combined to predict this interpersonal style providing support to the alternative model of personality diagnosis in DSM-5. Clinicians are encouraged to assess dimensions of personality traits as these are related to interpersonal problems frequently encountered in psychiatric settings. While potentially useful, the dimensional

Do DSM-5 Eating Disorder Criteria Overpathologize Normative Eating Patterns among Individuals with Obesity?

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Jennifer J. Thomas

2014-01-01

Full Text Available Background. DSM-5 revisions have been criticized in the popular press for overpathologizing normative eating patterns—particularly among individuals with obesity. To evaluate the evidence for this and other DSM-5 critiques, we compared the point prevalence and interrater reliability of DSM-IV versus DSM-5 eating disorders (EDs among adults seeking weight-loss treatment. Method. Clinicians (n=2 assigned DSM-IV and DSM-5 ED diagnoses to 100 participants via routine clinical interview. Research assessors (n=3 independently conferred ED diagnoses via Structured Clinical Interview for DSM-IV and a DSM-5 checklist. Results. Research assessors diagnosed a similar proportion of participants with EDs under DSM-IV (29% versus DSM-5 (32%. DSM-5 research diagnoses included binge eating disorder (9%, bulimia nervosa (2%, subthreshold binge eating disorder (5%, subthreshold bulimia nervosa (2%, purging disorder (1%, night eating syndrome (6%, and other (7%. Interrater reliability between clinicians and research assessors was “substantial” for both DSM-IV (κ = 0.64, 84% agreement and DSM-5 (κ = 0.63, 83% agreement. Conclusion. DSM-5 ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable to DSM-IV.

Do DSM-5 Eating Disorder Criteria Overpathologize Normative Eating Patterns among Individuals with Obesity?

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Eddy, Kamryn T.; Murray, Helen B.; Gorman, Mark J.

2014-01-01

Background. DSM-5 revisions have been criticized in the popular press for overpathologizing normative eating patterns—particularly among individuals with obesity. To evaluate the evidence for this and other DSM-5 critiques, we compared the point prevalence and interrater reliability of DSM-IV versus DSM-5 eating disorders (EDs) among adults seeking weight-loss treatment. Method. Clinicians (n = 2) assigned DSM-IV and DSM-5 ED diagnoses to 100 participants via routine clinical interview. Research assessors (n = 3) independently conferred ED diagnoses via Structured Clinical Interview for DSM-IV and a DSM-5 checklist. Results. Research assessors diagnosed a similar proportion of participants with EDs under DSM-IV (29%) versus DSM-5 (32%). DSM-5 research diagnoses included binge eating disorder (9%), bulimia nervosa (2%), subthreshold binge eating disorder (5%), subthreshold bulimia nervosa (2%), purging disorder (1%), night eating syndrome (6%), and other (7%). Interrater reliability between clinicians and research assessors was “substantial” for both DSM-IV (κ = 0.64, 84% agreement) and DSM-5 (κ = 0.63, 83% agreement). Conclusion. DSM-5 ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable to DSM-IV. PMID:25057413

Genetic and environmental influences on dimensional representations of DSM-IV cluster C personality disorders: a population-based multivariate twin study.

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Reichborn-Kjennerud, Ted; Czajkowski, Nikolai; Neale, Michael C; Ørstavik, Ragnhild E; Torgersen, Svenn; Tambs, Kristian; Røysamb, Espen; Harris, Jennifer R; Kendler, Kenneth S

2007-05-01

The DSM-IV cluster C Axis II disorders include avoidant (AVPD), dependent (DEPD) and obsessive-compulsive (OCPD) personality disorders. We aimed to estimate the genetic and environmental influences on dimensional representations of these disorders and examine the validity of the cluster C construct by determining to what extent common familial factors influence the individual PDs. PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV) in a sample of 1386 young adult twin pairs from the Norwegian Institute of Public Health Twin Panel (NIPHTP). A single-factor independent pathway multivariate model was applied to the number of endorsed criteria for the three cluster C disorders, using the statistical modeling program Mx. The best-fitting model included genetic and unique environmental factors only, and equated parameters for males and females. Heritability ranged from 27% to 35%. The proportion of genetic variance explained by a common factor was 83, 48 and 15% respectively for AVPD, DEPD and OCPD. Common genetic and environmental factors accounted for 54% and 64% respectively of the variance in AVPD and DEPD but only 11% of the variance in OCPD. Cluster C PDs are moderately heritable. No evidence was found for shared environmental or sex effects. Common genetic and individual environmental factors account for a substantial proportion of the variance in AVPD and DEPD. However, OCPD appears to be largely etiologically distinct from the other two PDs. The results do not support the validity of the DSM-IV cluster C construct in its present form.

The Relationship of DSM-IV Pathological Gambling to Compulsive Buying and other Possible Spectrum Disorders: Results from the Iowa PG Family Study

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Black, Donald W.; Coryell, William; Crowe, Raymond; Shaw, Martha; McCormick, Brett; Allen, Jeff

2015-01-01

This study investigates the possible relationship between pathological gambling (PG) and potential spectrum disorders including the DSM-IV impulse control disorders (intermittent explosive disorder, kleptomania, pyromania, trichotillomania) and several non-DSM disorders (compulsive buying disorder, compulsive sexual behavior, Internet addiction). PG probands, controls, and their first-degree relatives were assessed with instruments of known reliability. Detailed family history information was...

Executive functions as a potential neurocognitive endophenotype in anxiety disorders: A systematic review considering DSM-IV and DSM-5 diagnostic criteria classification

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Juliana de Lima Muller

Full Text Available Evidence in the literature indicates that neurocognitive impairments may represent endophenotypes in psychiatric disorders.Objective:This study aimed to conduct a systematic review on executive functions as a potential neurocognitive endophenotype in anxiety disorder diagnosis according to the DSM-IV and DSM-5 classifications.Methods:A literature search of the LILACS, Cochrane Library, Index Psi Periódicos Técnico-Científicos, PubMed and PsycInfo databases was conducted, with no time limits. Of the 259 studies found, 14 were included in this review.Results:Only studies on obsessive-compulsive disorder (OCD were found. The executive function components of decision-making, planning, response inhibition, behavioral reversal/alternation, reversal learning and set-shifting/cognitive flexibility were considered to be a neurocognitive endophenotypes in OCD.Conclusion:Further studies on executive functions as a neurocognitive endophenotype in other anxiety disorders are needed since these may have different neurocognitive endophenotypes and require other prevention and treatment approaches.

Predicting DMS-IV cluster B personality disorder criteria from MMPI-2 and Rorschach data: a test of incremental validity.

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Blais, M A; Hilsenroth, M J; Castlebury, F; Fowler, J C; Baity, M R

2001-02-01

Despite their frequent conjoint clinical use, the incremental validity of Rorschach (Rorschach, 1921/1942) and MMPI (Hathaway & McKinley, 1943) data has not been adequately established, nor has any study to date explored the incremental validity of these tests for predicting Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders (PDs). In a reanalysis of existing data, we used select Rorschach variables and the MMPI PD scales to predict DSM-IV antisocial, borderline, histrionic, and narcissistic PD criteria in a sample of treatment-seeking outpatients. The correlational findings revealed alimited relation between Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) variables, with only 5 of 30 correlations reaching significance (p psychological characteristics of the DSM-IV Cluster B PDs.

DSM-IV disorders in children with borderline to moderate intellectual disability. I: Prevalence and impact. [IF 3.6

NARCIS (Netherlands)

Dekker, M.C.; Koot, H.M.

2003-01-01

Objective: To assess the prevalence, comorbidity, and impact of DSM-IV disorders in 7- to 20-year-olds with intellectual disability. Method: A total of 474 children (response 86.8%) were randomly selected from a sample of students from Dutch schools for the intellectually disabled. Parents completed

Developmental Trajectories of DSM-IV Symptoms of Attention-Deficit/Hyperactivity Disorder: Genetic Effects, Family Risk and Associated Psychopathology

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Larsson, Henrik; Dilshad, Rezin; Lichtenstein, Paul; Barker, Edward D.

2011-01-01

Background: DSM-IV specifies three ADHD subtypes; the combined, the hyperactive-impulsive and the inattentive. Little is known about the developmental relationships underlying these subtypes. The objective of this study was to describe the development of parent-reported hyperactivity-impulsivity and inattention symptoms from childhood to…

Inter-observer reliability of DSM-5 substance use disorders.

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Denis, Cécile M; Gelernter, Joel; Hart, Amy B; Kranzler, Henry R

2015-08-01

Although studies have examined the impact of changes made in DSM-5 on the estimated prevalence of substance use disorder (SUD) diagnoses, there is limited evidence concerning the reliability of DSM-5 SUDs. We evaluated the inter-observer reliability of four DSM-5 SUDs in a sample in which we had previously evaluated the reliability of DSM-IV diagnoses, allowing us to compare the two systems. Two different interviewers each assessed 173 subjects over a 2-week period using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Using the percent agreement and kappa (κ) coefficient, we examined the reliability of DSM-5 lifetime alcohol, opioid, cocaine, and cannabis use disorders, which we compared to that of SSADDA-derived DSM-IV SUD diagnoses. We also assessed the effect of additional lifetime SUD and lifetime mood or anxiety disorder diagnoses on the reliability of the DSM-5 SUD diagnoses. Reliability was good to excellent for the four disorders, with κ values ranging from 0.65 to 0.94. Agreement was consistently lower for SUDs of mild severity than for moderate or severe disorders. DSM-5 SUD diagnoses showed greater reliability than DSM-IV diagnoses of abuse or dependence or dependence only. Co-occurring SUD and lifetime mood or anxiety disorders exerted a modest effect on the reliability of the DSM-5 SUD diagnoses. For alcohol, opioid, cocaine and cannabis use disorders, DSM-5 criteria and diagnoses are at least as reliable as those of DSM-IV. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Inter-Observer Reliability of DSM-5 Substance Use Disorders*

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Denis, Cécile M.; Gelernter, Joel; Hart, Amy B.; Kranzler, Henry R.

2015-01-01

Aims Although studies have examined the impact of changes made in DSM-5 on the estimated prevalence of substance use disorder (SUD) diagnoses, there is limited evidence of the reliability of DSM-5 SUDs. We evaluated the inter-observer reliability of four DSM-5 SUDs in a sample in which we had previously evaluated the reliability of DSM-IV diagnoses, allowing us to compare the two systems. Methods Two different interviewers each assessed 173 subjects over a 2-week period using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Using the percent agreement and kappa (κ) coefficient, we examined the reliability of DSM-5 lifetime alcohol, opioid, cocaine, and cannabis use disorders, which we compared to that of SSADDA-derived DSM-IV SUD diagnoses. We also assessed the effect of additional lifetime SUD and lifetime mood or anxiety disorder diagnoses on the reliability of the DSM-5 SUD diagnoses. Results Reliability was good to excellent for the four disorders, with κ values ranging from 0.65 to 0.94. Agreement was consistently lower for SUDs of mild severity than for moderate or severe disorders. DSM-5 SUD diagnoses showed greater reliability than DSM-IV diagnoses of abuse or dependence or dependence only. Co-occurring SUD and lifetime mood or anxiety disorders exerted a modest effect on the reliability of the DSM-5 SUD diagnoses. Conclusions For alcohol, opioid, cocaine and cannabis use disorders, DSM-5 criteria and diagnoses are at least as reliable as those of DSM-IV. PMID:26048641

Conversion disorder: current problems and potential solutions for DSM-5.

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Stone, Jon; LaFrance, W Curt; Brown, Richard; Spiegel, David; Levenson, James L; Sharpe, Michael

2011-12-01

Conversion disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) describes neurological symptoms, including weakness, numbness and events resembling epilepsy or syncope, which can be positively identified as not being due to recognised neurological disease. This review combines perspectives from psychiatry, psychology and neurology to identify and discuss key problems with the current diagnostic DSM-IV criteria for conversion disorder and to make the following proposals for DSM-5: (a) abandoning the label "conversion disorder" and replacing it with an alternative term that is both theoretically neutral and potentially more acceptable to patients and practitioners; (b) relegating the requirements for "association of psychological factors" and the "exclusion of feigning" to the accompanying text; (c) adding a criterion requiring clinical findings of internal inconsistency or incongruity with recognised neurological or medical disease and altering the current 'disease exclusion' criteria to one in which the symptom must not be 'better explained' by a disease if present, (d) adding a 'cognitive symptoms' subtype. We also discuss whether conversion symptoms are better classified with other somatic symptom disorders or with dissociative disorders and how we might address the potential heterogeneity of conversion symptoms in classification. 2011 Elsevier Inc. All rights reserved.

The quality of the DSM-IV obsessive-compulsive personality disorder construct as a prototype category.

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Hummelen, Benjamin; Wilberg, Theresa; Pedersen, Geir; Karterud, Sigmund

2008-06-01

The study evaluated the quality of the DSM-IV obsessive-compulsive personality disorder (OCPD) construct as a prototype category. A sample of 2237 patients from the Norwegian Network of Psychotherapeutic Day Hospitals was examined by a variety of psychometric analyses. A high number of OCPD patients (77%) had co-occurrent PDs, but only the co-occurrence with paranoid was significantly higher than expected. Exploratory factor analysis of the PD criteria indicated that OCPD consists of 2 dimensions. The first dimension, perfectionism, was constituted by OCPD criteria only and was significantly related to obsessive-compulsive disorder. The second dimension, aggressiveness, included 2 OCPD criteria, reluctance to delegate and stubbornness, but was also defined by criteria from paranoid, antisocial, and borderline PD. Confirmatory factor analysis of the OCPD criteria indicated a poor fit of both a unitary model and a 3-dimensional model. Overall, the OCPD criteria had poor psychometric properties. Although it seems that the quality of the DSM-IV OCPD as a prototype construct is insufficient, it may be improved by deleting the criteria hoarding behavior and miserliness. Alternative criteria could be related to problems in close relationships involving the need for predictability. Such revisions may add a third dimension to the 2 dimensions of perfectionism and aggressiveness.

DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects.

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Albert, Umberto; Maina, Giuseppe; Forner, Federica; Bogetto, Filippo

2004-01-01

The relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has not yet been fully clarified. The aim of the present study was to analyze DSM-IV OCPD prevalence rates in OCD and panic disorder (PD) patients to test for the specificity of the OCPD-OCD link, and to compare them to OCPD prevalence in a control group of subjects without any psychiatric disorder. A total of 109 patients with a principal diagnosis of DSM-IV (SCID-I) OCD and 82 with PD were interviewed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) in order to assess the prevalence of OCPD. All patients with a coexisting axis I diagnosis were excluded from the study to eliminate confounding factors when evaluating the association between prevalence rates of OCPD and anxiety disorder diagnoses. An exclusion criteria was also a Hamilton Depression Rating Scale (HAM-D) score >/=16. A sample of comparison subjects (age 18 to 65 years) without any psychiatric disorder was recruited from people registered with two general practitioners (GPs), whether or not they consulted the doctor, in order to evaluate OCPD prevalence rate in the community. A significant difference was found between the prevalence of OCPD in OCD (22.9%) and in PD (17.1%) on one hand, and that in the comparison sample (3.0%) on the other. No differences were found between the two psychiatric groups, even when splitting the samples according to gender. Our study failed to support the hypothesis of a specific relationship between OCPD and OCD; we confirmed the higher prevalence rate of this personality disorder in OCD subjects with regard to the general population, but we also confirmed the higher rate of OCPD in another anxiety disorder which is phenomenologically well characterized and different from OCD, such as PD.

Continuity between DSM-5 Categorical Criteria and Traits Criteria for Borderline Personality Disorder.

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Bach, Bo; Sellbom, Martin

2016-08-01

Borderline personality disorder (BPD) includes a heterogeneous constellation of symptoms operationalized with 9 categorical criteria. As the field of personality disorder (PD) research moves to emphasize dimensional traits in its operationalization, it is important to delineate continuity between the 9 DSM-IV/Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorical criteria for BPD and the trait dimensions in DSM-5 Section III. To date, no study has attempted such validation. We examined the associations between the 9 categorical DSM-IV/DSM-5 criteria for BPD and the trait dimensions of the alternative DSM-5 model for PDs in consecutively recruited psychiatric outpatients (N = 142; 68% female; age: mean 29.02, SD 8.38). This was investigated by means of bivariate correlations, followed by multiple logistic regression analysis. The categorical BPD criteria were associated with conceptually related DSM-5 Section III traits (P > 0.001), except for the criterion of chronic feelings of emptiness. Consistent with the proposed traits criteria for BPD in DSM-5 Section III, we found Emotional lability, Anxiousness, Separation insecurity, Depressivity, Impulsivity, Risk taking, and Hostility to capture conceptually coherent BPD categorical criteria, while Suspiciousness was also strongly associated with BPD criteria. At the domain level, this applied to Negative affectivity, Disinhibition, and Psychoticism. Notably, Emotional lability, Impulsivity, and Suspiciousness emerged as unique predictors of BPD (P > 0.05). In addition to the proposed BPD traits criteria, Suspiciousness and features of Psychoticism also augment BPD features. Provided that these findings are replicated in forthcoming research, a modified traits operationalization of BPD is warranted. © The Author(s) 2016.

A proposal for including nomophobia in the new DSM-V

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Bragazzi NL

2014-05-01

Full Text Available Nicola Luigi Bragazzi,1,2 Giovanni Del Puente21School of Public Health, Department of Health Sciences (DISSAL, University of Genoa, Genoa, Italy; 2DINOGMI, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, ItalyAbstract: The Diagnostic and Statistical Manual of Mental Disorders (DSM is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV, while a fifth (DSM-V has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.Keywords: behavioral dependence, mobile phone, social phobia, specific phobia

Item Response Theory Analyses of the Parent and Teacher Ratings of the DSM-IV ADHD Rating Scale

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Gomez, Rapson

2008-01-01

The graded response model (GRM), which is based on item response theory (IRT), was used to evaluate the psychometric properties of the inattention and hyperactivity/impulsivity symptoms in an ADHD rating scale. To accomplish this, parents and teachers completed the DSM-IV ADHD Rating Scale (DARS; Gomez et al., "Journal of Child Psychology and…

Quality of the relationship between origin of childhood perception of attachment and outcome of attachment associated with diagnosis of PTSD in adult Finnish war children and Finnish combat veterans from World War II (1939-1945) - DSM-IV applications of the attachment theory.

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Andersson, Pentti Kalevi

2015-06-01

Using diagnoses exclusively, comparable evaluations of the empirical evidence relevant to the content can be made. The term holocaust survivor syndrome according to the DSM-IV classification encompasses people with diagnoses of posttraumatic stress disorders and psychopathological symptoms exposed to the Nazi genocide from 1933-1945 identified by Natan Kellermann, AMCHA, Israel (1999). The relationships between disorders of affectionate parenting and the development of dysfunctional models on one hand, and various psychopathological disorders on the other hand were investigated. Multi-axial assessment based on PTSD diagnosis (APA, 2000) with DSM-IV classification criteria of holocaust survivor syndrome and child survivor syndrome earlier found in holocaust survivors was used as criteria for comparison among Finnish sub-populations. Symptoms similar to those previously described in association with holocaust survivor syndrome and child survivor syndrome were found in the population of Finnish people who had been displaced as children between 1939-1945. Complex PTSD syndrome is found among survivors of prolonged or repeated trauma who have coping strategies intended to assist their mental survival. Surviving Finnish child evacuees had symptoms at similar level to those reported among holocaust survivors, though Finnish combat veterans exhibited good mental adjustment with secure attachment.

Risk factors for mental disorders in women survivors of human trafficking: a historical cohort study

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2013-01-01

Background Previous studies have found high levels of symptoms of depression, anxiety, and post-traumatic stress disorder among women survivors of human trafficking. No previous research has described risk factors for diagnosed mental disorders in this population. Methods A historical cohort study of women survivors of trafficked women aged 18 and over who returned to Moldova and registered for assistance with the International Organisation for Migration (IOM). Women were approached by IOM social workers and, if they gave informed consented to participate in the study, interviewed by the research team. At 2–12 months post-return to Moldova, a psychiatrist assessed DSM-IV mental disorders blind to information about women’s pre-trafficking and post-trafficking experiences using the Structured Clinical Interview for DSM-IV (SCID). A backwards stepwise selection procedure was used to create a multivariable regression model of risk factors for DSM-IV mental disorder measured at an average of 6 months post-return. Results 120/176 (68%) eligible women participated. At an average of 6 months post-return, 54% met criteria for any DSM-IV mental disorder: 35.8% of women had PTSD (alone or co-morbid), 12.5% had depression without PTSD and 5.8% had another anxiety disorder. Multivariable regression analysis found that childhood sexual abuse (Adjusted Odds Ratio [AOR] 4.68, 95% CI 1.04-20.92), increased number of post-trafficking unmet needs (AOR 1.80; 95% CI 1.28-2.52) and post-trafficking social support (AOR 0.64; 95% CI 0.52-0.79) were independent risk factors for mental disorder, and that duration of trafficking showed a borderline association with mental disorder (AOR 1.12, 95% CI 0.98-1.29). Conclusions Assessment for mental disorders should be part of re-integration follow-up care for women survivors of human trafficking. Mental disorders at that time, most commonly PTSD and depression, are likely to be influenced by a range of predisposing, precipitating and

Risk factors for mental disorders in women survivors of human trafficking: a historical cohort study.

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Abas, Melanie; Ostrovschi, Nicolae V; Prince, Martin; Gorceag, Viorel I; Trigub, Carolina; Oram, Siân

2013-08-03

Previous studies have found high levels of symptoms of depression, anxiety, and post-traumatic stress disorder among women survivors of human trafficking. No previous research has described risk factors for diagnosed mental disorders in this population. A historical cohort study of women survivors of trafficked women aged 18 and over who returned to Moldova and registered for assistance with the International Organisation for Migration (IOM). Women were approached by IOM social workers and, if they gave informed consented to participate in the study, interviewed by the research team. At 2-12 months post-return to Moldova, a psychiatrist assessed DSM-IV mental disorders blind to information about women's pre-trafficking and post-trafficking experiences using the Structured Clinical Interview for DSM-IV (SCID). A backwards stepwise selection procedure was used to create a multivariable regression model of risk factors for DSM-IV mental disorder measured at an average of 6 months post-return. 120/176 (68%) eligible women participated. At an average of 6 months post-return, 54% met criteria for any DSM-IV mental disorder: 35.8% of women had PTSD (alone or co-morbid), 12.5% had depression without PTSD and 5.8% had another anxiety disorder. Multivariable regression analysis found that childhood sexual abuse (Adjusted Odds Ratio [AOR] 4.68, 95% CI 1.04-20.92), increased number of post-trafficking unmet needs (AOR 1.80; 95% CI 1.28-2.52) and post-trafficking social support (AOR 0.64; 95% CI 0.52-0.79) were independent risk factors for mental disorder, and that duration of trafficking showed a borderline association with mental disorder (AOR 1.12, 95% CI 0.98-1.29). Assessment for mental disorders should be part of re-integration follow-up care for women survivors of human trafficking. Mental disorders at that time, most commonly PTSD and depression, are likely to be influenced by a range of predisposing, precipitating and maintaining factors. Care plans for survivors of

A Brief "DSM-IV"-Referenced Teacher Rating Scale for Monitoring Behavioral Improvement in ADHD and Co-Occurring Symptoms

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Sprafkin, Joyce; Mattison, Richard E.; Gadow, Kenneth D.; Schneider, Jayne; Lavigne, John V.

2011-01-01

Objective: To examine the psychometric properties of the 30-item teacher's version of the Child and Adolescent Symptom Inventory Progress Monitor (CASI-PM-T), a "DSM-IV"-referenced rating scale for monitoring change in ADHD and co-occurring symptoms in youths receiving behavioral or pharmacological interventions. Method: Three separate studies…

Cross-cultural and comparative epidemiology of insomnia: the Diagnostic and statistical manual (DSM), International classification of diseases (ICD) and International classification of sleep disorders (ICSD).

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Chung, Ka-Fai; Yeung, Wing-Fai; Ho, Fiona Yan-Yee; Yung, Kam-Ping; Yu, Yee-Man; Kwok, Chi-Wa

2015-04-01

To compare the prevalence of insomnia according to symptoms, quantitative criteria, and Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th Edition (DSM-IV and DSM-5), International Classification of Diseases, 10th Revision (ICD-10), and International Classification of Sleep Disorders, 2nd Edition (ICSD-2), and to compare the prevalence of insomnia disorder between Hong Kong and the United States by adopting a similar methodology used by the America Insomnia Survey (AIS). Population-based epidemiological survey respondents (n = 2011) completed the Brief Insomnia Questionnaire (BIQ), a validated scale generating DSM-IV, DSM-5, ICD-10, and ICSD-2 insomnia disorder. The weighted prevalence of difficulty falling asleep, difficulty staying asleep, waking up too early, and non-restorative sleep that occurred ≥3 days per week was 14.0%, 28.3%, 32.1%, and 39.9%, respectively. When quantitative criteria were included, the prevalence dropped the most from 39.9% to 8.4% for non-restorative sleep, and the least from 14.0% to 12.9% for difficulty falling asleep. The weighted prevalence of DSM-IV, ICD-10, ICSD-2, and any of the three insomnia disorders was 22.1%, 4.7%, 15.1%, and 22.1%, respectively; for DSM-5 insomnia disorder, it was 10.8%. Compared with 22.1%, 3.9%, and 14.7% for DSM-IV, ICD-10, and ICSD-2 in the AIS, cross-cultural difference in the prevalence of insomnia disorder is less than what is expected. The prevalence is reduced by half from DSM-IV to DSM-5. ICD-10 insomnia disorder has the lowest prevalence, perhaps because excessive concern and preoccupation, one of its diagnostic criteria, is not always present in people with insomnia. Copyright © 2014 Elsevier B.V. All rights reserved.

Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions.

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Grant, Bridget F; Chou, S Patricia; Saha, Tulshi D; Pickering, Roger P; Kerridge, Bradley T; Ruan, W June; Huang, Boji; Jung, Jeesun; Zhang, Haitao; Fan, Amy; Hasin, Deborah S

2017-09-01

Lack of current and comprehensive trend data derived from a uniform, reliable, and valid source on alcohol use, high-risk drinking, and DSM-IV alcohol use disorder (AUD) represents a major gap in public health information. To present nationally representative data on changes in the prevalences of 12-month alcohol use, 12-month high-risk drinking, 12-month DSM-IV AUD, 12-month DSM-IV AUD among 12-month alcohol users, and 12-month DSM-IV AUD among 12-month high-risk drinkers between 2001-2002 and 2012-2013. The study data were derived from face-to-face interviews conducted in 2 nationally representative surveys of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions, with data collected from April 2001 to June 2002, and the National Epidemiologic Survey on Alcohol and Related Conditions III, with data collected from April 2012 to June 2013. Data were analyzed in November and December 2016. Twelve-month alcohol use, high-risk drinking, and DSM-IV AUD. The study sample included 43 093 participants in the National Epidemiologic Survey on Alcohol and Related Conditions and 36 309 participants in the National Epidemiologic Survey on Alcohol and Related Conditions III. Between 2001-2002 and 2012-2013, 12-month alcohol use, high-risk drinking, and DSM-IV AUD increased by 11.2%, 29.9%, and 49.4%, respectively, with alcohol use increasing from 65.4% (95% CI, 64.3%-66.6%) to 72.7% (95% CI, 71.4%-73.9%), high-risk drinking increasing from 9.7% (95% CI, 9.3%-10.2%) to 12.6% (95% CI, 12.0%-13.2%), and DSM-IV AUD increasing from 8.5% (95% CI, 8.0%-8.9%) to 12.7% (95% CI, 12.1%-13.3%). With few exceptions, increases in alcohol use, high-risk drinking, and DSM-IV AUD between 2001-2002 and 2012-2013 were also statistically significant across sociodemographic subgroups. Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income. Increases were also

Autism Spectrum Disorders in the DSM-V: Better or Worse than the DSM-IV?

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Wing, Lorna; Gould, Judith; Gillberg, Christopher

2011-01-01

The DSM-V-committee has recently published proposed diagnostic criteria for autism spectrum disorders. We examine these criteria in some detail. We believe that the DSM-committee has overlooked a number of important issues, including social imagination, diagnosis in infancy and adulthood, and the possibility that girls and women with autism may…

Toward a model for assessing level of personality functioning in DSM-5, part II: empirical articulation of a core dimension of personality pathology

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Morey, L.C.; Berghuis, H.; Bender, D.S.; Verheul, R.; Krueger, R.F.; Skodol, A.E.

2011-01-01

The extensive comorbidity among Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders might be compelling evidence of essential commonalities among these disorders reflective of a general level of personality

Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview.

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Schneider, Barbara; Maurer, Konrad; Sargk, Dieter; Heiskel, Harald; Weber, Bernhard; Frölich, Lutz; Georgi, Klaus; Fritze, Jürgen; Seidler, Andreas

2004-06-30

The validity and reliability of using psychological autopsies to diagnose a psychiatric disorder is a critical issue. Therefore, interrater and test-retest reliability of the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders and the usefulness of these instruments for the psychological autopsy method were investigated. Diagnoses by informant's interview were compared with diagnoses generated by a personal interview of 35 persons. Interrater reliability and test-retest reliability were assessed in 33 and 29 persons, respectively. Chi-square analysis, kappa and intraclass correlation coefficients, and Kendall's tau were used to determine agreement of diagnoses. Kappa coefficients were above 0.84 for substance-related disorders, mood disorders, and anxiety and adjustment disorders, and above 0.65 for Axis II disorders for interrater and test-retest reliability. Agreement by personal and relative's interview generated kappa coefficients above 0.79 for most Axis I and above 0.65 for most personality disorder diagnoses; Kendall's tau for dimensional individual personality disorder scores ranged from 0.22 to 0.72. Despite of a small number of psychiatric disorders in the selected population, the present results provide support for the validity of most diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders. This instrument can be recommended as a tool for the psychological autopsy procedure in post-mortem research. Copyright 2004 Elsevier Ireland Ltd.

Adult separation anxiety disorder in the DSM-5

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Bögels, S.M.; Knappe, S.; Clark, L.A.

2013-01-01

Unlike other DSM-IV anxiety disorders, separation anxiety disorder (SAD) has been considered a disorder that typically begins in childhood, and could be diagnosed only in adults "if onset is before 18." Moreover, SAD is the only DSM-IV anxiety disorder placed under "Disorders Usually First Diagnosed

[Anxiety disorders in DSM-5: an overview on changes in structure and content].

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Wittchen, H-U; Heinig, I; Beesdo-Baum, K

2014-05-01

The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) "anxiety, obsessive-compulsive spectrum, posttraumatic, and dissociative disorders" work group addressed reconceptualization issues regarding all anxiety-related disorders. Based on systematic literature reviews, reanalyses of available data and evaluation of results following the DSM-5 principles it was decided to rearrange the disorder spectrum into separate groupings for the classical anxiety disorders, trauma- and stressor-related disorders, obsessive-compulsive and related disorders, and dissociative disorders. Among the classical anxiety disorders DSM-5 now also includes selective mutism and separation anxiety disorder. A major change from DSM-IV is a drastically simplified classification of panic disorder and agoraphobia. Both conditions can be separately coded in DSM-5 and the overlap is disclosed by a comorbid double diagnosis. The anxiety disorder criteria have been generally harmonized regarding content and order. It was assured that criteria are applicable to all age, gender and cultural groups. Furthermore, diagnosis-specific and cross-cutting dimensional anxiety scales have been developed to supplement categorical diagnosis which appears to facilitate assessment of severity and course of treatment.

DSM-IV disorders in children with borderline to moderate intellectual disability. II: Child and family predictors. [IF 3.6

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Dekker, M.C.; Koot, H.M.

2003-01-01

Objective: To identify child and family factors that predict DSM-IV disorders in children with intellectual disability. Method: In 1997, a total of 968 6- to 18-year-olds were randomly selected from Dutch schools for intellectual disability (response 69.3%). Parents completed the Child Behavior

Associations between DSM-IV mental disorders and subsequent non-fatal, self-reported stroke

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Swain, Nicola R.; Lim, Carmen C. W.; Levinson, Daphna; Fiestas, Fabian; de Girolamo, Giovanni; Moskalewicz, Jacek; Lepine, Jean-Pierre; Posada-Villa, Jose; Maria Haro, Josep; Elena Medina-Mora, Maria; Xavier, Miguel; Lwata, Noboru; de Jonge, Peter; Bruffaerts, Ronny; O'Neill, Siobhan; Kessler, Ron C.; Scott, Kate M.

Objectives: To examine the associations between a wide range of mental disorders and subsequent onset of stroke. Lifecourse timing of stroke was examined using retrospectively reconstructed data from cross-sectional surveys. Methods: Data from the World Mental Health Surveys were accessed. This data

An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings: factor analysis and comparisons to ICD-10 and DSM-IV.

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Haravuori, Henna; Kiviruusu, Olli; Suomalainen, Laura; Marttunen, Mauri

2016-05-12

The proposed posttraumatic stress disorder (PTSD) criteria for the International Classification of Diseases (ICD) 11th revision are simpler than the criteria in ICD-10, DSM-IV or DSM-5. The aim of this study was to evaluate the ICD-11 PTSD factor structure in samples of young people, and to compare PTSD prevalence rates and diagnostic agreement between the different diagnostic systems. Possible differences in clinical characteristics of the PTSD cases identified by ICD-11, ICD-10 and DSM-IV are explored. Two samples of adolescents and young adults were followed after exposure to similar mass shooting incidents in their schools. Semi-structured diagnostic interviews were performed to assess psychiatric diagnoses and PTSD symptom scores (N = 228, mean age 17.6 years). PTSD symptom item scores were used to compose diagnoses according to the different classification systems. Confirmatory factor analyses indicated that the proposed ICD-11 PTSD symptoms represented two rather than three factors; re-experiencing and avoidance symptoms comprised one factor and hyperarousal symptoms the other factor. In the studied samples, the three-factor ICD-11 criteria identified 51 (22.4%) PTSD cases, the two-factor ICD-11 identified 56 (24.6%) cases and the DSM-IV identified 43 (18.9%) cases, while the number of cases identified by ICD-10 was larger, being 85 (37.3%) cases. Diagnostic agreement of the ICD-11 PTSD criteria with ICD-10 and DSM-IV was moderate, yet the diagnostic agreement turned to be good when an impairment criterion was imposed on ICD-10. Compared to ICD-11, ICD-10 identified cases with less severe trauma exposure and posttraumatic symptoms and DSM-IV identified cases with less severe trauma exposure. The findings suggest that the two-factor model of ICD-11 PTSD is preferable to the three-factor model. The proposed ICD-11 criteria are more restrictive compared to the ICD-10 criteria. There were some differences in the clinical characteristics of the PTSD cases

The DSM5/RDoC debate on the future of mental health research: implication for studies on human stress and presentation of the signature bank.

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Lupien, S J; Sasseville, M; François, N; Giguère, C E; Boissonneault, J; Plusquellec, P; Godbout, R; Xiong, L; Potvin, S; Kouassi, E; Lesage, A

2017-01-01

In 2008, the National Institute of Mental Health (NIMH) announced that in the next few decades, it will be essential to study the various biological, psychological and social "signatures" of mental disorders. Along with this new "signature" approach to mental health disorders, modifications of DSM were introduced. One major modification consisted of incorporating a dimensional approach to mental disorders, which involved analyzing, using a transnosological approach, various factors that are commonly observed across different types of mental disorders. Although this new methodology led to interesting discussions of the DSM5 working groups, it has not been incorporated in the last version of the DSM5. Consequently, the NIMH launched the "Research Domain Criteria" (RDoC) framework in order to provide new ways of classifying mental illnesses based on dimensions of observable behavioral and neurobiological measures. The NIMH emphasizes that it is important to consider the benefits of dimensional measures from the perspective of psychopathology and environmental influences, and it is also important to build these dimensions on neurobiological data. The goal of this paper is to present the perspectives of DSM5 and RDoC to the science of mental health disorders and the impact of this debate on the future of human stress research. The second goal is to present the "Signature Bank" developed by the Institut Universitaire en Santé Mentale de Montréal (IUSMM) that has been developed in line with a dimensional and transnosological approach to mental illness.

Variability among Research Diagnostic Interview Instruments in the Application of "DSM-IV-TR" Criteria for Pediatric Bipolar Disorder

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Galanter, Cathryn A.; Hundt, Stephanie R.; Goyal, Parag; Le, Jenna; Fisher, Prudence W.

2012-01-01

Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and…

Co-morbidity and factor analysis on attention deficit hyperactivity disorder and autism spectrum disorder DSM-IV-derived items

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Ahmad Ghanizadeh

2012-01-01

Full Text Available Background: There is a gap in the literature regarding the extent of possible co-occurrence of attention deficit hyperactivity disorder (ADHD and pervasive developmental disorders (PDD. This study aimed to investigate co-occurring of ADHD in children with PDD. Methods: A clinical sample of 68 children with PDD was assessed according to DSM-IV criteria to make ADHD and/ or PDD diagnoses. All the different types of PDD were included. DSM-IV derived criteria for ADHD and PDD were analyzed. An exploratory factor analysis was conducted. Results: the rate of autism, Asperger syndrome, Rett′s disorder, childhood disintegrative disorder and PDD-NOS (not otherwise specified was 55.4%, 16.9%, 3.1%, 3.1%, 21.5%, respectively. 53.8% of the sample was with ADHD co-morbidity. The rate of ADHD subtypes was 37.1%, 22.9%, and 40.0% for inattentive type, hyperactivity/impulsivity type and combined type, respectively. Conclusion: ADHD and its symptoms highly co-occur with PDD. Meanwhile, the result of factor analysis supports the independence of ADHD and PDD diagnostic criteria.

Mental disorders among college students in the WHO World Mental Health Surveys

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Auerbach, Randy P.; Alonso, Jordi; Axinn, William G.; Cuijpers, Pim; Ebert, David D.; Green, Jennifer Greif; Hwang, Irving; Kessler, Ronald C.; Liu, Howard; Mortier, Philippe; Nock, Matthew K.; Pinder-Amaker, Stephanie; Sampson, Nancy A.; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Andrade, Laura H.; Benjet, Corina; Caldas-de-Almeida, José Miguel; Demyttenaere, Koen; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Haro, Josep Maria; Karam, Elie G.; Kiejna, Andrzej; Kovess-Masfety, Viviane; Lee, Sing; McGrath, John J.; O’Neill, Siobhan; Pennell, Beth-Ellen; Scott, Kate; ten Have, Margreet; Torres, Yolanda; Zaslavsky, Alan M.; Zarkov, Zahari; Bruffaerts, Ronny

2016-01-01

Background Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Methods The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1,572) and nonstudents in the same age range (18–22; n = 4,178), including nonstudents who recently left college without graduating (n = 702) based on surveys in 21 countries (4 low/lower-middle income, 5 upper middle-income, 1 lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioural and substance disorders were assessed with the Composite International Diagnostic Interview. Results One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders. 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning. PMID:27484622

Externalizing disorders: cluster 5 of the proposed meta-structure for DSM-V and ICD-11.

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Krueger, R F; South, S C

2009-12-01

The extant major psychiatric classifications DSM-IV and ICD-10 are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of the etiology. In an attempt to group mental disorders on the basis of etiology, five clusters have been proposed. We consider the validity of the fifth cluster, externalizing disorders, within this proposal. We reviewed the literature in relation to 11 validating criteria proposed by the Study Group of the DSM-V Task Force, in terms of the extent to which these criteria support the idea of a coherent externalizing spectrum of disorders. This cluster distinguishes itself by the central role of disinhibitory personality in mental disorders spread throughout sections of the current classifications, including substance dependence, antisocial personality disorder and conduct disorder. Shared biomarkers, co-morbidity and course offer additional evidence for a valid cluster of externalizing disorders. Externalizing disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria.

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Wagner, Gudrun; Zeiler, Michael; Waldherr, Karin; Philipp, Julia; Truttmann, Stefanie; Dür, Wolfgang; Treasure, Janet L; Karwautz, Andreas F K

2017-12-01

This is a nationwide epidemiological study using DSM-5 criteria to assess the prevalence of mental disorders in a large sample of Austrian adolescents between 10 and 18 years including hard-to-reach samples. A sample of 3615 adolescents from four cohorts (school grades 5, 7, 9, 11; age range 10-18 years) was recruited from 261 schools, samples of unemployed adolescents (n = 39) and adolescents from mental health institutions (n = 137) were added. The Youth Self-Report and SCOFF were used to screen for mental health problems. In a second phase, the Childrens' Diagnostic Interview for Mental Disorders was used to make point and lifetime psychiatric diagnoses. Mental health service use was also assessed. Point prevalence and lifetime prevalence rates for at least one psychiatric disorder were 23.9% and 35.8%. The highest lifetime prevalence rates were found for anxiety disorders (15.6%), neurodevelopmental disorders (9.3%; ADHD 5.2%) and depressive disorders (6.2%). Forty-seven percent of adolescents with a lifetime psychiatric disorder had a second diagnosis. Internalising disorders were more prevalent in girls, while neurodevelopmental disorders and disruptive, impulse control and conduct disorders were more prevalent in boys. Of those with a lifetime psychiatric disorder, 47.5% had contacted mental health services. Of the residual 52.5% who had not contacted mental health services, 18.1% expressed an interest in treatment. DSM-5 mental health disorders are highly prevalent among Austrian adolescents. Over 50% had or were interested in accessing treatment. Early access to effective interventions for these problems is needed to reduce burden due to mental health disorders.

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys.

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Kessler, Ronald C; McLaughlin, Katie A; Green, Jennifer Greif; Gruber, Michael J; Sampson, Nancy A; Zaslavsky, Alan M; Aguilar-Gaxiola, Sergio; Alhamzawi, Ali Obaid; Alonso, Jordi; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; Chatterji, Somnath; de Girolamo, Giovanni; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Haro, Josep Maria; Hu, Chi-Yi; Karam, Elie G; Kawakami, Norito; Lee, Sing; Lépine, Jean-Pierre; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tsang, Adley; Ustün, T Bedirhan; Vassilev, Svetlozar; Viana, Maria Carmen; Williams, David R

2010-11-01

Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

Potential Impact of DSM-5 Criteria on Autism Spectrum Disorder Prevalence Estimates

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Maenner, Matthew J.; Rice, Catherine E.; Arneson, Carrie L.; Cunniff, Christopher; Schieve, Laura A.; Carpenter, Laura A.; Van Naarden Braun, Kim; Kirby, Russell S.; Bakian, Amanda V.; Durkin, Maureen S.

2014-01-01

IMPORTANCE The DSM-5 contains revised diagnostic criteria for autism spectrum disorder (ASD) from the DSM-IV-TR. Potential impacts of the new criteria on ASD prevalence are unclear. OBJECTIVE To assess potential effects of the DSM-5 ASD criteria on ASD prevalence estimation by retrospectively applying the new criteria to population-based surveillance data collected for previous ASD prevalence estimation. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based ASD surveillance based on clinician review of coded behaviors documented in children’s medical and educational evaluations from 14 geographically defined areas in the United States participating in the Autism and Developmental Disabilities Monitoring (ADDM) Network in 2006 and 2008. This study included 8-year-old children living in ADDM Network study areas in 2006 or 2008, including 644 883 children under surveillance, of whom 6577 met surveillance ASD case status based on the DSM-IV-TR. MAIN OUTCOMES AND MEASURES Proportion of children meeting ADDM Network ASD criteria based on the DSM-IV-TR who also met DSM-5 criteria; overall prevalence of ASD using DSM-5 criteria. RESULTS Among the 6577 children classified by the ADDM Network as having ASD based on the DSM-IV-TR, 5339 (81.2%) met DSM-5 ASD criteria. This percentage was similar for boys and girls but higher for those with than without intellectual disability (86.6% and 72.5%, respectively; P DSM-5 ASD criteria but not current ADDM Network ASD case status. Based on these findings, ASD prevalence per 1000 for 2008 would have been 10.0 (95% CI, 9.6–10.3) using DSM-5 criteria compared with the reported prevalence based on DSM-IV-TR criteria of 11.3 (95% CI, 11.0–11.7). CONCLUSIONS AND RELEVANCE Autism spectrum disorder prevalence estimates will likely be lower under DSM-5 than under DSM-IV-TR diagnostic criteria, although this effect could be tempered by future adaptation of diagnostic practices and documentation of behaviors to fit the new

Positive mental health: is there a cross-cultural definition?

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Vaillant, George E

2012-06-01

SEVEN MODELS FOR CONCEPTUALIZING POSITIVE MENTAL HEALTH ARE REVIEWED: mental health as above normal, epitomized by a DSM-IV's Global Assessment of Functioning (GAF) score of over 80; mental health as the presence of multiple human strengths rather than the absence of weaknesses; mental health conceptualized as maturity; mental health as the dominance of positive emotions; mental health as high socio-emotional intelligence; mental health as subjective well-being; mental health as resilience. Safeguards for the study of mental health are suggested, including the need to define mental health in terms that are culturally sensitive and inclusive, and the need to empirically and longitudinally validate criteria for mental health.

An Introduction to the New DSM-III.

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Seligman, Linda

1983-01-01

Discusses and clarifies the diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II). The DSM-II seeks to provide a detailed description of all categories of mental illness according to five diagnostic axes. Diagnoses are divided into 17 broad categories, each subdivided into specific diagnoses. (JAC)

Should the DSM V drop Asperger syndrome?

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Ghaziuddin, Mohammad

2010-09-01

The DSM IV defines Asperger syndrome (AS) as a pervasive developmental (autistic spectrum) disorder characterized by social deficits and rigid focused interests in the absence of language impairment and cognitive delay. Since its inclusion in the DSM-IV, there has been a dramatic increase in its recognition both in children and adults. However, because studies have generally failed to demonstrate a clear distinction between AS and autism, some researchers have called for its elimination from the forthcoming DSM V. This report argues for a modification of its diagnostic criteria and its continued retention in the diagnostic manual.

Prevalence of DSM-IV Disorder in a Representative, Healthy Birth Cohort at School Entry: Sociodemographic Risks and Social Adaptation

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Carter, Alice S.; Wagmiller, Robert J.; Gray, Sarah A. O.; McCarthy, Kimberly J.; Horwitz, Sarah M.; Briggs-Gowan, Margaret J.

2010-01-01

Objective: The aims of this paper are as follows: to present past-year prevalence data for DSM-IV disorders in the early elementary school years; to examine the impact of impairment criteria on prevalence estimates; to examine the relation of sociodemographic and psychosocial risk factors to disorders; and to explore associations between…

Mental disorders and subsequent educational attainment in a US national sample.

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Breslau, Joshua; Lane, Michael; Sampson, Nancy; Kessler, Ronald C

2008-07-01

As part of a larger investigation of the adverse effects of mental disorders on role functioning, we examined the associations of early-onset mental disorders with subsequent educational attainment in a large nationally representative survey of the US adult population. Diagnoses and age of onset for each of 17 DSM-IV disorders were assessed through retrospective self-report with the fully structured WHO Composite International Diagnostic Instrument (CIDI). Survival analysis was used to examine the associations between early-onset DSM-IV/CIDI disorders and subsequent termination of schooling with controls for socio-demographic characteristics and childhood adversities (i.e. childhood traumatic events, childhood neglect, parental mental illness, family disruption, and low parental educational attainment). Mental disorders were found to be significantly associated with termination of schooling prior to completion of each of four educational milestones (primary school graduation, high school graduation, college entry, college graduation), with odds ratios in the range of 1.3-7.0. The proportion of school terminations attributable to mental disorders was largest for high school graduation (10.2%) but also meaningful for primary school graduation (3.8%), college entry (4.4%) and college graduation (2.6%). These results add to a growing body of evidence documenting a wide variety of adverse life course effects of mental disorders.

Implications of DSM-5 for the diagnosis of pediatric eating disorders.

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Limburg, Karina; Shu, Chloe Y; Watson, Hunna J; Hoiles, Kimberley J; Egan, Sarah J

2018-03-08

The aim of the study was to compare the DSM-IV, DSM-5, and ICD-10 eating disorders (ED) nomenclatures to assess their value in the classification of pediatric eating disorders. We investigated the prevalence of the disorders in accordance with each system's diagnostic criteria, diagnostic concordance between the systems, and interrater reliability. Participants were 1062 children and adolescents assessed at intake to a specialist Eating Disorders Program (91.6% female, mean age 14.5 years, SD = 1.75). Measures were collected from routine intake assessments. DSM-5 categorization led to a lower prevalence of unspecified EDs when compared with DSM-IV. There was almost complete overlap for specified EDs. Kappa values indicated almost excellent agreement between the two coders on all three diagnostic systems, although there was higher interrater reliability for DSM-5 and ICD-10 when compared with DSM-IV. DSM-5 nomenclature is useful in classifying eating disorders in pediatric clinical samples. © 2018 Wiley Periodicals, Inc.

Synthesizing dimensional and categorical approaches to personality disorders: refining the research agenda for DSM-V Axis II.

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Krueger, Robert F; Skodol, Andrew E; Livesley, W John; Shrout, Patrick E; Huang, Yueqin

2007-01-01

Personality disorder researchers have long considered the utility of dimensional approaches to diagnosis, signaling the need to consider a dimensional approach for personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Nevertheless, a dimensional approach to personality disorders in DSM-V is more likely to succeed if it represents an orderly and logical progression from the categorical system in DSM-IV. With these considerations and opportunities in mind, the authors sought to delineate ways of synthesizing categorical and dimensional approaches to personality disorders that could inform the construction of DSM-V. This discussion resulted in (1) the idea of having a set of core descriptive elements of personality for DSM-V, (2) an approach to rating those elements for specific patients, (3) a way of combining those elements into personality disorder prototypes, and (4) a revised conception of personality disorder as a construct separate from personality traits. Copyright (c) 2007 John Wiley & Sons, Ltd.

Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys.

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Evans-Lacko, S; Aguilar-Gaxiola, S; Al-Hamzawi, A; Alonso, J; Benjet, C; Bruffaerts, R; Chiu, W T; Florescu, S; de Girolamo, G; Gureje, O; Haro, J M; He, Y; Hu, C; Karam, E G; Kawakami, N; Lee, S; Lund, C; Kovess-Masfety, V; Levinson, D; Navarro-Mateu, F; Pennell, B E; Sampson, N A; Scott, K M; Tachimori, H; Ten Have, M; Viana, M C; Williams, D R; Wojtyniak, B J; Zarkov, Z; Kessler, R C; Chatterji, S; Thornicroft, G

2018-07-01

The treatment gap between the number of people with mental disorders and the number treated represents a major public health challenge. We examine this gap by socio-economic status (SES; indicated by family income and respondent education) and service sector in a cross-national analysis of community epidemiological survey data. Data come from 16 753 respondents with 12-month DSM-IV disorders from community surveys in 25 countries in the WHO World Mental Health Survey Initiative. DSM-IV anxiety, mood, or substance disorders and treatment of these disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI). Only 13.7% of 12-month DSM-IV/CIDI cases in lower-middle-income countries, 22.0% in upper-middle-income countries, and 36.8% in high-income countries received treatment. Highest-SES respondents were somewhat more likely to receive treatment, but this was true mostly for specialty mental health treatment, where the association was positive with education (highest treatment among respondents with the highest education and a weak association of education with treatment among other respondents) but non-monotonic with income (somewhat lower treatment rates among middle-income respondents and equivalent among those with high and low incomes). The modest, but nonetheless stronger, an association of education than income with treatment raises questions about a financial barriers interpretation of the inverse association of SES with treatment, although future within-country analyses that consider contextual factors might document other important specifications. While beyond the scope of this report, such an expanded analysis could have important implications for designing interventions aimed at increasing mental disorder treatment among socio-economically disadvantaged people.

Treatment recommendations for DSM-5-defined mixed features.

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Rosenblat, Joshua D; McIntyre, Roger S

2017-04-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) mixed features specifier provides a less restrictive definition of mixed mood states, compared to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), including mood episodes that manifest with subthreshold symptoms of the opposite mood state. A limited number of studies have assessed the efficacy of treatments specifically for DSM-5-defined mixed features in mood disorders. As such, there is currently an inadequate amount of data to appropriately inform evidence-based treatment guidelines of DSM-5 defined mixed features. However, given the high prevalence and morbidity of mixed features, treatment recommendations based on the currently available evidence along with expert opinion may be of benefit. This article serves to provide these interim treatment recommendations while humbly acknowledging the limited amount of evidence currently available. Second-generation antipsychotics (SGAs) appear to have the greatest promise in the treatment of bipolar disorder (BD) with mixed features. Conventional mood stabilizing agents (ie, lithium and divalproex) may also be of benefit; however, they have been inadequately studied. In the treatment of major depressive disorder (MDD) with mixed features, the comparable efficacy of antidepressants versus other treatments, such as SGAs, remains unknown. As such, antidepressants remain first-line treatment of MDD with or without mixed features; however, there are significant safety concerns associated with antidepressant monotherapy when mixed features are present, which merits increased monitoring. Lurasidone is the only SGA monotherapy that has been shown to be efficacious specifically in the treatment of MDD with mixed features. Further research is needed to accurately determine the efficacy, safety, and tolerability of treatments specifically for mood episodes with mixed features to adequately inform

DSM-5 AND ICD-11 DEFINITIONS OF POSTTRAUMATIC STRESS DISORDER: INVESTIGATING “NARROW” AND “BROAD” APPROACHES

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Stein, Dan J.; McLaughlin, Katie A.; Koenen, Karestan C.; Atwoli, Lukoye; Friedman, Matthew J.; Hill, Eric D.; Maercker, Andreas; Petukhova, Maria; Shahly, Victoria; van Ommeren, Mark; Alonso, Jordi; Borges, Guilherme; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia; Karam, Elie G.; Kawakami, Norito; Matschinger, Herbert; Okoliyski, Michail; Posada-Villa, Jose; Scott, Kate M.; Viana, Maria Carmen; Kessler, Ronald C.

2014-01-01

Background The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10. Methods WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSMIV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview (CIDI). DSM-5 and proposed ICD-11 criteria were approximated. Associations of the different criteria sets with indicators of clinical severity (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate the implications of using the different systems. Results A total of 5.6% of respondents met criteria for “broadly defined” PTSD (i.e., full criteria in at least one diagnostic system), with prevalence ranging from 3.0% with DSM-5 to 4.4% with ICD-10. Only one-third of broadly defined cases met criteria in all four systems and another one third in only one system (narrowly defined cases). Between-system differences in indicators of clinical severity suggest that ICD-10 criteria are least strict and DSM-IV criteria most strict. The more striking result, though, is that significantly elevated indicators of clinical significance were found even for narrowly defined cases for each of the four diagnostic systems. Conclusions These results argue for a broad definition of PTSD defined by any one of the different systems to capture all clinically significant cases of PTSD in future studies. PMID:24894802

Mental disorders among college students in the World Health Organization World Mental Health Surveys.

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Auerbach, R P; Alonso, J; Axinn, W G; Cuijpers, P; Ebert, D D; Green, J G; Hwang, I; Kessler, R C; Liu, H; Mortier, P; Nock, M K; Pinder-Amaker, S; Sampson, N A; Aguilar-Gaxiola, S; Al-Hamzawi, A; Andrade, L H; Benjet, C; Caldas-de-Almeida, J M; Demyttenaere, K; Florescu, S; de Girolamo, G; Gureje, O; Haro, J M; Karam, E G; Kiejna, A; Kovess-Masfety, V; Lee, S; McGrath, J J; O'Neill, S; Pennell, B-E; Scott, K; Ten Have, M; Torres, Y; Zaslavsky, A M; Zarkov, Z; Bruffaerts, R

2016-10-01

Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.

Paradigm shifts and the development of the diagnostic and statistical manual of mental disorders: past experiences and future aspirations.

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First, Michael B

2010-11-01

Work is currently under way on the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, due to be published by the American Psychiatric Association in 2013. Dissatisfaction with the current categorical descriptive approach has led to aspirations for a paradigm shift for DSM-5. A historical review of past revisions of the DSM was performed. Efforts undertaken before the start of the DSM-5 development process to conduct a state-of-the science review and set a research agenda were examined to determine if results supported a paradigm shift for DSM-5. Proposals to supplement DSM-5 categorical diagnosis with dimensional assessments are reviewed and critiqued. DSM revisions have alternated between paradigm shifts (the first edition of the DSM in 1952 and DSM-III in 1980) and incremental improvements (DSM-II in 1968, DSM-III-R in 1987, and DSM-IV in 1994). The results of the review of the DSM-5 research planning initiatives suggest that despite the scientific advances that have occurred since the descriptive approach was first introduced in 1980, the field lacks a sufficiently deep understanding of mental disorders to justify abandoning the descriptive approach in favour of a more etiologically based alternative. Proposals to add severity and cross-cutting dimensions throughout DSM-5 are neither paradigm shifting, given that simpler versions of such dimensions are already a component of DSM-IV, nor likely to be used by busy clinicians without evidence that they improve clinical outcomes. Despite initial aspirations that DSM would undergo a paradigm shift with this revision, DSM-5 will continue to adopt a descriptive categorical approach, albeit with a greatly expanded dimensional component.

The DSM and Professional Practice: Research, Clinical, and Institutional Perspectives.

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Halpin, Michael

2016-06-01

How mental illnesses are defined has significant ramifications, given the substantial social and individual repercussions of these conditions. Using actor-network theory, I analyze how mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) in their work. Drawing on observations of a neuropsychological laboratory and interviews with 27 professionals (i.e., psychiatrists, psychologists), I investigate how the DSM is used in research, clinical, and institutional work. In research, the DSM influences study design and exclusion/inclusion criteria. In the clinic, the DSM influences how disorders are conceptualized and diagnosed. Institutionally, the DSM aligns the patient-professional encounter to insurance and pharmaceutical interests. I conclude that the DSM operates as multiple, context-specific taxonomies that pervasively influence professional practices, such that all possible actions must orient to DSM criteria, with professionals both a source and an object of institutionalized gaze. © American Sociological Association 2016.

Twenty Years of Diagnosis and the DSM.

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Seligman, Linda

1999-01-01

The process of diagnosing mental disorders and the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have been increasingly important for counselors. This article provides information on the hallmarks of this shift. Reviews and discusses the changes form the third and fourth editions of the DSM. Offers predictions as to future…

Is the Eating Disorder Questionnaire-Online (EDQ-O) a valid diagnostic instrument for the DSM-IV-TR classification of eating disorders?

NARCIS (Netherlands)

ter Huurne, Elke D.; de Haan, Hein A.; ten Napel-Schutz, Marieke C.; Postel, Marloes Gerda; Menting, Juliane; van der Palen, Jacobus Adrianus Maria; Vroling, Maartje S.; de Jong, Cor A.J.

2015-01-01

Background The Eating Disorder Questionnaire-Online (EDQ-O) is an online self-report questionnaire, which was developed specifically to provide a DSM-IV-TR classification of anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and eating disorder not otherwise specified (EDNOS),

Is the Eating Disorder Questionnaire-Online (EDQ-O) a valid diagnostic instrument for the DSM-IV-TR classification of eating disorders?

NARCIS (Netherlands)

Huurne, E.D. ter; Haan, H.A. de; Napel-Schutz, M.C. ten; Postel, M.G.; Menting, J.; Palen, J.A.M. van der; Vroling, M.S.; Jong, C.A.J. de

2015-01-01

Background: The Eating Disorder Questionnaire-Online (EDQ-O) is an online self-report questionnaire, which was developed specifically to provide a DSM-IV-TR classification of anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and eating disorder not otherwise specified

Social anxiety disorder: questions and answers for the DSM-V

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Bogels, S.M.; Stein, M.; Alden, L.; Beidel, D.C.; Clark, L.A.; Pine, D.S.; Stein, M.B.; Voncken, M.

2010-01-01

Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A

Re-evaluating DSM-I.

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Cooper, R; Blashfield, R K

2016-02-01

The DSM-I is currently viewed as a psychoanalytic classification, and therefore unimportant. There are four reasons to challenge the belief that DSM-I was a psychoanalytic system. First, psychoanalysts were a minority on the committee that created DSM-I. Second, psychoanalysts of the time did not use DSM-I. Third, DSM-I was as infused with Kraepelinian concepts as it was with psychoanalytic concepts. Fourth, contemporary writers who commented on DSM-I did not perceive it as psychoanalytic. The first edition of the DSM arose from a blending of concepts from the Statistical Manual for the Use of Hospitals of Mental Diseases, the military psychiatric classifications developed during World War II, and the International Classification of Diseases (6th edition). As a consensual, clinically oriented classification, DSM-I was popular, leading to 20 printings and international recognition. From the perspective inherent in this paper, the continuities between classifications from the first half of the 20th century and the systems developed in the second half (e.g. DSM-III to DSM-5) become more visible.

Diagnostic Classification of Eating Disorders in Children and Adolescents: How Does DSM-IV-TR Compare to Empirically-Derived Categories?

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Eddy, Kamryn T.; Le Grange, Daniel; Crosby, Ross D.; Hoste, Renee Rienecke; Doyle, Angela Celio; Smyth, Angela; Herzog, David B.

2010-01-01

Objective: The purpose of this study was to empirically derive eating disorder phenotypes in a clinical sample of children and adolescents using latent profile analysis (LPA), and to compare these latent profile (LP) groups to the DSM-IV-TR eating disorder categories. Method: Eating disorder symptom data collected from 401 youth (aged 7 through 19…

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

NARCIS (Netherlands)

Kessler, Ronald C.; McLaughlin, Katie A.; Green, Jennifer Greif; Gruber, Michael J.; Sampson, Nancy A.; Zaslavsky, Alan M.; Aguilar-Gaxiola, Sergio; Alhamzawi, Ali Obaid; Alonso, Jordi; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; Chatterji, Somnath; de Girolamo, Giovanni; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Maria Haro, Josep; Hu, Chi-yi; Karam, Elie G.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Tsang, Adley; Uestuen, T. Bedirhan; Vassilev, Svetlozar; Viana, Maria Carmen; Williams, David R.

2010-01-01

Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV

Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11.

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Doernberg, Ellen; Hollander, Eric

2016-08-01

Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide.

Measurement non-invariance of DSM-IV narcissistic personality disorder criteria across age and sex in a population-based sample of Norwegian twins.

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Kubarych, Thomas S; Aggen, Steven H; Kendler, Kenneth S; Torgersen, Sven; Reichborn-Kjennerud, Ted; Neale, Michael C

2010-09-01

We investigated measurement non-invariance of DSM-IV narcissistic personality disorder (NPD) criteria across age and sex in a population-based cohort sample of 2794 Norwegian twins. Age had a statistically significant effect on the factor mean for NPD. Sex had a statistically significant effect on the factor mean and variance. Controlling for these factor level effects, item-level analysis indicated that the criteria were functioning differently across age and sex. After correcting for measurement differences at the item level, the latent factor mean effect for age was no longer statistically significant. The mean difference for sex remained statistically significant after correcting for item threshold effects. The results indicate that DSM-IV NPD criteria perform differently in males and females and across age. Differences in diagnostic rates across groups may not be valid without correcting for measurement non-invariance.

Delusional disorder-jealous type: how inclusive are the DSM-IV diagnostic criteria?

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Easton, Judith A; Shackelford, Todd K; Schipper, Lucas D

2008-03-01

Delusional disorder-jealous type is a new diagnostic category in the Diagnostic and Statistical Manual for Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) in which delusions concerning a partner's infidelity must be present. Therefore, patients who experience a jealousy disorder, but do not experience delusions will not fit the diagnostic criteria. Using a database of 398 case histories of jealousy disorders reported in the literature from 1940-2002, we examined the percentage of these cases that met the diagnostic criteria for delusional disorder-jealous type. Only 4% of the cases met all diagnostic criteria. This is the first systematic comparison of the prevalence of these disorders. The results provide evidence that the diagnostic criteria are not inclusive, as most individuals suffering with a jealousy disorder were excluded from the diagnosis.

The Life and Death of Axis IV: Caught in the Quest for a Theory of Mental Disorder

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Probst, Barbara

2014-01-01

Axis IV, one of the five dimensions of clinical description, has provided a way to report psychosocial and environmental problems that may affect the diagnosis, treatment, and/or prognosis of a psychiatric disorder. Originally conceived in DSM-III as a way to rate and rank the severity of particular environmental stressors, axis IV was simplified…

Brief Report: Should the DSM V Drop Asperger Syndrome?

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Ghaziuddin, Mohammad

2010-01-01

The DSM IV defines Asperger syndrome (AS) as a pervasive developmental (autistic spectrum) disorder characterized by social deficits and rigid focused interests in the absence of language impairment and cognitive delay. Since its inclusion in the DSM-IV, there has been a dramatic increase in its recognition both in children and adults. However,…

Original article The structure of symptoms of posttraumatic stress disorder according to DSM-5 and assessed by PDS-5 – preliminary results

Directory of Open Access Journals (Sweden)

Bogdan Zawadzki

2015-03-01

Full Text Available Background The structure of posttraumatic stress disorder (PTSD symptoms has been studied and discussed since the introduction of PTSD as a diagnostic entity in the DSM-III (Diagnostic and Statistical Manual of Mental Disorders III in 1980. Many studies supported a four-factor or a five-factor models, both inconsistent with DSM-IV. It is unclear whether current DSM-5 criteria appropriately reflect the empirical structure of PTSD symptoms. Participants and procedure In this study the structure of PTSD symptoms was examined by confirmatory factor analysis conducted on the data obtained from 388 individuals (150 males and 239 females aged 18-83 who experienced a traumatic event and completed the PDS-5 (Posttraumatic Diagnostic Scale-5, a self-report scale according to the DSM-5 criteria. Results Fitting of different models based on DSM-IV, DSM-5 and other the most common four- and five-factor conceptualizations of PTSD symptoms structure was examined. The data analyses demonstrated the best fit of the six-factor model based on the conceptualization of Elhai et al. (2011 with the additional factor of negative cognitions and mood. Conclusions The DSM-5 diagnostic criteria do not reflect the empirical PTSD symptom structure. The data suggest also that it is reasonable to separate the core PTSD symptoms from broad PTSD symptomatology.

Food insecurity and mental disorders in a national sample of U.S. adolescents.

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McLaughlin, Katie A; Green, Jennifer Greif; Alegría, Margarita; Jane Costello, E; Gruber, Michael J; Sampson, Nancy A; Kessler, Ronald C

2012-12-01

To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture's Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status). Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14% increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation. Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Measuring mental disorders: The failed commensuration project of DSM-5.

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Whooley, Owen

2016-10-01

Commensuration - the comparison of entities according to a common quantitative metric - is a key process in efforts to rationalize medicine. The push toward evidence-based medicine and quantitative assessment has led to the proliferation of metrics in healthcare. While social scientific attention has revealed the effects of these metrics once institutionalized - on clinical practice, on medical expertise, on outcome assessment, on valuations of medical services, and on experiences of illness - less attention has been paid to the process of developing metrics. This article examines the attempt to create severity scales during the revision to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a case of failed commensuration. Using data from interviews with participants in the DSM-5 revision (n = 30), I reconstruct the problems that emerged in the DSM-5 Task Force's effort to develop viable psychometric instruments to measure severity. Framed as a part of a "paradigm shift" in psychiatry, the revision produced ad hoc, heterogeneous severity scales with divergent logics. I focus on two significant issues of metric construction in this case - diagnostic validity and clinical utility. Typically perceived as technical and conceptual challenges of design, I show how these issues were infused with, and undermined by, professional political dynamics, specifically tensions between medical researchers and clinicians. This case reveals that, despite its association with objectivity and transparency, commensuration encompasses more than identifying, operationalizing, and measuring an entity; it demands the negotiation of extra-scientific, non-empirical concerns that get written into medical metrics themselves. Copyright © 2016 Elsevier Ltd. All rights reserved.

DSM-IV-defined anxiety disorder symptoms in a middle-childhood-aged group of Malaysian children using the Spence Children's Anxiety Scale.

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Ahmadi, Atefeh; Mustaffa, Mohamed Sharif; Udin, Amirmudin; Haghdoost, AliAkbar

2016-01-01

Pediatric anxiety disorders are the most common mental health disorders in the middle-childhood age group. The purpose of this study is to assess anxiety disorder symptoms, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), in a large community sample of low socioeconomic level rural children and to investigate some of the psychometric properties (internal consistency, construct and convergent validity and items rated as often or always experienced) of the Malay version of the Spence Children's Anxiety Scale - Child version (SCAS-C). Six hundred children aged 9-11 and 424 of their parents completely answered the child or parent versions of the SCAS. Results indicated that the internal reliability of subscales were moderate to adequate. Significant correlations between child and parent reports supported the measure's concurrent validity. Additionally, anxiety levels in this Malaysian sample were lower than among South-African children and higher than among their Western peers. There were both similarities and differences between symptom items reported as often or always experienced by Malaysian students and by children from other cultures. Confirmatory factor analysis provided evidence of the existence of five inter-correlated factors for anxiety disorders based on SCAS-C. Although some of the instrument's psychometric properties deviated from those observed in some other countries, it nevertheless appears to be useful for assessing childhood anxiety symptoms in this country.

A distinct language and a historic pendulum: the evolution of the Diagnostic and Statistical Manual of Mental Disorders.

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Sanders, James L

2011-12-01

Historically, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has met an important need in defining a common language of psychiatric diagnosis in North America. Understanding the development of the DSM can help researchers and practitioners better understand this diagnostic language. The history of the DSM, from its precursors to recent proposed revisions for its fifth edition, is reviewed and compared while avoiding the presentist bias. The development of DSM resembles a historic pendulum, from DSM-I emphasizing psychodynamics and causality to DSM-III and DSM-IV emphasizing empiricism and logical positivism. The proposed changes in etiological- and dimensional-based classification for DSM-V represent a slight backswing toward the center. 2011 Elsevier Inc. All rights reserved.

Transition from Pervasive Developmental Disorders to Autism Spectrum Disorder: Proposed Changes for the Upcoming DSM-5

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Banu Tortamis Ozkaya

2013-06-01

Full Text Available American Psychiatry Assosiation has scheduled to release The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5 in May 2013. According to the main changes being proposed about autism, there will be one unified Autism Spectrum Disorder diagnosis in the DSM-5 classification. This unified diagnosis will eliminate the distinct diagnostic categories under Pervasive Developmental Disorders in the DSM-IV-TR, namely autistic disorder, asperger syndrome, pervasive developmental disorder-not otherwise specified, and childhood disintegrative disorder. Rett syndrome will be excluded from autism spectrum disorder due to its genetic basis. In addition, severity of symptoms will be measured among individuals with autism spectrum disorder based on the support level required due to the impairment in their lives. The basic rationale behind this revision is that it is better to conceptualize autism as a spectrum including various individuals whose symptoms in different developmental areas range from mild to severe. It is aimed to increase the specificity of autism diagnosis by using one single diagnostic category with its specified severity rather than differentiating several subtypes. The major concern raised over the DSM-5 proposal has been the possibility that some of the individuals who were diagnosed with pervasive developmental disorder according to the DSM-IV-TR might not get a diagnosis in this new system. After the DSM-5 is released, clinical, legal, and educational rearrengements regarding the use of new autism spectrum disorder diagnostic criteria are expected to accelerate worldwide and in Turkey. This paper aims to review briefly the upcoming autism spectrum disorder diagnosis planned to appear in the DSM-5, the rationale of the proposed revision, main critics to the DSM-5 draft that has been publicized, and some of the regulations expected to occur in practice after the changes.

A follow-up study of patients with DSM-IV schizophreniform disorder.

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Iancu, Iulian; Dannon, Pinhas N; Ziv, Reuven; Lepkifker, Elie

2002-02-01

Schizophreniform disorder (SFD) has an unclear diagnostic and prognostic status within the psychotic spectrum. We studied 36 inpatients admitted to our ward between 1983 and 1993 due to SFD. The patients were contacted an average of 12 years after index hospitalization, and we noted the course of their illness, as well as their present diagnosis. Of the sample, 84% had additional, mostly psychotic, episodes during the follow-up, and 70% had diagnoses in the schizophrenic spectrum (that is, schizophrenia and schizoaffective disorder). A survival analysis revealed that confusion and the presence of at least 2 good prognostic factors (GPF) at index hospitalization predicted better outcome. SFD seems to be an early manifestation of schizophrenia. Only a few of those sampled did not experience additional relapses--a pessimistic finding at 12-year follow-up. The findings of this study accord with DSM-IV criteria and the literature regarding the long-term prognosis of SFD and the importance of the GPF.

A psychometric evaluation of the DSM-IV borderline personality disorder criteria: age and sex moderation of criterion functioning

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Aggen, S. H.; Neale, M. C.; Røysamb, E.; Reichborn-Kjennerud, T.; Kendler, K. S.

2009-01-01

Background Despite its importance as a paradigmatic personality disorder, little is known about the measurement invariance of the DSM-IV borderline personality disorder (BPD) criteria ; that is, whether the criteria assess the disorder equivalently across different groups. Method BPD criteria were evaluated at interview in 2794 young adult Norwegian twins. Analyses, based on item-response modeling, were conducted to test for differential age and sex moderation of the individual BPD criteria characteristics given factor-level covariate effects. Results Confirmatory factor analytic results supported a unidimensional structure for the nine BPD criteria. Compared to males, females had a higher BPD factor mean, larger factor variance and there was a significant age by sex interaction on the factor mean. Strong differential sex and age by sex interaction effects were found for the ‘ impulsivity ’ criterion factor loading and threshold. Impulsivity related to the BPD factor poorly in young females but improved significantly in older females. Males reported more impulsivity compared to females and this difference increased with age. The ‘ affective instability ’ threshold was also moderated, with males reporting less than expected. Conclusions The results suggest the DSM-IV BPD ‘ impulsivity ’ and ‘ affective instability ’ criteria function differentially with respect to age and sex, with impulsivity being especially problematic. If verified, these findings have important implications for the interpretation of prior research with these criteria. These non-invariant age and sex effects may be identifying criteria-level expression features relevant to BPD nosology and etiology. Criterion functioning assessed using modern psychometric methods should be considered in the development of DSM-V. PMID:19400977

DSM-5 somatic symptom disorder in patients with vertigo and dizziness symptoms.

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Limburg, Karina; Sattel, Heribert; Radziej, Katharina; Lahmann, Claas

2016-12-01

DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires. The diagnosis of SSD was assigned retrospectively. The prevalence of SSD, its diagnostic criteria, and its overlap with former DSM-IV somatoform disorders were evaluated; comparisons were drawn between (1) patients fulfilling different components of the B-criterion and (2) patients with diagnoses after DSM-IV vs. DSM-5. SSD was almost twice as common as DSM-IV somatoform disorders. Patients with all three components of the B-criterion reported the highest impairment levels. Patients with both DSM-IV somatoform disorders and DSM-5 SSD were more impaired compared to groups with one of the diagnoses; patients with DSM-IV somatoform disorders only were more impaired than those with SSD only. Our findings demonstrate that SSD is highly prevalent in patients with vertigo and dizziness. The classification of severity based on the number of psychological symptoms appears valid and may assist in finding suitable treatment options according to clinical practice guidelines. Future studies should investigate the overlap of SSD and other psychiatric disorders, this may assist in better defining the diagnostic criteria of SSD. Copyright © 2016 Elsevier Inc. All rights reserved.

DSM-5 changes enhance parent identification of symptoms in adolescents with ADHD.

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Sibley, Margaret H; Kuriyan, Aparajita B

2016-08-30

This study evaluates the impact of the DSM-5 ADHD symptom wording changes on symptom endorsement among adolescents with ADHD. Parents of adolescents with systematically diagnosed DSM-IV-TR ADHD (N=78) completed counterbalanced DSM-IV-TR and DSM-5 ADHD symptom checklists in a single sitting. General linear models were conducted to evaluate whether the new DSM-5 symptom descriptors influenced the total number of ADHD symptoms and overall ADHD symptom severity endorsed by parents, how demographic factors were associated with noted changes in symptom endorsement when moving to the DSM-5, and which DSM ADHD items displayed notable changes in endorsement rates under the new wording. On average, parents identified 1.15 additional symptoms of ADHD in adolescents when moving from the DSM-IV-TR to the DSM-5. Increased symptom identification was not specific to age, sex, ethnicity, race, or socioeconomic status. Over half of the sample experienced increased symptom endorsement when changing texts (59.0%). Under the new DSM-5 wording, four symptoms had statistically significant endorsement increases (range: 11.2-16.7%): difficulty sustaining attention, easily distracted, difficulty organizing tasks and activities, and does not seem to listen. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Examining sex differences in DSM-IV-TR narcissistic personality disorder symptom expression using Item Response Theory (IRT).

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Hoertel, Nicolas; Peyre, Hugo; Lavaud, Pierre; Blanco, Carlos; Guerin-Langlois, Christophe; René, Margaux; Schuster, Jean-Pierre; Lemogne, Cédric; Delorme, Richard; Limosin, Frédéric

2017-12-14

The limited published literature on the subject suggests that there may be differences in how females and males experience narcissistic personality disorder (NPD) symptoms. The aim of this study was to use methods based on item response theory to examine whether, when equating for levels of NPD symptom severity, there are sex differences in the likelihood of reporting DSM-IV-TR NPD symptoms. We conducted these analyses using a large, nationally representative sample from the USA (n=34,653), the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). There were statistically and clinically significant sex differences for 2 out of the 9 DSM-IV-TR NPD symptoms. We found that males were more likely to endorse the item 'lack of empathy' at lower levels of narcissistic personality disorder severity than females. The item 'being envious' was a better indicator of NPD severity in males than in females. There were no clinically significant sex differences on the remaining NPD symptoms. Overall, our findings indicate substantial sex differences in narcissistic personality disorder symptom expression. Although our results may reflect sex-bias in diagnostic criteria, they are consistent with recent views suggesting that narcissistic personality disorder may be underpinned by shared and sex-specific mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

Alcohol and Substance Use Disorders in DSM-5

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Gulcan Gulec

2015-12-01

Full Text Available When we compare the categories about alcohol, and substance-related disorders in DSM-IV and DSM-5, the new category, named addictive disorders is the most striking change. Only gambling disorder have been identified currently in this category. This may be the most remarkable change among the changes in the DSM-5. Because the expansion of the existing diagnostic criteria may cause the assessment of and lsquo;normal behavior' as a disorder. Additionally, withdrawal of caffeine and cannabis are defined in the DSM-5. Disorders collected under the title of substance-related disorders in the DSM-IV were collected under the name of substance-related and addictive disorders in the DSM-5. Specific criterias for substance abuse and substance addiction have been combined into the name of "substance use disorders". In substance abuse, "experienced legal problems" criteria was removed and "a strong desire or urge or craving for substance use" criteria has been introduced. Henceforth, substance abuse is defined as a mild form of substance use disorders in the DSM-5. A change in the prevalence of substance use disorders should be investigated by the new researches.

Personality pathology is dimensional, so what shall we do with the DSM-IV personality disorder categories? The case of narcissistic personality disorder: Comment on Miller and Campbell (2010).

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Krueger, Robert F

2010-07-01

What is narcissism? Is it a dimensional personality trait? Is it the core element of a categorical form of psychopathology? Miller and Campbell (see record 2010-17135-004) present a thoughtful, scholarly, and well-written review of a substantial literature aimed at synthesizing research on trait narcissism and contemplating its relevance to the category of narcissistic personality disorder (NPD). They also present an argument that research on trait narcissism should be used to help propel research on NPD, as explicated in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994). This latter argument is somewhat surprising in the context of the rest of Miller and Campbell's article and it is the focus of my commentary. PsycINFO Database Record (c) 2010 APA, all rights reserved

Short-interval test-retest interrater reliability of the Dutch version of the structured clinical interview for DSM-IV personality disorders (SCID-II)

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Weertman, A; ArntZ, A; Dreessen, L; van Velzen, C; Vertommen, S

2003-01-01

This study examined the short-interval test-retest reliability of the Structured Clinical Interview (SCID-II: First, Spitzer, Gibbon, & Williams, 1995) for DSM-IV personality disorders (PDs). The SCID-II was administered to 69 in- and outpatients on two occasions separated by 1 to 6 weeks. The

The Structured Clinical Interview for DSM-IV Childhood Diagnoses (Kid-SCID): first psychometric evaluation in a Dutch sample of clinically referred youths

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Roelofs, J.; Muris, P.; Braet, C.; Arntz, A.; Beelen, I.

2015-01-01

The Structured Clinical Interview for DSM-IV Childhood Disorders (Kid-SCID) is a semi-structured interview for the classification of psychiatric disorders in children and adolescents. This study presents a first evaluation of the psychometric properties of the Kid-SCID in a Dutch sample of children

A Clinical Comparison Study of Attention Deficit/Hyperactivity Disorder (DSM-IV) and Hyperkinetic Disorder (ICD-10) in Indian children and Adolescents

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Sitholey, Prabhat; Agarwal, Vivek; Bharti, Vikram

2012-01-01

Aims: To compare the usefulness of DSM IV and ICD-10 DCR criteria in clinic children presenting with the symptoms of inattention and hyperactivity-impulsivity. Methods: 62 children (54 boys and 8 girls) participated in the study. Children were assessed on Kiddie schedule for affective disorders and schizophrenia--present and lifetime version and…

Harmonisation of ICD-11 and DSM-V: opportunities and challenges.

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First, Michael B

2009-11-01

Differences in the ICD-10 and DSM-IV definitions for the same disorder impede international communication and research efforts. The forthcoming parallel development of DSM-V and ICD-11 offers an opportunity to harmonise the two classifications. This paper aims to facilitate the harmonisation process by identifying diagnostic differences between the two systems. DSM-IV-TR criteria sets and the ICD-10 Diagnostic Criteria for Research were compared and categorised into those with identical definitions, those with conceptually based differences and those in which differences are not conceptually based and appear to be unintentional. Of the 176 criteria sets in both systems, only one, transient tic disorder, is identical. Twenty-one per cent had conceptually based differences and 78% had non-conceptually based differences. Harmonisation of criteria sets, especially those with non-conceptually based differences, should be prioritised in the DSM-V and ICD-11 development process. Prior experience with the DSM-IV and ICD-10 harmonisation effort suggests that for the process to be successful steps should be taken as early as possible.

Investigating the cross-cultural validity of DSM-5 autism spectrum disorder: evidence from Finnish and UK samples.

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Mandy, William; Charman, Tony; Puura, Kaija; Skuse, David

2014-01-01

The recent Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) reformulation of autism spectrum disorder has received empirical support from North American and UK samples. Autism spectrum disorder is an increasingly global diagnosis, and research is needed to discover how well it generalises beyond North America and the United Kingdom. We tested the applicability of the DSM-5 model to a sample of Finnish young people with autism spectrum disorder (n = 130) or the broader autism phenotype (n = 110). Confirmatory factor analysis tested the DSM-5 model in Finland and compared the fit of this model between Finnish and UK participants (autism spectrum disorder, n = 488; broader autism phenotype, n = 220). In both countries, autistic symptoms were measured using the Developmental, Diagnostic and Dimensional Interview. Replicating findings from English-speaking samples, the DSM-5 model fitted well in Finnish autism spectrum disorder participants, outperforming a Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) model. The DSM-5 model fitted equally well in Finnish and UK autism spectrum disorder samples. Among broader autism phenotype participants, this model fitted well in the United Kingdom but poorly in Finland, suggesting that cross-cultural variability may be greatest for milder autistic characteristics. We encourage researchers with data from other cultures to emulate our methodological approach, to map any cultural variability in the manifestation of autism spectrum disorder and the broader autism phenotype. This would be especially valuable given the ongoing revision of the International Classification of Diseases-11th Edition, the most global of the diagnostic manuals.

Mental Health Stigma among Adolescents: Implications for School Social Workers

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Kranke, Derrick; Floersch, Jerry

2009-01-01

This study investigated adolescents with a mental health diagnosis and their experience of stigma in schools. Forty adolescents between the ages of twelve and seventeen who met DSM-IV criteria for a psychiatric illness and who were prescribed psychiatric medication were selected. The Teen Subjective Experience of Medication Interview was used to…

Impact of deleting 5 DSM-IV personality disorders on prevalence, comorbidity, and the association between personality disorder pathology and psychosocial morbidity.

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Zimmerman, Mark; Chelminski, Iwona; Young, Diane; Dalrymple, Kristy; Martinez, Jennifer

2012-02-01

A high rate of comorbidity among the personality disorders has been consistently identified as a problem. To address the problem of excessive comorbidity, the DSM-5 Personality and Personality Disorders Work Group recommended reducing the number of specific personality disorder diagnoses from 10 to 5 by eliminating paranoid, schizoid, histrionic, narcissistic, and dependent personality disorders. No study has examined the impact of this change. The present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project examined the impact of eliminating these 5 personality disorders on the prevalence of personality disorders in a large sample of psychiatric outpatients presenting for treatment, comorbidity among the personality disorders, and association with psychosocial morbidity. From September 1997 to June 2008, 2,150 psychiatric patients presenting to the Rhode Island Hospital outpatient practice were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders and measures of psychosocial morbidity. More than one-quarter of the patients were diagnosed with one of the 10 DSM-IV personality disorders (28.6%, n = 614). When 5 personality disorders were excluded from consideration, then 25.8% (n = 555) were diagnosed with at least 1 of the 5 personality disorders proposed for retention in DSM-5, and the comorbidity rate dropped from 29.8% to 21.3%. Compared to patients without a personality disorder, the patients with either a retained or an excluded personality disorder had greater psychosocial morbidity. There was little difference in psychosocial morbidity between patients with a retained and an excluded personality disorder. The Personality and Personality Disorders Work Group's desired goal of reducing comorbidity would be achieved by deleting 5 personality disorders, although comorbidity would not be eliminated. The reduction of comorbidity could come with a cost of false-negative diagnoses

Dimensional and Cross-Cutting Assessment in the "DSM-5"

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Jones, K. Dayle

2012-01-01

A significant proposed change to the 5th edition of the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM-5") that will significantly affect the way counselors diagnose mental disorders is the addition of dimensional assessments to the categorical diagnoses. The author reviews the current "DSM"'s (4th ed., text rev.; American…

Association of DSM-IV Posttraumatic Stress Disorder With Traumatic Experience Type and History in the World Health Organization World Mental Health Surveys.

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Liu, Howard; Petukhova, Maria V; Sampson, Nancy A; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Bromet, Evelyn J; de Girolamo, Giovanni; Haro, Josep Maria; Hinkov, Hristo; Kawakami, Norito; Koenen, Karestan C; Kovess-Masfety, Viviane; Lee, Sing; Medina-Mora, Maria Elena; Navarro-Mateu, Fernando; O'Neill, Siobhan; Piazza, Marina; Posada-Villa, José; Scott, Kate M; Shahly, Victoria; Stein, Dan J; Ten Have, Margreet; Torres, Yolanda; Gureje, Oye; Zaslavsky, Alan M; Kessler, Ronald C

2017-03-01

Previous research has documented significant variation in the prevalence of posttraumatic stress disorder (PTSD) depending on the type of traumatic experience (TE) and history of TE exposure, but the relatively small sample sizes in these studies resulted in a number of unresolved basic questions. To examine disaggregated associations of type of TE history with PTSD in a large cross-national community epidemiologic data set. The World Health Organization World Mental Health surveys assessed 29 TE types (lifetime exposure, age at first exposure) with DSM-IV PTSD that was associated with 1 randomly selected TE exposure (the random TE) for each respondent. Surveys were administered in 20 countries (n = 34 676 respondents) from 2001 to 2012. Data were analyzed from October 1, 2015, to September 1, 2016. Prevalence of PTSD assessed with the Composite International Diagnostic Interview. Among the 34 676 respondents (55.4% [SE, 0.6%] men and 44.6% [SE, 0.6%] women; mean [SE] age, 43.7 [0.2] years), lifetime TE exposure was reported by a weighted 70.3% of respondents (mean [SE] number of exposures, 4.5 [0.04] among respondents with any TE). Weighted (by TE frequency) prevalence of PTSD associated with random TEs was 4.0%. Odds ratios (ORs) of PTSD were elevated for TEs involving sexual violence (2.7; 95% CI, 2.0-3.8) and witnessing atrocities (4.2; 95% CI, 1.0-17.8). Prior exposure to some, but not all, same-type TEs was associated with increased vulnerability (eg, physical assault; OR, 3.2; 95% CI, 1.3-7.9) or resilience (eg, participation in sectarian violence; OR, 0.3; 95% CI, 0.1-0.9) to PTSD after the random TE. The finding of earlier studies that more general history of TE exposure was associated with increased vulnerability to PTSD across the full range of random TE types was replicated, but this generalized vulnerability was limited to prior TEs involving violence, including participation in organized violence (OR, 1.3; 95% CI, 1.0-1.6), experience of

Significance of the criteria evolution from DSM-IV to DSM-5%DSM-IV到DSM-5早泄诊断标准演变意义的研究

Institute of Scientific and Technical Information of China (English)

陶林; 刘捷; 王春华; 席晓慧

2013-01-01

本文是一篇有关美国精神疾病诊断系统中早泄诊断标准演变的综述,重点谈论DSM-IV到DSM-5的演变过程和临床意义,以及还存在哪些问题等,用来指导对早泄的研究和治疗.DSM-IV早泄诊断标准引进我国之后,对男科学界产生深远影响,而DSM-5的颁布也一定会掀起又一轮研究早泄的热潮.本文在DSM-5早泄诊断标准最后征求意见稿的发表过程中捷足先登,与同道进行交流,为今后引进早泄诊断标准起到铺路搭桥的作用,对早泄的进一步研究也不无裨益.

Impact of altering DSM-IV criteria for anorexia and bulimia nervosa on the base rates of eating disorder diagnoses.

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Thaw, J M; Williamson, D A; Martin, C K

2001-09-01

The diagnostic criteria used to define eating disorders have been the focus of debate for many years. The primary aim of this study was to evaluate the impact of altering DSM-IV diagnostic criteria upon the base rates of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS). Five controversial criteria were systematically modified and the impact of these changes on base rates of full-syndrome and partial-syndrome eating disorders was assessed in 193 patients referred to two specialty eating disorder clinics. Modification of a single criterion resulted in relatively small changes in base rates of AN and BN, whereas modification of the two severity criteria led to more substantial changes. These findings have significant implications for future modifications of the DSM classification.

Associations between DSM-IV mental disorders and onset of self-reported peptic ulcer in the World Mental Health Surveys

NARCIS (Netherlands)

Scott, Kate M.; Alonso, Jordi; de Jonge, Peter; Carmen Viana, Maria; Liu, Zhaorui; O'Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J.; Angermeyer, Matthias; Benjet, Corina; de Girolamo, Giovanni; Firuleasa, Ingrid-Laura; Hu, Chiyi; Kiejna, Andrzej; Kovess-Masfety, Viviane; Levinson, Daphna; Nakane, Yoshibumi; Piazza, Marina; Posada-Villa, Jose A.; Khalaf, Mohammad Salih; Lim, Carmen C. W.; Kessler, Ronald C.

Objective: Recent research demonstrating concurrent associations between mental disorders and peptic ulcers has renewed interest in links between psychological factors and ulcers. However, little is known about associations between temporally prior mental disorders and subsequent ulcer onset. Nor

Clashing Diagnostic Approaches: DSM-ICD versus RDoC

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Lilienfeld, Scott O.; Treadway, Michael T.

2016-01-01

Since at least the middle of the past century, one overarching model of psychiatric classification, namely, that of the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases (DSM-ICD), has reigned supreme. This DSM-ICD approach embraces an Aristotelian view of mental disorders as largely discrete entities that are characterized by distinctive signs, symptoms, and natural histories. Over the past several years, however, a competing vision, namely, the Research Domain Criteria (RDoC) initiative launched by the National Institute of Mental Health, has emerged in response to accumulating anomalies within the DSM-ICD system. In contrast to DSM-ICD, RDoC embraces a Galilean view of psychopathology as the product of dysfunctions in neural circuitry. RDoC appears to be a valuable endeavor that holds out the long-term promise of an alternative system of mental illness classification. We delineate three sets of pressing challenges – conceptual, methodological, and logistical/pragmatic – that must be addressed for RDoC to realize its scientific potential, and conclude with a call for further research, including investigation of a rapprochement between Aristotelian and Galilean approaches to psychiatric classification. PMID:26845519

DSM-IV-defined anxiety disorder symptoms in a middle-childhood-aged group of Malaysian children using the Spence Children's Anxiety Scale

Directory of Open Access Journals (Sweden)

Atefeh Ahmadi

2016-03-01

Full Text Available Introduction Pediatric anxiety disorders are the most common mental health disorders in the middle-childhood age group. The purpose of this study is to assess anxiety disorder symptoms, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV, in a large community sample of low socioeconomic level rural children and to investigate some of the psychometric properties (internal consistency, construct and convergent validity and items rated as often or always experienced of the Malay version of the Spence Children's Anxiety Scale - Child version (SCAS-C. Method Six hundred children aged 9-11 and 424 of their parents completely answered the child or parent versions of the SCAS. Results Results indicated that the internal reliability of subscales were moderate to adequate. Significant correlations between child and parent reports supported the measure's concurrent validity. Additionally, anxiety levels in this Malaysian sample were lower than among South-African children and higher than among their Western peers. There were both similarities and differences between symptom items reported as often or always experienced by Malaysian students and by children from other cultures. Confirmatory factor analysis provided evidence of the existence of five inter-correlated factors for anxiety disorders based on SCAS-C. Conclusion Although some of the instrument's psychometric properties deviated from those observed in some other countries, it nevertheless appears to be useful for assessing childhood anxiety symptoms in this country.

Latent Factor Structure of DSM-5 Posttraumatic Stress Disorder

Science.gov (United States)

Gentes, Emily; Dennis, Paul A.; Kimbrel, Nathan A.; Kirby, Angela C.; Hair, Lauren P.; Beckham, Jean C.; Calhoun, Patrick S.

2015-01-01

The current study examined the latent factor structure of posttraumatic stress disorder (PTSD) based on DSM-5 criteria in a sample of participants (N = 374) recruited for studies on trauma and health. Confirmatory factor analyses (CFA) were used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 as well as to a competing 4-factor “dysphoria” model (Simms, Watson, & Doebbeling, 2002) and a 5-factor (Elhai et al., 2011) model of PTSD. Results indicated that the Elhai 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best fit to the data, although substantial support was demonstrated for the DSM-5 4-factor model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), which raises questions regarding the adequacy of fit of these symptoms with other core features of the disorder. Overall, the findings from the present research suggest the DSM-5 model of PTSD is a significant improvement over the previous DSM-IV model of PTSD. PMID:26366290

The relation between the patient health questionnaire-15 and DSM somatic diagnoses

Directory of Open Access Journals (Sweden)

Shih-Cheng Liao

2016-10-01

Full Text Available Abstract Background Our purpose was to examine the reliability and validity of the Chinese version of the Patient Health Questionnaire-15 (PHQ-15 in Taiwan, and to explore its relation to somatoform disorders (DSM-IV and to somatic symptom and related disorders (DSM-5. Methods We recruited 471 individuals, 151 with somatoform disorders and 200 with somatic symptom and related disorders. Subjects completed the Chinese version of the PHQ-15, Beck Depression Inventory-II (BDI-II, Beck Anxiety Inventory (BAI, and received a DSM-IV- and DSM-5-based diagnostic interview. We performed exploratory factor analysis and assessed test-retest reliability, internal consistency, and correlation with BDI-II/BAI to confirm reliability and validity, and carried out ROC curve analysis to determine suitability for evaluation or screening purposes. PHQ-15 scores were compared between patients with various DSM-IV psychiatric diagnoses (such as DSM-IV somatoform disorders, panic disorder, other anxiety/depressive disorders or no DSM-IV diagnosis and patients with DSM-5 somatic symptom and related disorders or no DSM-5 diagnosis. Results The Chinese version identified cardiopulmonary, pain-fatigue, and gastrointestinal as major factors and had good reliability (0.803–0.930, internal consistency (0.637–0.861, and correlation coefficients with BDI-II/BAI (0.407–0.619, 0.536–0.721, respectively. The PHQ-15 scores were similar in patients with somatoform disorders and patients with panic disorder; higher in patients with somatoform disorders and panic disorder than in patients with other anxiety/depressive disorders; and significantly higher in patients with somatic symptom and related disorders than in patients without this diagnosis. The AUC of the PHQ-15 was 0.678 (cutoff 6/7 for screening somatoform disorders (DSM-IV and 0.725 (cutoff 4/5 for screening somatic symptom and related disorders (DSM-5. Conclusions The Chinese version of the PHQ-15 is suitable for

Moving beyond average values: assessing the night-to-night instability of sleep and arousal in DSM-IV-TR insomnia subtypes.

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Sánchez-Ortuño, M Montserrat; Carney, Colleen E; Edinger, Jack D; Wyatt, James K; Harris, Andrea

2011-04-01

We explored differences between individuals with DSM-IV-TR diagnoses of primary insomnia (PI) and insomnia related to a mental disorder (IMD) by using serial measurements of self-reported sleep variables (sleep onset latency, SOL; wake after sleep onset, WASO; total sleep time, TST; sleep efficiency, SE), and visual analogue scale ratings of 2 forms of bedtime arousal (cognitive and emotional). Furthermore, we sought to examine the relationship between sleep and arousal within each diagnostic subgroup. Between-group and within-group comparisons. Duke and Rush University Medical Centers, USA. One hundred eighty-seven insomnia sufferers (126 women, average age 47.15 years) diagnosed by sleep specialists at 2 sleep centers as PI patients (n=126) and IMD patients (n=61). N/A. Multilevel models for sleep measures indicated that IMD displayed significantly more instability across nights in their TST (i.e., larger changes) than did PI patients. With respect to pre-sleep arousal, IMD patients exhibited higher mean levels of emotional arousal, as well as more instability on the nightly ratings of this measure. Within the PI group, correlational analyses revealed a moderate relationship between the 2 arousal variables and SOL (r values 0.29 and 0.26), whereas the corresponding correlations were negligible and statistically nonsignificant in the IMD group. We found a number of differences on nighttime variables between those diagnosed with primary insomnia and those diagnosed with insomnia related to a mental disorder. These differences imply different perpetuating mechanisms involved in their ongoing sleep difficulties. Additionally, they support the categorical distinctiveness and the concurrent validity of these insomnia subtypes.

DSM-5 Further Inflates Attention Deficit Hyperactivity Disorder

NARCIS (Netherlands)

Batstra, Laura; Frances, Allen

Since the publication of DSM-IV in 1994, attention deficit hyperactivity disorder (ADHD) prevalence and medication use unexpectedly increased significantly. In this article, we explore the DSM-5 proposals for ADHD that are likely to further increase its prevalence. We also address the possible

[Alcohol-related cognitive impairment and the DSM-5

NARCIS (Netherlands)

Walvoort, S.J.; Wester, A.J.; Doorakkers, M.C.; Kessels, R.P.C.; Egger, J.I.

2016-01-01

BACKGROUND: It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant

[Clinical Implications of Changes in Child Psychiatry in the DSM-5. Strengths and Weaknesses of the Changes].

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Botero-Franco, Diana; Palacio-Ortíz, Juan David; Arroyave-Sierra, Pilar; Piñeros-Ortíz, Sandra

2016-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and related health problems (ICD) integrate the diagnostic criteria commonly used in psychiatric practice, but the DSM-IV-TR was insufficient for current clinical work. The DSM-5 was first made public in May at the Congress of the American Psychiatric Association, and it includes changes to some aspects of Child Psychiatry, as many of the conditions that were at the beginning in chapter of infancy, childhood and adolescence disorders have been transferred to other chapters and there are new diagnostic criteria or new terms are added. It is therefore important to provide it to Psychiatrists who attend children in order to assess the changes they will be facing in the nomenclature and classification in pursuit of a better classification of the childhood psychopathology. Copyright © 2016. Publicado por Elsevier España.

Associations between DSM-IV mental disorders and subsequent heart disease onset : Beyond depression

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Scott, Kate M.; de Jonge, Peter; Alonso, Jordi; Viana, Maria Carmen; Liu, Zhaorui; O'Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J.; de Girolamo, Giovanni; Florescu, Silvia E.; Hu, Chiyi; Taib, Nezar Ismet; Lepine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Elena Medina-Mora, Maria; Piazza, Marina; Posada-Villa, Jose A.; Uda, Hidenori; Wojtyniak, Bogdan J.; Lim, Carmen C. W.; Kessler, Ronald C.

2013-01-01

Background: Prior studies on the depression-heart disease association have not usually used diagnosticmeasures of depression, or taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific

The Reliability and Validity of the Dominic Interactive: A Computerized Child Report Instrument for Mental Health Problems

NARCIS (Netherlands)

Kuijpers, R.C.W.M.; Otten, R.; Krol, N.P.C.M.; Vermulst, A.A.; Engels, R.C.M.E.

2013-01-01

Children and youths' self-report of mental health problems is considered essential but complicated. This study examines the psychometric properties of the Dominic Interactive, a computerized DSM-IV based self-report questionnaire and explores informant correspondence. The Dominic Interactive was

New DSM-V neurocognitive disorders criteria and their impact on diagnostic classifications of mild cognitive impairment and dementia in a memory clinic setting.

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Tay, Laura; Lim, Wee Shiong; Chan, Mark; Ali, Noorhazlina; Mahanum, Shariffah; Chew, Pamela; Lim, June; Chong, Mei Sian

2015-08-01

To examine diagnostic agreement between Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) Neurocognitive Disorders (NCDs) criteria and DSM, Fourth Edition (DSM-IV) criteria for dementia and International Working Group (IWG) criteria for mild cognitive impairment (MCI) and DSM-V's impact on diagnostic classifications of NCDs. The authors further examined clinical factors for discrepancy in diagnostic classifications between the different operational definitions. Using a cross-sectional study in tertiary memory clinic, the authors studied consecutive new patients aged 55 years or older who presented with cognitive symptoms. Dementia severity was scored based on the Clinical Dementia Rating scale (CDR). All patients completed neuropsychological evaluation. Agreement in diagnostic classifications between DSM-IV/IWG and DSM-V was examined using the kappa test and AC1 statistic, with multinomial logistic regression for factors contributing to MCI reclassification as major NCDs as opposed to diagnostically concordant MCI and dementia groups. Of 234 patients studied, 166 patients achieved concordant diagnostic classifications, with overall kappa of 0.41. Eighty-six patients (36.7%) were diagnosed with MCI and 131 (56.0%) with DSM-IV-defined dementia. With DSM-V, 40 patients (17.1%) were classified as mild NCDs and 183 (78.2%) as major NCDs, representing a 39.7% increase in frequency of dementia diagnoses. CDR sum-of-boxes score contributed independently to differentiation of MCI patients reclassified as mild versus major NCDs (OR: 0.01; 95% CI: 0-0.09). CDR sum-of-boxes score (OR: 5.18; 95% CI: 2.04-13.15), performance in amnestic (OR: 0.14; 95% CI: 0.06-0.34) and language (Boston naming: OR: 0.52; 95% CI: 0.29-0.94) tests, were independent determinants of diagnostically concordant dementia diagnosis. The authors observed moderate agreement between the different operational definitions and a 40% increase in dementia diagnoses with

Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses: implications for DSM-V and ICD-11.

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Ramtekkar, Ujjwal P; Reiersen, Angela M; Todorov, Alexandre A; Todd, Richard D

2010-03-01

To examine gender and age differences in attention-deficit/hyperactivity disorder (ADHD) symptom endorsement in a large community-based sample. Families with four or more full siblings ascertained from Missouri birth records completed telephone interviews regarding lifetime DSM-IV ADHD symptoms and the Strengths and Weaknesses of ADHD-Symptoms and Normal-behavior (SWAN) questionnaire for current ADHD symptoms. Complete data were available for 9,380 subjects aged 7 through 29 years. Lifetime and current DSM-IV-like ADHD diagnoses were assigned by the DSM-IV symptom criteria. Linear regression was used to examine sex and age effects on SWAN ADHD symptom scores. Logistic regression was used to examine sex and age effects on specific ADHD diagnoses. Fractional polynomial graphs were used to examine ADHD symptom count variations across age. Overall prevalence of current DSM-IV-like ADHD was 9.2% with a male:female ratio of 2.28:1. The prevalence of DSM-IV-like ADHD was highest in children. Gender differences in DSM-IV-like ADHD subtype prevalences were highest in adolescents. On average, individuals with lifetime DSM-IV-like ADHD diagnoses had elevated current ADHD symptoms even as adolescents or adults. Lower male:female ratios than reported in some clinic-based studies suggest that females are underdiagnosed in the community. Although they may no longer meet the full symptom criteria, young adults with a history of lifetime DSM-IV-like ADHD maintain higher levels of ADHD symptoms compared with the general population. The use of age-specific diagnostic criteria should be considered for DSM-V and ICD-11.

Narcissistic personality disorder in DSM-5.

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Skodol, Andrew E; Bender, Donna S; Morey, Leslie C

2014-10-01

The criteria for personality disorders in Section II of DSM-5 have not changed from those in DSM-IV. Therefore, the diagnosis of Section II narcissistic personality disorder (NPD) will perpetuate all of the well-enumerated shortcomings associated with the diagnosis since DSM-III. In this article, we will briefly review problems associated with Section II NPD and then discuss the evolution of a new model of personality disorder and the place in the model of pathological narcissism and NPD. The new model was intended to be the official approach to the diagnosis of personality pathology in DSM-5, but was ultimately placed as an alternative in Section III for further study. The new model is a categorical-dimensional hybrid based on the assessment of core elements of personality functioning and of pathological personality traits. The specific criteria for NPD were intended to rectify some of the shortcomings of the DSM-IV representation by acknowledging both grandiose and vulnerable aspects, overt and covert presentations, and the dimensionality of narcissism. In addition, criteria were assigned and diagnostic thresholds set based on empirical data. The Section III representation of narcissistic phenomena using dimensions of self and interpersonal functioning and relevant traits offers a significant improvement over Section II NPD. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Mental disorders in cancer patients: observations at a tertiary care centre in Pakistan

International Nuclear Information System (INIS)

Iqbal, M.; Syed, G.M.S.; Siddiqui, K.S.

2002-01-01

To study the frequencies of metal disorders among adult cancer patients in relation to their age, gender, marital status and type of malignancy. Socio-demographic characteristics and cancer diagnoses were recorded on a data capture form. diagnoses of metal disorders were made on the basis of diagnostic and statistical manual (DSM-IV) fourth edition. Shuakat Khanum Memorial Hospital and Research Centre. Two hundred and twenty newly diagnosed cancer patients were interviewed by a clinical psychologist before commencing any cancer treatment. Diagnosis of any metal disorder was transcribed using DSM-IV criteria and data thus collected were analyzed using SPSS for Windows. Observed frequencies of various metal disorders were compared with respect to patient's age, gender, martial status and type of cancer. Sixty five percent patients presented with various mental disorder. Adjusting disorders and mood disorders accounted for 34% each, while anxiety disorder was seen in 30% and remaining had delirium and somatoform disorders. Mental disorders were more common in males, and in younger age group. The oncologist and physicians treating cancer patients should carefully evaluate their patients for symptom of associated mental disorder and provide the required clinical support. (author)

Food Insecurity and Mental Disorders in a National Sample of U.S. Adolescents

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McLaughlin, Katie A.; Green, Jennifer Greif; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.

2012-01-01

Objective: To examine whether food insecurity is associated with past-year "DSM-IV" mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method: Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication…

An evaluation of the clinical application of the DSM-5 for the diagnosis of autism spectrum disorder.

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Burns, Claire O; Matson, Johnny L

2017-09-01

The changes to the diagnostic criteria for autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were met with much controversy by researchers, clinicians, and families of individuals with ASD. The goal of this paper is to review the literature on the impact of these changes. Areas covered: This paper reviews the major changes to diagnostic criteria from DSM-IV-TR to DSM-5. It emphasizes how these changes are hypothesized to impact prevalence rates, as well as trends in characteristics of individuals who would have met previous criteria for ASD but no longer qualify for a diagnosis under DSM-5. Policy issues such as access to services and research considerations are also briefly reviewed. Expert commentary: Researchers have found that the DSM-5 diagnostic criteria for ASD may significantly impact which children receive diagnoses, which in turn affects access to services that address impairments characteristic of this disorder. Despite the fact that the DSM-5 has now been in use for four years, fewer recent studies were identified than was expected. Future research should continue to focus on the impact of changes in criteria, as well as on translational scientific advances across disciplines.

Mental disorders in megacities: findings from the Sao Paulo megacity mental health survey, Brazil.

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Laura Helena Andrade

Full Text Available BACKGROUND: World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. METHODS AND RESULTS: A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI, to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%, followed by mood (11%, impulse-control (4.3%, and substance use (3.6% disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. DISCUSSION: Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion

Exploring the Proposed DSM-5 Criteria in a Clinical Sample

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Taheri, Azin; Perry, Adrienne

2012-01-01

The proposed DSM-5 criteria for Autism Spectrum Disorder (ASD) depart substantially from the previous DSM-IV criteria. In this file review study of 131 children aged 2-12, previously diagnosed with either Autistic Disorder or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), 63% met the new DSM-5 ASD criteria, including 81%…

De H. Cleckley ao DSM-IV-TR: a evolução do conceito de psicopatia rumo à medicalização da delinquência

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Rogério Paes Henriques

2009-06-01

Full Text Available A psicopatia é descrita como personalidade antissocial pelos manuais nosográficos contemporâneos: CID-10 e DSM-IV-TR. Contrastando tais nosografias entre si quanto aos critérios diagnósticos propostos para a psicopatia, assinalam-se as consequências de sua operacionalização, promovida, sobretudo, pelo DSM. Dentre elas, destacam-se: (1 a degradação do diagnóstico ao mero levantamento protocolar; (2 a acentuação da correlação histórica entre psicopatia e delinquência.

DSM-IV-TR "pain disorder associated with psychological factors" as a nonhysterical form of somatization.

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Aragona, Massimiliano; Tarsitani, Lorenzo; De Nitto, Serena; Inghilleri, Maurizio

2008-01-01

Elevated Minnesota Multiphasic Personality Inventory (MMPI) scores on the hysteria (Hy) scale are reported in several forms of pain. Previous results were possibly biased by diagnostic heterogeneity (psychogenic, somatic and mixed pain syndromes included in the same index sample) or Hy heterogeneity (failure to differentiate Hy scores into clinically meaningful subscales, such as admission of symptoms [Ad] and denial of symptoms [Dn]). To overcome this drawback, 48 patients diagnosed as having a Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Text Revision (DSM-IV-TR) diagnosis of "pain disorder associated with psychological factors" were compared with 48 patients experiencing somatic pain excluding psychological factors, and 42 somatic controls without pain. MMPI Hy and hypochondriasis (Hs) scores were significantly higher in the pain disorder group than in control groups, who scored similarly. MMPI correction (K) scores and Dn scores were similar in the three groups, whereas Ad was significantly higher in the pain disorder group and lower and similar in the two control groups, respectively. In the pain disorder group, Ad and Dn were negatively correlated, whereas in control groups they were unrelated. These findings suggest that whereas a pattern of high Hs and Hy scores together with a normal K score might characterize patients with a pain disorder associated with psychological factors, elevated Hy scores per se do not indicate hysterical traits. In the pain disorder group, elevated Hy scores reflected the Ad subscale alone, indicating a strikingly high frequency of distressing somatic symptoms. They tend not to repress or deny the emotional malaise linked to symptoms, as the hysterical construct expects. The pain disorder designation should be considered a nonhysterical form of somatization.

DSM-5-classificatie van persoonlijkheidsstoornissen bij ouderen

NARCIS (Netherlands)

van Alphen, S P J; Rossi, G; Dierckx, E; Oude Voshaar, R C

2014-01-01

BACKGROUND: Although it is generally agreed that personality disorders are an important topic in old-age psychiatry, DSM-5 has paid relatively little attention to older persons affected with this severe mental disorder. AIM: To look closely and carefully at several aspects of the way in which DSM-5

Requiring both avoidance and emotional numbing in DSM-V PTSD: will it help?

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Forbes, David; Fletcher, Susan; Lockwood, Emma; O'Donnell, Meaghan; Creamer, Mark; Bryant, Richard A; McFarlane, Alexander; Silove, Derrick

2011-05-01

The proposed DSM-V criteria for posttraumatic stress disorder (PTSD) specifically require both active avoidance and emotional numbing symptoms for a diagnosis. In DSM-IV, since both are included in the same cluster, active avoidance is not essential. Numbing symptoms overlap with depression, which may result in spurious comorbidity or overdiagnosis of PTSD. This paper investigated the impact of requiring both active avoidance and emotional numbing on the rates of PTSD diagnosis and comorbidity with depression. We investigated PTSD and depression in 835 traumatic injury survivors at 3 and 12 months post-injury. We used the DSM-IV criteria but explored the potential impact of DSM-IV and DSM-V approaches to avoidance and numbing using comparison of proportion analyses. The DSM-V requirement of both active avoidance and emotional numbing resulted in significant reductions in PTSD caseness compared with DSM-IV of 22% and 26% respectively at 3 and 12 months posttrauma. By 12 months, the rates of comorbid PTSD in those with depression were significantly lower (44% vs. 34%) using the new criteria, primarily due to the lack of avoidance symptoms. These preliminary data suggest that requiring both active avoidance and numbing as separate clusters offers a useful refinement of the PTSD diagnosis. Requiring active avoidance may help to define the unique aspects of PTSD and reduce spurious diagnoses of PTSD in those with depression. Copyright © 2010. Published by Elsevier B.V.

Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults.

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Eramudugolla, Ranmalee; Mortby, Moyra E; Sachdev, Perminder; Meslin, Chantal; Kumar, Rajeev; Anstey, Kaarin J

2017-03-04

There is little information on the application and impact of revised criteria for diagnosing dementia and mild cognitive impairment (MCI), now termed major and mild neurocognitive disorders (NCDs) in the DSM-5. We evaluate a psychometric algorithm for diagnosing DSM-5 NCDs in a community-dwelling sample, and characterize the neuropsychological and functional profile of expert-diagnosed DSM-5 NCDs relative to DSM-IV dementia and International Working Group criteria for MCI. A population-based sample of 1644 adults aged 72-78 years was assessed. Algorithmic diagnostic criteria used detailed neuropsychological data, medical history, longitudinal cognitive performance, and informant interview. Those meeting all criteria for at least one diagnosis had data reviewed by a neurologist (expert diagnosis) who achieved consensus with a psychiatrist for complex cases. The algorithm accurately classified DSM-5 major NCD (area under the curve (AUC) = 0.95, 95% confidence interval (CI) 0.92-0.97), DSM-IV dementia (AUC = 0.91, 95% CI 0.85-0.97), DSM-5 mild NCD (AUC = 0.75, 95% CI 0.70-0.80), and MCI (AUC = 0.76, 95% CI 0.72-0.81) when compared to expert diagnosis. Expert diagnosis of dementia using DSM-5 criteria overlapped with 90% of DSM-IV dementia cases, but resulted in a 127% increase in diagnosis relative to DSM-IV. Additional cases had less severe memory, language impairment, and instrumental activities of daily living (IADL) impairments compared to cases meeting DSM-IV criteria for dementia. DSM-5 mild NCD overlapped with 83% of MCI cases and resulted in a 19% increase in diagnosis. These additional cases had a subtly different neurocognitive profile to MCI cases, including poorer social cognition. DSM-5 NCD criteria can be operationalized in a psychometric algorithm in a population setting. Expert diagnosis using DSM-5 NCD criteria captured most cases with DSM-IV dementia and MCI in our sample, but included many additional cases suggesting that DSM-5

Should OCD be classified as an anxiety disorder in DSM-V?

NARCIS (Netherlands)

Stein, Dan J.; Fineberg, Naomi A.; Bienvenu, O. Joseph; Denys, Damiaan; Lochner, Christine; Nestadt, Gerald; Leckman, James F.; Rauch, Scott L.; Phillips, Katharine A.

2010-01-01

In DSM-III, DSM-III-R, and DSM-IV, obsessive-compulsive disorder (OCD) was classified as an anxiety disorder. In ICD-10, OCD is classified separately from the anxiety disorders, although within the same larger category as anxiety disorders (as one of the "neurotic, stress-related, and somatoform

The DSM revision process: needing to keep an eye on the empirical ball.

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First, M B

2017-01-01

From DSM-III onward, successive DSM editions have strived to ground the diagnostic definitions in empirical evidence. DSM-IV established a three-stage process of empirical review, consisting of comprehensive and systematic literature reviews, secondary analyses of datasets, and field trials to provide reliability and validity data for the most substantial or controversial proposals. DSM-IV Work Group members were required to review the empirical literature to document explicitly the evidence supporting the text and criteria published in DSM-IV. As noted by Kendler and Solomon (2016), in contrast to the emphasis on systematic reviews in medicine which is a manifestation of the evidence-based medicine movement, such systematic evidence-based reviews have not been consistently integrated into the development of DSM-5, raising questions about empirical rigor underlying the DSM-5 revision. It is likely that this regression in terms of anchoring the revision process in a comprehensive review of empirical data stemmed from the emphasis during the DSM-5 revision process on trying to move DSM-5 from its categorical descriptive approach towards a more etiological dimensional approach. Although such a shift ultimately did not occur, the effort spent on trying to achieve a paradigm shift likely came at the expense of the hard work of conducting systematic empirical reviews. For the DSM to continue to remain credible in the current era of evidence-based medicine, it is essential that the developers of future editions of the DSM avoid taking their eye off the empirical ball and insure that the manual remains grounded in solid empirical evidence.

Comparing profiles of mental disorder across birth cohorts: results from the 2007 Australian National Survey of Mental Health and Wellbeing.

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Sunderland, Matthew; Carragher, Natacha; Buchan, Heather; Batterham, Philip J; Slade, Tim

2014-05-01

To describe and compare individuals with any DSM-IV mental disorder from three different birth cohorts - young (16-34 years), middle age (35-59 years) and older age (60-85 years) - on a range of clinically relevant factors. Data were derived from the 2007 Australian National Survey of Mental Health and Wellbeing. Individuals from three birth cohorts with a range of mental health and substance use disorders were identified using DSM-IV criteria and compared using regression analysis. The specific factors that were compared include: (1) type of disorder/disorders present; (2) suicidality; (3) number of co-occurring disorders; (4) levels of distress and impairment; (5) self-assessed physical and mental health; (6) presence of physical conditions; (7) size and quality of social support/network; and (8) treatment-seeking behaviour. The birth cohorts differed dramatically in terms of the specific disorders that were present. The older cohort were significantly more likely to experience internalising disorders and significantly less likely to experience externalising disorders in comparison to the young cohort. The older cohort were significantly more likely to experience co-morbid physical conditions as well as lower life satisfaction, poorer self-rated physical health, increased functional impairment, and more days out of role. The younger cohort had a significantly larger peer group that they could confide in and rely on in comparison to the older cohort. Clinicians and researchers need to be cognisant that mental disorders manifest as highly heterogeneous constructs. The presentation of a disorder in a younger individual could be vastly different from the presentation of the same disorder in an older individual. The additional burden associated with these factors and how they apply to different birth cohorts must be taken into consideration when planning mental health services and effective treatment for the general population.

Open issues in psychiatric nosology: A conceptual framework of the American classification of mental disorders (DSM

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Jović Vladimir M.

2014-01-01

Full Text Available New, Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM -5 , was published In May 2013, by the American Psychiatric Association, which was expected to bring a new paradigm shift in the understanding of mental disorders. This document in its main presumptions did not depart significantly from the Third edition in 1980. The aim of this paper is to provide an overview of the conceptual framework of this classification, elements of which could be enlisted as following: mental disorders are conceptualized as a diseases by the biomedical model , and as such they are clearly separated from the 'healthy' mental functioning; they are the consequence of a pathological processes in the structure and functioning of the brain, and manifested by clusters of symptoms and signs of disease which are assumed to have a specific etiology. This paper provides an overview of the current discussions and criticism of this paradigm that is currently dominant in academic psychiatry .

Values and DSM-5: looking at the debate on attenuated psychosis syndrome.

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Gonçalves, Arthur Maciel Nunes; Dantas, Clarissa de Rosalmeida; Banzato, Claudio E M

2016-01-20

Although values have increasingly received attention in psychiatric literature over the last three decades, their role has been only partially acknowledged in psychiatric classification endeavors. The review process of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) received harsh criticism, and was even considered secretive by some authors. Also, it lacked an official discussion of values at play. In this perspective paper we briefly discuss the interplay of some values in the scientific and non-scientific debate around one of the most debated DSM-5 category proposals, the Attenuated Psychosis Syndrome (APS). Then, we point out some ethical consequences of a facts-plus-values perspective in psychiatric classification. Different stakeholders participated in the APS-debate and for analytical purposes we divided them into four groups: (i) researchers in the field of high-risk mental states; (ii) the DSM-5 Psychotic Disorders Work Group; (iii) patient, carers and advocacy groups; and (iv) external stakeholders, not related to the previous groups, but which also publicly expressed their opinions about APS inclusion in DSM-5. We found that each group differently stressed the role of values we examined in the APS-debate. These values were ethical, but also epistemic, political, economic and ontological. The prominence given to some values, and the lack of discussion about others, generated divergent positions among stakeholders in the debate. As exemplified by the APS discussion, although medicine is primarily an ethical endeavor, values of different kinds that take part in it also shape to a large extent the profession. Thus, it may be strategic to openly discuss values at play in the elaboration of diagnostic tools and classificatory systems. This task, more than scientifically or politically significant, is ethically important.

Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil

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Andrade, Laura Helena; Wang, Yuan-Pang; Andreoni, Solange; Silveira, Camila Magalhães; Alexandrino-Silva, Clovis; Siu, Erica Rosanna; Nishimura, Raphael; Anthony, James C.; Gattaz, Wagner Farid; Kessler, Ronald C.; Viana, Maria Carmen

2012-01-01

Background World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. Methods and Results A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. Discussion Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the

[Autism Spectrum Disorder in DSM-5 - concept, validity, and reliability, impact on clinical care and future research].

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Freitag, Christine M

2014-05-01

Autism Spectrum Disorder (ASD) in DSM-5 comprises the former DSM-IV-TR diagnoses of Autistic Disorder, Asperger's Disorder and PDD-nos. The criteria for ASD in DSM-5 were considerably revised from those of ICD-10 and DSM-IV-TR. The present article compares the diagnostic criteria, presents studies on the validity and reliability of ASD, and discusses open questions. It ends with a clinical and research perspective.

Relating DSM-5 section III personality traits to section II personality disorder diagnoses.

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Morey, L C; Benson, K T; Skodol, A E

2016-02-01

The DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system - antisocial, avoidant, borderline, narcissistic, obsessive-compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses. Data were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait-disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters. Findings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance. Although the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

Screening for mental disorders in cardiology outpatients

DEFF Research Database (Denmark)

Birket-Smith, M.; Rasmussen, A.

2008-01-01

The objective of the study was to compare the frequency of mental disorders in cardiology outpatients to the number of patients with psychological problems identified by cardiologists. In a cardiology outpatient service, 103 consecutive patients were asked to participate in the study. Of these 86...... were included and screened for mental disorder with the Primary Care Evaluation of Mental Disorders (PRIME-MD), Structured Clinical Interview for DSM-IV (SCID) psychosis screening, the Clock Drawing Test, and the WHO-5 Well-being Index. The cardiologists were asked to rate the severity of somatic...... and mental problems in each patient on visual analogue scales (VAS-som and VAS-men). The current treatments, including psychiatric and psychological treatments, were noted, and the survival was followed for 3 years. Of the 86 patients included, 34 (40%) had a diagnosis of mental disorder. Eleven (12.8%) had...

Consistencia interna del cuestionario autoadministrado de la Entrevista Clínica Estructurada para Trastornos del Eje II del DSM-IV*

OpenAIRE

Campo-Arias, Adalberto; Díaz-Martínez, Luis Alfonso; Barros-Bermúdez, Jaider Alfonso

2008-01-01

Introducción: Es infrecuente identificar posibles casos de trastornos de personalidad en la población general, debido a la carencia de instrumentos autoadministrados con buena validez y confiabilidad. Hasta la fecha no se ha explorado la confiabilidad del cuestionario autoadministrado de la Entrevista Clínica Estructurada para Diagnósticos del eje II (SDID-II) del DSM-IV en la población colombiana. Objetivo: Determinar la consistencia interna de las subescalas del cuestionario autoadministrad...

DSM-V Changes for Autism Spectrum Disorder (ASD): Implications for Diagnosis, Management, and Care Coordination for Children With ASDs.

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Lobar, Sandra L

2016-01-01

The purpose of this article is to highlight issues about diagnosis and management of autism spectrum disorders (ASDs) in all settings, along with care coordination for all children with ASDs. The article outlines differences between the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised (DSM-IV-TR) and the newer version (DSM-V) for ASDs. These changes may limit the eligibility of some children for services in school, leading to poorer social/academic outcomes, lower rates of employment, and decreased assistance in eventual independent living. Primary care providers identified a lack of knowledge regarding ASDs before the DSM-V was published, describing difficulty in making ASD diagnoses, recognizing early symptoms of developmental concern, and managing care. Care coordination is part of the role of the advanced practice nurse, and lack of understanding of ASD changes in the DSM-V may diminish the ability of advanced practice nurses to screen for ASDs and make the appropriate referrals. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

A Comparison of Substance Abuse and Mental Illness in Male Offenders in Jamaica and England and Wales

Directory of Open Access Journals (Sweden)

CA Sewell

2015-03-01

Full Text Available Background: The present study sought to determine the prevalence of substance abuse, mental illness, sociodemographics and clinical characteristics of mentally ill offenders. These data were compared to data from the prison population in the United Kingdom. Method: This is a cross-sectional study of male, mentally ill offenders in two prisons in Jamaica, and four prisons in England and Wales. For the Jamaican sample, a psychopathology and forensic survey instrument was developed by the research personnel to extract specific information from the diagnostic interview. Data extraction was done over a one-year period. For the England and Wales sample, the participants were interviewed and assessed using various structured instruments. Results: The results indicate that approximately 18% of persons within the Jamaican prison population under study had a mental illness. Of this number, 57% of these persons had been previously diagnosed with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM IV-TR Axis 1 disorder. Substance abuse was the most frequently diagnosed DSM-IV Axis I disorder within both populations. The prevalence of mental illness found in the Jamaican prison population was approximately four times greater than the rate in the comparison population of England and Wales. Conclusions: There was an over-representation of mentally ill offenders in the Jamaican prison population. This is most likely linked to the lack of appropriate diversion programmes and a forensic mental hospital in Jamaica.

Should DSM-V include dimensional diagnostic criteria for alcohol use disorders?

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Helzer, John E; Bucholz, Kathleen K; Bierut, Laura Jean; Regier, Darrel A; Schuckit, Marc A; Guth, Sarah E

2006-02-01

This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V.

Psychotic experiences co-occur with sleep problems, negative affect and mental disorders in preadolescence

DEFF Research Database (Denmark)

Jeppesen, Pia; Clemmensen, Lars; Munkholm, Anja

2015-01-01

or definitely present. The Development and Well-Being Assessment (DAWBA) was used independently to diagnose DSM-IV-mental disorders. Puberty development and sleep disturbance were self-reported. The associations between PE (any lifetime hallucination and/or delusion) and various mental problems and disorders......-reported mental health difficulties in absence of a diagnosis (31.4%). The risk of delusions increased with onset of puberty. The risk of PE increased with emotional and neurodevelopmental disorders, subthreshold depressive symptoms, sleep problems and lack of sleep, regardless of whether PE were expressed...

The impact of endorsing Spitzer's proposed criteria for PTSD in the forthcoming DSM-V on male and female Veterans.

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Miller, Lyndsey N; Chard, Kathleen M; Schumm, Jeremiah A; O'Brien, Carol

2011-06-01

This study explored differences between Spitzer's proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer's proposed criteria. Veterans who met both DSM-IV and Spitzer's proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed criteria. These findings have important implications regarding proposed changes to the diagnostic classification criteria for PTSD in the forthcoming DSM-V. Copyright © 2011 Elsevier Ltd. All rights reserved.

Dimensional structure of DSM-5 posttraumatic stress symptoms: support for a hybrid Anhedonia and Externalizing Behaviors model.

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Armour, Cherie; Tsai, Jack; Durham, Tory A; Charak, Ruby; Biehn, Tracey L; Elhai, Jon D; Pietrzak, Robert H

2015-02-01

Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms. Copyright © 2014 Elsevier Ltd. All rights reserved.

A comparison of ICD-11 and DSM criteria for posttraumatic stress disorder in two national samples of U.S. military veterans.

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Wisco, Blair E; Marx, Brian P; Miller, Mark W; Wolf, Erika J; Krystal, John H; Southwick, Steven M; Pietrzak, Robert H

2017-12-01

The proposed ICD-11 criteria for posttraumatic stress disorder (PTSD) differ substantially from the DSM-5. ICD-11 eliminated several PTSD symptoms thought to be nonspecific, with the goal of reducing psychiatric comorbidities. However, this change also results in a narrower PTSD definition that may fail to capture individuals with clinically significant PTSD. The purpose of the current study was to compare prevalence and psychiatric comorbidities of DSM (IV/5) and ICD-11 PTSD. We evaluated concordance between DSM (IV/5) and ICD-11 PTSD diagnoses in a web survey of two nationally representative samples of U.S. military veterans (ns = 3517 and 1484). Lifetime and past-month PTSD symptoms were assessed with the DSM-IV-based PTSD Checklist-Specific Stressor version and the DSM-5-based PTSD Checklist-5. Psychiatric comorbidities were assessed using MINI Neuropsychiatric Interview modules. A significantly greater proportion of veterans met criteria for lifetime and past-month PTSD under DSM-IV/5 than under ICD-11. 21.8-35.9% of those who met criteria under DSM IV/5 did not meet under ICD-11, whereas only 2.4-7.1% of those who met under ICD-11 did not meet under DSM-IV/5. Psychiatric comorbidities did not significantly differ between DSM-IV/5 and ICD-11. This study relied upon self-report measures of PTSD, distress/impairment, and psychiatric comorbidities. The proposed ICD-11 criteria identify fewer PTSD cases than DSM-IV/5 without reducing psychiatric comorbidities. Veterans with clinically significant PTSD symptoms may not meet ICD-11 PTSD criteria, possibly affecting eligibility for healthcare, disability, and other services. The ICD-11 criteria could be revised to capture more PTSD cases before ICD-11 is published in 2018. Copyright © 2017 Elsevier B.V. All rights reserved.

Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder.

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Grilo, C M

2004-01-01

This study examined the diagnostic efficiency of the DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive adult patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. Conditional probabilities-sensitivity, specificity, positive predictive power (PPP), and negative predictive power (NPP)-were calculated for each of the eight criteria for OCPD, using the 'best-estimate' OCPD diagnosis as the standard. The diagnostic efficiencies of the OCPD criteria were variable, with three criteria failing to have predictive value (PPPOCPD based on performance and call into question the utility of some criteria.

Longitudinal diagnostic efficiency of DSM-IV criteria for obsessive-compulsive personality disorder: a 2-year prospective study.

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Grilo, C M; Skodol, A E; Gunderson, J G; Sanislow, C A; Stout, R L; Shea, M T; Morey, L C; Zanarini, M C; Bender, D S; Yen, S; McGlashan, T H

2004-07-01

To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for obsessive-compulsive personality disorder (OCPD). At baseline, criteria and diagnoses were determined using diagnostic interviews, and blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, using the independent OCPD diagnosis at follow-up as the standard. Longitudinal diagnostic efficiencies for the OCPD criteria varied; findings suggested the overall predictive utility of 'preoccupied with details', 'rigid and stubborn', and 'reluctant to delegate'. These findings suggest the predictive validity of three cognitive-interpersonal OCPD criteria.

Prevalence and correlates of DSM-5 eating disorders in patients with bipolar disorder.

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McElroy, Susan L; Crow, Scott; Blom, Thomas J; Biernacka, Joanna M; Winham, Stacey J; Geske, Jennifer; Cuellar-Barboza, Alfredo B; Bobo, William V; Prieto, Miguel L; Veldic, Marin; Mori, Nicole; Seymour, Lisa R; Bond, David J; Frye, Mark A

2016-02-01

To determine prevalence rates and clinical correlates of current DSM-5 eating disorders in patients with bipolar disorder (BP). Prevalence rates of current DSM-5- and DSM-IV-defined binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) were assessed with the Eating Disorder Diagnostic Scale (EDDS) in 1092 patients with BP. Psychiatric illness burden was evaluated with five proxy measures of BP illness severity. Medical illness burden was evaluated with the Cumulative Index Rating Scale (CIRS). Twenty-seven percent of patients had a current DSM-5 eating disorder: 12% had BED, 15% had BN, and 0.2% had AN. Rates of DSM-5-defined BED and BN were higher than clinical diagnosis rates and rates of DSM-IV-defined BED and BN. Compared with BP patients without an eating disorder, BP patients with a DSM-5 eating disorder were younger and more likely to be women; had an earlier age of onset of BP; had higher EDDS composite scores and higher degrees of suicidality, mood instability, and anxiety disorder comorbidity; and had a higher mean BMI, higher rate of obesity, and higher CIRS total scores. In a logistic regression model controlling for previously identified correlates of an eating disorder, younger age, female gender, and higher BMI remained significantly associated with an eating disorder. The EDDS has not been validated in BP patients. DSM-5-defined BED and BN are common in BP patients, possibly more common than DSM-IV-defined BED and BN, and associated with greater psychiatric and general medical illness burden. Further studies assessing DSM-5 eating disorders in people with BP are greatly needed. Copyright © 2015 Elsevier B.V. All rights reserved.

The parental alienation debate belongs in the courtroom, not in DSM-5.

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Houchin, Timothy M; Ranseen, John; Hash, Phillip A K; Bartnicki, Daniel J

2012-01-01

The DSM-5 Task Force is presently considering whether to adopt parental alienation disorder (PAD) as a mental illness. Although controversy has surrounded PAD since its inception in 1985, pro-PAD groups and individuals have breathed new life into the push to establish it as a mental health diagnosis. In this analysis, we argue that it would be a serious mistake to adopt parental alienation disorder as a formal mental illness in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

ICD-11 and DSM-5 personality trait domains capture categorical personality disorders: Finding a common ground.

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Bach, Bo; Sellbom, Martin; Skjernov, Mathias; Simonsen, Erik

2018-05-01

The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive-compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. These preliminary findings suggest that little information is 'lost' in a transition to trait domain

Craving as a DSM-5 Symptom of Alcohol Use Disorder in Non-Treatment Seekers.

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Hartwell, Emily E; Ray, Lara A

2018-05-01

DSM-5 has added craving as a new criterion and changed the diagnostic structure of alcohol use disorder (AUD). Though craving has long been a target of intervention, less is known about the impact this addition will have on prevalence and factor structure of AUD, particularly in non-treatment seeker with alcohol problems. Non-treatment seeking individuals reporting alcohol-related problems (N = 296) completed a structured clinical interview and the Penn Alcohol Craving Scale (PACS). PACS scores greater than 20 were considered to meet diagnostic criteria for the alcohol craving symptom. This study examined DSM-IV to DSM-5 diagnostic conversion and conducted an exploratory factor analysis to test the factor structure of the DSM-5 symptoms, including craving. The mean PACS score was 13.1 and alcohol craving was strongly correlated with other measures of alcohol use. Using the proposed cut-off score of PACS > 20, 46 participants (16.2%) met criteria for alcohol craving. Craving loaded moderately (0.47) onto the retained DSM symptoms and produced a unidimensional factor structure. The majority of participants who met for a DSM-IV AUD also met for a DSM-5 AUD (98.8%). Craving prevalence using the PACS was relatively low compared to the remaining 10 DSM-5 symptoms, possibly due to the non-treatment seeking nature of the sample. Conversion of DSM-IV to DSM-5 in this sample led to a small increase in overall AUD prevalence. Craving loaded well onto a single factor structure for AUD.

DSM-5 Boom o esperanza

OpenAIRE

Cuartas Arias, Jorge Mauricio; Psychology faculty, University of San Buenaventura. Medellin, Colombia.; López Jaramillo, Carlos; Faculty of Medicine, Department of Psychiatry, University of Antioquia. Medellin, Colombia.

2013-01-01

After fourteen years of review, the expected update of the Diagnostic and Statistical Manual of Mental Disorders (DSM) has generated great controversy among psychiatrists and psychologists around the world. So far, it is known that the new version (DSM-5), officially presented for the first time in May 18 of this year as part of the annual meeting of the American Psychiatric Association (APA), will be available in Spanish language at the beginning of 2014. However, the reviews and comments fo...

Influence of mental disorders on school dropout in Mexico.

Science.gov (United States)

Borges, Guilherme; Medina Mora-Icaza, María Elena; Benjet, Corina; Lee, Sing; Lane, Michael; Breslau, Joshua

2011-11-01

To study the impact of mental disorders on failure in educational attainment in Mexico. Diagnoses and age of onset for each of 16 DSM-IV disorders were assessed through retrospective self-reports with the Composite International Diagnostic Instrument (CIDI) during fieldwork in 2001-2002. Survival analysis was used to examine associations between early onset DSM-IV/CIDI disorders and subsequent school dropout or failure to reach educational milestones. More than one of two Mexicans did not complete secondary education. More than one-third of those who finished secondary education did not enter college, and one of four students who entered college did not graduate. Impulse control disorders and substance use disorders were associated with higher risk for school dropout, secondary school dropout and to a lesser degree failure to enter college. Anxiety disorders were associated with lower risk for school dropout, especially secondary school dropout and, to a lesser degree, primary school dropout. The heterogeneity of results found in Mexico may be due to the effect of mental disorders being diminished or masked by the much greater effect of economic hardship and low cultural expectations for educational achievement. Future research should inquire deeper into possible reasons for the better performance of students with anxiety disorders in developing countries.

Binge eating disorder should be included in DSM-IV: a reply to Fairburn et al.'s "the classification of recurrent overeating: the binge eating disorder proposal".

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Spitzer, R L; Stunkard, A; Yanovski, S; Marcus, M D; Wadden, T; Wing, R; Mitchell, J; Hasin, D

1993-03-01

Extensive recent research supports a proposal that a new eating disorder, binge eating disorder (BED), be included in DSM-IV. BED criteria define a relatively pure group of individuals who are distressed by recurrent binge eating who do not exhibit the compensatory features of bulimia nervosa. This large number of patients currently can only be diagnosed as eating disorder not otherwise specified (EDNOS). Recognizing this new disorder will help stimulate research and clinical programs for these patients. Fairburn et al.'s critique of BED fails to acknowledge the large body of knowledge that indicates that BED represents a distinct and definable subgroup of eating disordered patients and that the diagnosis provides useful information about psychopathology, prognosis, and outcome (Fairburn, Welch, & Hay [in press]. The classification of recurrent overeating: The "binge eating disorder" proposal. International Journal of Eating Disorders.) Against any reasonable standard for adding a new diagnosis to DSM-IV, BED meets the test.

Personality disorder in DSM-5: an oral history.

Science.gov (United States)

Zachar, P; Krueger, R F; Kendler, K S

2016-01-01

As the revision process leading to DSM-5 began, the domain of personality disorder embodied the highest aspirations for major change. After an initial prototype-based proposal failed to gain acceptance, the Personality and Personality Disorders Work Group (P&PDWG) developed a hybrid model containing categorical and dimensional components. A clash of perspectives both within the P&PDWG and between the P&PDWG and DSM-5 oversight committees led to the rejection of this proposal from the main body of DSM-5. Major issues included conflicting ways of conceptualizing validation, differences of opinion from personality disorder experts outside the P&PDWG, divergent concepts of the magnitude of evidence needed to support substantial changes, and the disagreements about clinical utility of the hybrid model. Despite these setbacks, the 'Alternative DSM-5 Model of Personality Disorder' is presented in Section III of the DSM-5. Further research should clarify its performance relative to the DSM-IV criteria reprinted in the main DSM-5 text.

The Effects of DSM-5 Criteria on Number of Individuals Diagnosed with Autism Spectrum Disorder: A Systematic Review

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Smith, Isaac C.; Reichow, Brian; Volkmar, Fred R.

2015-01-01

A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and…

Detection of Mental Disorders Other Than Depression with the Edinburgh Postnatal Depression Scale in a Sample of Pregnant Women in Northern Mexico

OpenAIRE

Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

2016-01-01

We sought to evaluate the capacity of the Edinburgh Postnatal Depression Scale (EPDS) in discriminating mental disorders other than depression in pregnant women in northern Mexico. Three hundred pregnant women attending prenatal consultations in a public hospital in Durango City, Mexico submitted a validated EPDS and were examined for mental disorders other than depression using the Diagnostic and Statistical Manual of Mental Disorders - 4th Ed. (DSM-IV) criteria. Sensitivity and specificity ...

The DSM diagnostic criteria for gender identity disorder in children.

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Zucker, Kenneth J

2010-04-01

In this article, I review the diagnostic criteria for Gender Identity Disorder (GID) in children as they were formulated in the DSM-III, DSM-III-R, and DSM-IV. The article focuses on the cumulative evidence for diagnostic reliability and validity. It does not address the broader conceptual discussion regarding GID as "disorder," as this issue is addressed in a companion article by Meyer-Bahlburg (2009). This article addresses criticisms of the GID criteria for children which, in my view, can be addressed by extant empirical data. Based in part on reanalysis of data, I conclude that the persistent desire to be of the other gender should, in contrast to DSM-IV, be a necessary symptom for the diagnosis. If anything, this would result in a tightening of the diagnostic criteria and may result in a better separation of children with GID from children who display marked gender variance, but without the desire to be of the other gender.

Dimensional indicators of generalized anxiety disorder severity for DSM-V.

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Niles, Andrea N; Lebeau, Richard T; Liao, Betty; Glenn, Daniel E; Craske, Michelle G

2012-03-01

For DSM-V, simple dimensional measures of disorder severity will accompany diagnostic criteria. The current studies examine convergent validity and test-retest reliability of two potential dimensional indicators of worry severity for generalized anxiety disorder (GAD): percent of the day worried and number of worry domains. In study 1, archival data from diagnostic interviews from a community sample of individuals diagnosed with one or more anxiety disorders (n = 233) were used to assess correlations between percent of the day worried and number of worry domains with other measures of worry severity (clinical severity rating (CSR), age of onset, number of comorbid disorders, Penn state worry questionnaire (PSWQ)) and DSM-IV criteria (excessiveness, uncontrollability and number of physical symptoms). Both measures were significantly correlated with CSR and number of comorbid disorders, and with all three DSM-IV criteria. In study 2, test-retest reliability of percent of the day worried and number of worry domains were compared to test-retest reliability of DSM-IV diagnostic criteria in a non-clinical sample of undergraduate students (n = 97) at a large west coast university. All measures had low test-retest reliability except percent of the day worried, which had moderate test-retest reliability. Findings suggest that these two indicators capture worry severity, and percent of the day worried may be the most reliable existing indicator. These measures may be useful as dimensional measures for DSM-V. Copyright © 2012 Elsevier Ltd. All rights reserved.

A retrospective study of the impact of DSM-5 on the diagnosis of eating disorders in Victoria, Australia

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Caudle, Henry; Pang, Christine; Mancuso, Sam; Castle, David; Newton, Richard

2015-01-01

Background This study compares the DSM-IV and DSM-5 diagnostic criteria for eating disorders. DSM-IV resulted in a large number of patients being diagnosed with Eating Disorder Not Otherwise Specified (EDNOS). In DSM-5 the residual category is renamed Other Specified Feeding and Eating Disorders (OSFED) and Unspecified Eating Disorders (UFED) however the diagnostic criteria for the residual category in each of the diagnostic systems remains the same. This study aims to evaluate the changes in...

75 FR 23105 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System Payment-Update for...

Science.gov (United States)

2010-04-30

...-charge ratio. CAH Critical access hospital. DSM-IV-TR Diagnostic and Statistical Manual of Mental... Revision of the American Psychiatric Association's Diagnostic and Statistical Manual, (DSM-IV-TR). IPF... psychiatric principal diagnosis that is listed in Chapter Five (``Mental Disorders'') of the International...

Beyond the DSM: trends in psychiatry diagnoses

Directory of Open Access Journals (Sweden)

Andre Russowsky Brunoni

Full Text Available Abstract Background: Although widely used in clinical practice and research, Diagnostic and Statistical Manual of Mental Disorders (DSM diagnoses have low validity: patients with different mental disorders can share similar symptoms, while those with the same diagnosis might have different symptoms. In fact, the DSM diagnostic system has been considered one of the main obstacles for further development of psychiatric research. Recently, it has been proposed that psychiatry nosology should be reframed according to a biologically-based etiology. Objectives: To review present and past endeavors of establishing an etiology-based nosology. Methods: Comprehensive review of articles on the topic. Results: From Hippocrates onwards, multiple attempts have been undertaken aiming to move etiology and nosology closer. The most recent efforts are represented by Developmental Psychopathology (DP and the Research Domain Criteria (RDoC, which presents an operational matrix recommended to be used in clinical research instead of the DSM diagnoses. Discussion: The DSM-based nosology is faulty. RDoC and DP might be interesting alternatives for an etiology-based nosology. However, while DP has already brought promising results, RDoC is a novel proposal, whose advantages and disadvantages should gradually be identified in the upcoming years.

Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders.

Science.gov (United States)

Ormel, J; Raven, D; van Oort, F; Hartman, C A; Reijneveld, S A; Veenstra, R; Vollebergh, W A M; Buitelaar, J; Verhulst, F C; Oldehinkel, A J

2015-01-01

With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders. We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths. Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5-10% of the sample, experiencing 34-55% of all severe lifetime disorders. At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5-10% of the adolescent population.

Hoarding disorder: a new diagnosis for DSM-V?

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Mataix-Cols, David; Frost, Randy O; Pertusa, Alberto; Clark, Lee Anna; Saxena, Sanjaya; Leckman, James F; Stein, Dan J; Matsunaga, Hisato; Wilhelm, Sabine

2010-06-01

This article provides a focused review of the literature on compulsive hoarding and presents a number of options and preliminary recommendations to be considered for DSM-V. In DSM-IV-TR, hoarding is listed as one of the diagnostic criteria for obsessive-compulsive personality disorder (OCPD). According to DSM-IV-TR, when hoarding is extreme, clinicians should consider a diagnosis of obsessive-compulsive disorder (OCD) and may diagnose both OCPD and OCD if the criteria for both are met. However, compulsive hoarding seems to frequently be independent from other neurological and psychiatric disorders, including OCD and OCPD. In this review, we first address whether hoarding should be considered a symptom of OCD and/or a criterion of OCPD. Second, we address whether compulsive hoarding should be classified as a separate disorder in DSM-V, weighing the advantages and disadvantages of doing so. Finally, we discuss where compulsive hoarding should be classified in DSM-V if included as a separate disorder. We conclude that there is sufficient evidence to recommend the creation of a new disorder, provisionally called hoarding disorder. Given the historical link between hoarding and OCD/OCPD, and the conservative approach adopted by DSM-V, it may make sense to provisionally list it as an obsessive-compulsive spectrum disorder. An alternative to our recommendation would be to include it in an Appendix of Criteria Sets Provided for Further Study. The creation of a new diagnosis in DSM-V would likely increase public awareness, improve identification of cases, and stimulate both research and the development of specific treatments for hoarding disorder. (c) 2010 Wiley-Liss, Inc.

The DSM diagnostic criteria for vaginismus.

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Binik, Yitzchak M

2010-04-01

Vaginal spasm has been considered the defining diagnostic characteristic of vaginismus for approximately 150 years. This remarkable consensus, based primarily on expert clinical opinion, is preserved in the DSM-IV-TR. The available empirical research, however, does not support this definition nor does it support the validity of the DSM-IV-TR distinction between vaginismus and dyspareunia. The small body of research concerning other possible ways or methods of diagnosing vaginismus is critically reviewed. Based on this review, it is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called "genito-pelvic pain/penetration disorder." This diagnostic category is defined according to the following five dimensions: percentage success of vaginal penetration; pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

DSM 5: Precedents, present and prospects

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Jordi E. Obiols

2012-01-01

Full Text Available La próxima edición del DSM (DSM 5 aparecerá en Mayo de 2013. Los borradores publicados ya han generado diversas polémicas. Se ha criticado la posible inflación diagnóstica con una previsible epidemia de falsos positivos en nuevos diagnósticos como el "síndrome psicótico atenuado". La propuesta de otros nuevos diagnósticos como el «trastorno cognitivo leve", el "trastorno por atracones" o las "adicciones conductuales", entre otros, se suman a esta polémica. También se han criticado ciertos aspectos metodológicos del proceso, como la exigencia de confidencialidad y la falta de transparencia y los conflictos de intereses. El artículo repasa los antecedentes históricos del proceso DSM, con la revolución en la fiabilidad diagnóstica del DSM-III, los problemas de validez del DSM IV y las dudas que genera el DSM 5 en el supuesto cambio de "paradigma dimensional". Asimismo, se apunta a posibles vías futuras de solución, más allá del DSM 5, en el avance de las ciencias básicas del cerebro y de la conducta.

Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A)

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Merikangas, Kathleen Ries; He, Jian-ping; Burstein, Marcy; Swanson, Sonja A.; Avenevoli, Shelli; Cui, Lihong; Benjet, Corina; Georgiades, Katholiki; Swendsen, Joel

2010-01-01

Objective: To present estimates of the lifetime prevalence of "DSM-IV" mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and their sociodemographic correlates. Method: The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of…

Is the Eating Disorder Questionnaire-Online (EDQ-O) a valid diagnostic instrument for the DSM-IV-TR classification of eating disorders?

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ter Huurne, Elke D; de Haan, Hein A; ten Napel-Schutz, Marieke C; Postel, Marloes G; Menting, Juliane; van der Palen, Job; Vroling, Maartje S; DeJong, Cor A J

2015-02-01

The Eating Disorder Questionnaire-Online (EDQ-O) is an online self-report questionnaire, which was developed specifically to provide a DSM-IV-TR classification of anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and eating disorder not otherwise specified (EDNOS), without using a face-to-face clinical interview. The purpose of the present study was to examine the psychometric quality of the EDQ-O. The validity of the EDQ-O was determined by examining the agreement with the diagnoses obtained from the Longitudinal, Expert, and All DATA (LEAD) standard. Participants included 134 new patients of a specialist center for eating disorders located in the Netherlands. Assessment of the validity of the EDQ-O yielded acceptable to good AUC (area under the receiver operating characteristic curve) values with a range from 0.72 to 0.83. Most other diagnostic efficiency statistics were also good except for a low sensitivity for AN (0.44), a low positive predictive value for BN (0.50), and a relatively low sensitivity for BED (0.66). The results of the present study suggest that the EDQ-O performs acceptably as a diagnostic instrument for all DSM-IV-TR eating disorder classifications. However, suggestions are made to further improve the validity of the EDQ-O. Copyright © 2014 Elsevier Inc. All rights reserved.

DSM-IV "criterion A" schizophrenia symptoms across ethnically different populations: evidence for differing psychotic symptom content or structural organization?

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McLean, Duncan; Thara, Rangaswamy; John, Sujit; Barrett, Robert; Loa, Peter; McGrath, John; Mowry, Bryan

2014-09-01

There is significant variation in the expression of schizophrenia across ethnically different populations, and the optimal structural and diagnostic representation of schizophrenia are contested. We contrasted both lifetime frequencies of DSM-IV criterion A (the core symptom criterion of the internationally recognized DSM classification system) symptoms and types/content of delusions and hallucinations in transethnic schizophrenia populations from Australia (n = 776), India (n = 504) and Sarawak, Malaysia (n = 259), to elucidate clinical heterogeneity. Differences in both criterion A symptom composition and symptom content were apparent. Indian individuals with schizophrenia reported negative symptoms more frequently than other sites, whereas individuals from Sarawak reported disorganized symptoms more frequently. Delusions of control and thought broadcast, insertion, or withdrawal were less frequent in Sarawak than Australia. Curiously, a subgroup of 20 Indian individuals with schizophrenia reported no lifetime delusions or hallucinations. These findings potentially challenge the long-held view in psychiatry that schizophrenia is fundamentally similar across cultural groups, with differences in only the content of psychotic symptoms, but equivalence in structural form.

Bereavement-related depression: Did the changes induced by DSM-V make a difference? Results from a large population-based survey of French residents.

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Clesse, Florence; Leray, Emmanuelle; Bodeau-Livinec, Florence; Husky, Mathilde; Kovess-Masfety, Viviane

2015-08-15

DSM-V has been criticized for excessively expanding criteria for bereavement-related depression. The aim of this study was to quantify a potential increase in depression prevalence due to changes in diagnostic criteria and to assess the severity, clinical profile and healthcare use of new cases. A cross-sectional telephone survey was performed in 2005-2006 in four French regions. Twelve-month prevalence of psychiatric disorders was measured by CIDI-SF. Bereavement was assessed in those who endorsed the gate question to the depression module. Persons with bereavement-related depression according to DSM-IV and DSM-V diagnosis criteria were compared. Of the 22,138 respondents, 692 were bereaved. The prevalence of depression among those bereaved was 49.9% (95% CI ¼=43.7−56.0) according to DSM-IV and 59.6% (53.1−66.1) according to DSM-V [corrected]. The overall prevalence of major depression increased from 8.6% (8.1–9.1) with DSM-IV to 8.8% (8.3−9.3) with DSM-V . Cases diagnosed using DSM-IV presented more symptoms than cases diagnosed using DSM-V but clinical features were similar except regarding criterion E׳s symptoms. Healthcare use was similar between the two groups regarding consultations and psychotropic drug prescription. Some DSM-IV and DSM-V criteria were difficult to operationalize in the survey. The observed difference in prevalence according to DSM-IV and DSM-V may be reduced when clinical judgment is taken into account. The overall prevalence of major depression is only marginally increased by the new criteria. However, diagnostic changes increase the prevalence by 10 points among those bereaved. Diagnostic changes do not appear to modify service use. Copyright © 2015 Elsevier B.V. All rights reserved.

[DSM-5 classification of personality disorders in older persons

NARCIS (Netherlands)

Alphen, S.P. van; Rossi, G.; Dierckx, E.; Oude Voshaar, R.C.

2014-01-01

BACKGROUND: Although it is generally agreed that personality disorders are an important topic in old-age psychiatry, DSM-5 has paid relatively little attention to older persons affected with this severe mental disorder. AIM: To look closely and carefully at several aspects of the way in which DSM-5

Emotional disorders: cluster 4 of the proposed meta-structure for DSM-V and ICD-11.

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Goldberg, D P; Krueger, R F; Andrews, G; Hobbs, M J

2009-12-01

The extant major psychiatric classifications DSM-IV, and ICD-10, are atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis would be greatly enhanced by an understanding of risk factors and clinical manifestations. In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. This paper considers the validity of the fourth cluster, emotional disorders, within that proposal. We reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force, as applied to the cluster of emotional disorders. An emotional cluster of disorders identified using the 11 validators is feasible. Negative affectivity is the defining feature of the emotional cluster. Although there are differences between disorders in the remaining validating criteria, there are similarities that support the feasibility of an emotional cluster. Strong intra-cluster co-morbidity may reflect the action of common risk factors and also shared higher-order symptom dimensions in these emotional disorders. Emotional disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

[An approach to DSM-5: a breakthrough in psychiatry?].

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Heerlein, Andrés L

2014-01-01

One of the main problems of current psychiatry is that its diagnostic classification systems are not precise and reliable, they do not help to identify with certainty a specific type of mental disorder and they frequently overlap two or more diagnoses. This may conduce to over diagnosis and overtreatment, which is the main criticism of the DSM system. The American Psychiatric Association (APA) launched recently the DSM-5, the fifth edition of its diagnostic manual, which provides diagnostic criteria for thousands of psychiatrist, psychologist and researchers and who will be using it in the next coming years. DSM-5, like the preceding editions, placed disorders in discrete categories such as bipolar disorder or schizophrenia. The problem is that scientists have been unable to find yet a genetic or neurobiological evidence to support the theory of mental disorders as separate categories. Several authors wanted the latest DSM to move away from the category model towards a new "dimensional approach", where disorders can be measured and mental illnesses overlapping can be reduced. Recent findings supports this new dimensional strategy, suggesting that the disorders are a product of shared risk factors that lead to abnormalities in specific drives, which can be measured and used to place persons on one of several spectra. In some parts the DSM-5 entered changes aiming to achieve a greater objectivity. The door for new changes in each category, dimension or criteria has been opened, favoring an evidence-based development of the future versions. DSM-5 is presented as a "living document" that can be updated easily. However, the category model still remains for many disorders. The future research in psychiatric diagnostic systems requires more genetic-molecular and neurophysiological evidence and more objective multinational field trials, in order to confirm the existence of the new diagnostic entities, spectrums or dimensions. This approach may provide us reliable

Measures of Narcissism and Their Relations to DSM-5 Pathological Traits: A Critical Reappraisal.

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Miller, Joshua D; Lynam, Donald R; Campbell, W Keith

2016-02-01

There exists substantial debate about how to best assess pathological narcissism with a variety of measures designed to assess grandiose and vulnerable narcissism, as well as the DSM-IV and DSM-5 based conceptualizations of narcissistic personality disorder (NPD). Wright and colleagues published correlations between several narcissism measures (Narcissistic Personality Inventory [NPI]; Pathological Narcissism Inventory [PNI]; Personality Diagnostic Questionnaire [PDQ] NPD) with the traits comprising the DSM-5 Section III personality trait model. In the current study, we examine the agreement manifested by Wright and colleagues' narcissism-DSM-5 trait profiles with expert ratings of the DSM-5 traits most relevant to descriptions of DSM-IV NPD. Despite concerns regarding the NPI's ability to measure pathological narcissism, its trait profile was strongly correlated with expert ratings, as was PDQ NPD's profile. Conversely, the trait profiles associated with the PNI were primarily uncorrelated with the expert rated NPD profile. The implications of these findings with regard to the assessment of narcissism are discussed. © The Author(s) 2014.

Mixed states in bipolar disorder - changes in DSM-5 and current treatment recommendations.

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Betzler, Felix; Stöver, Laura Apollonia; Sterzer, Philipp; Köhler, Stephan

2017-11-01

Mixed states in affective disorders represent a particular challenge in clinical routine, characterized by a complicated course of treatment and a worse treatment response. Clinical features of mixed states and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria are presented and critical discussed. We then performed a systematic review using the terms 'bipolar', 'mixed' and 'randomized' to evaluate current treatment options. For pharmacological treatment of mixed states in total, there is still insufficient data from RCTs. However, there is some evidence for efficacy in mixed states from RCTs for atypical antipsychotics, especially olanzapine, aripiprazole and asenapine as well as mood stabilizers as valproate and carbamazepine. Mixed states are of a high clinical relevance and the DSM-5 criteria substantially reduced the diagnostic threshold. Besides advantages of a better characterization of patients with former DSM-IV-defined mixed episodes, disadvantages arise for example differential diagnoses with a substantial overlap in symptoms such as borderline personality disorders. Atypical antipsychotics, valproate and carbamazepine demonstrated efficacy in a limited sample of RCTs. The number of RCTs in the treatment of mixed states is highly limited. Furthermore, nearly all studies were funded by pharmaceutical companies which may lead to an underestimation of classical mood stabilizers such as lithium.

The psychometric properties of the personality inventory for DSM-5 in an APA DSM-5 field trial sample.

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Quilty, Lena C; Ayearst, Lindsay; Chmielewski, Michael; Pollock, Bruce G; Bagby, R Michael

2013-06-01

Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a hybrid model of personality pathology, in which dimensional personality traits are used to derive one of seven categorical personality disorder diagnoses. The Personality Inventory for DSM-5 (PID-5) was developed by the DSM-5 Personality and Personality Disorders workgroup and their consultants to produce a freely available instrument to assess the personality traits within this new system. To date, the psychometric properties of the PID-5 have been evaluated primarily in undergraduate student and community adult samples. In the current investigation, we extend this line of research to a psychiatric patient sample who participated in the APA DSM-5 Field Trial (Centre for Addiction and Mental Health site). A total of 201 psychiatric patients (102 men, 99 women) completed the PID-5 and the Revised NEO Personality Inventory (NEO PI-R). The internal consistencies of the PID-5 domain and facet trait scales were acceptable. Results supported the unidimensional structure of all trait scales but one, and the convergence between the PID-5 and analogous NEO PI-R scales. Evidence for discriminant validity was mixed. Overall, the current investigation provides support for the psychometric properties of this diagnostic instrument in psychiatric samples.

FY 1997 report on the verification survey of new mechanisms for load leveling. IEA`s international collaboration `Participation of Japan in IEA/DSM Task VI`; 1997 nendo chosa hokokusho (fuka heijunka shinshuho jissho chosa). IEA kokusai kyoryoku jigyo `IEA/DSM task IV eno sanka ni tsuite`

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-03-01

Current electricity markets in Europe and the USA are drastically changing due to the introduction of competition principle and the reconsideration of business systems. Are also changing the activities and their forms of DSM (demand side management) for load leveling which has been conventionally conducted by electricity companies for the efficient operation of facilities. Task IV and Task VI aim at developing new mechanisms to promote DSM in the changing electricity markets as well as disseminating and communicating information on the new mechanism. Japan participates in Sub-task IV/6 and 7 and Task VI. Activities for developing new mechanisms are divided into Phase 1 and Phase 2. The Phase 1 includes review of existing mechanisms and preliminary development and evaluation of new mechanisms. The Phase 2 includes the detailed development of new mechanisms and evaluation criteria, communication and information about mechanisms, and identification of the public policy implications which would follow a decision by the responsible authorities to implement each of various DSM mechanisms. The time frame of Phase 1 is between February 1996 and March 1997, and that of Phase 2 is between January 1997 and December 1999. 2 figs., 4 tabs.

DSM-IV-TR “pain disorder associated with psychological factors” as a nonhysterical form of somatization

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Aragona, Massimiliano; Tarsitani, Lorenzo; De Nitto, Serena; Inghilleri, Maurizio

2008-01-01

BACKGROUND: Elevated Minnesota Multiphasic Personality Inventory (MMPI) scores on the hysteria (Hy) scale are reported in several forms of pain. Previous results were possibly biased by diagnostic heterogeneity (psychogenic, somatic and mixed pain syndromes included in the same index sample) or Hy heterogeneity (failure to differentiate Hy scores into clinically meaningful sub-scales, such as admission of symptoms [Ad] and denial of symptoms [Dn]). METHODS: To overcome this drawback, 48 patients diagnosed as having a Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Text Revision (DSM-IV-TR) diagnosis of “pain disorder associated with psychological factors” were compared with 48 patients experiencing somatic pain excluding psychological factors, and 42 somatic controls without pain. RESULTS: MMPI Hy and hypochondriasis (Hs) scores were significantly higher in the pain disorder group than in control groups, who scored similarly. MMPI correction (K) scores and Dn scores were similar in the three groups, whereas Ad was significantly higher in the pain disorder group and lower and similar in the two control groups, respectively. In the pain disorder group, Ad and Dn were negatively correlated, whereas in control groups they were unrelated. CONCLUSIONS: These findings suggest that whereas a pattern of high Hs and Hy scores together with a normal K score might characterize patients with a pain disorder associated with psychological factors, elevated Hy scores per se do not indicate hysterical traits. In the pain disorder group, elevated Hy scores reflected the Ad subscale alone, indicating a strikingly high frequency of distressing somatic symptoms. They tend not to repress or deny the emotional malaise linked to symptoms, as the hysterical construct expects. The pain disorder designation should be considered a nonhysterical form of somatization. PMID:18301811

Olfactory reference syndrome: issues for DSM-V.

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Feusner, Jamie D; Phillips, Katharine A; Stein, Dan J

2010-06-01

The published literature on olfactory reference syndrome (ORS) spans more than a century and provides consistent descriptions of its clinical features. The core symptom is preoccupation with the belief that one emits a foul or offensive body odor, which is not perceived by others. This syndrome is associated with substantial distress and disability. DSM-IV and ICD-10 do not explicitly mention ORS, but note convictions about emitting a foul body odor in their description of delusional disorder, somatic type. However, the fact that such symptoms can be nondelusional poses a diagnostic conundrum. Indeed, DSM-IV also mentions fears about the offensiveness of one's body odor in the social phobia text (as a symptom of taijin kyofusho). There also seems to be phenomenological overlap with body dysmorphic disorder, obsessive-compulsive disorder, and hypochondriasis. This article provides a focused review of the literature to address issues for DSM-V, including whether ORS should continue to be mentioned as an example of another disorder or should be included as a separate diagnosis. We present a number of options and preliminary recommendations for consideration for DSM-V. Because research is still very limited, it is unclear how ORS should best be classified. Nonetheless, classifying ORS as a type of delusional disorder seems problematic. Given this syndrome's consistent clinical description across cultures for more than a century, substantial morbidity and a small but growing research literature, we make the preliminary recommendation that ORS be included in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and we suggest diagnostic criteria. (c) 2010 Wiley-Liss, Inc.

Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders.

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Xiong, Nana; Zhang, Yaoyin; Wei, Jing; Leonhart, Rainer; Fritzsche, Kurt; Mewes, Ricarda; Hong, Xia; Cao, Jinya; Li, Tao; Jiang, Jing; Zhao, Xudong; Zhang, Lan; Schaefert, Rainer

2017-11-07

The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients. This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive, affective, and behavioral features associated with somatic complaints" was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus. Cohen's к scores were given to illustrate the agreement of the diagnoses. A three-structure model of the interview, within which items were classified as respectively assessing the cognitive (B1), affective (B2), and behavioral (B3) features, was examined. According to percentages of screening-positive persons and the receiver operator characteristic (ROC) analysis, a cut-off point of 2 was recommended for each subscale of the interview. With the operationalization, the frequency of DSM-5 SSD was estimated as 36.5% in our sample, and that of DSM-IV somatoform disorders was 8.2%. The agreement between them was small (Cohen's к = 0.152). Comparisons of sociodemographic features of SSD patients with different severity levels (mild, moderate, severe) showed that mild SSD patients were better-off in terms of financial and employment status, and that the severity subtypes were congruent with the level of depression, anxiety, quality of life impairment, and the frequency of doctor visits. The operationalization of the diagnosis and severity specifications of SSD was valid, but the diagnostic agreement between DSM-5 SSD and DSM-IV somatoform disorders was small. The interpretation the SSD criteria should be made cautiously, so that the diagnosis would not became over-inclusive.

Del DSM-IV-TR al DSM-5: análisis de algunos cambios

Directory of Open Access Journals (Sweden)

Juan Francisco Rodríguez Testal

2014-01-01

Full Text Available La publicación de la quinta edición del DSM ha avivado un debate iniciado tiempo atrás, desde el anuncio de los cambios en los criterios de diagnóstico propuestos por la APA. En este artículo se analizan algunas de estas modificaciones. Se plantean aspectos interesantes y acertados, como la inclusión de la dimensionalidad, tanto en las clases diagnósticas como en algunos trastornos, la incorporación de un espectro obsesivo-compulsivo o la desaparición de los subtipos de esquizofrenia. También se analizan otros aspectos más controvertidos como la consideración del síndrome de psicosis atenuada, la descripción de un trastorno depresivo persistente, la reordenación en trastornos de síntomas somáticos los clásicos trastornos somatoformes, o el mantenimiento de los tres grandes grupos de trastornos de la personalidad, siempre insatisfactorios, junto con un planteamiento anunciado, pero marginal, de la perspectiva dimensional de las alteraciones de la personalidad. La nueva clasificación del DSM-5 abre numerosos interrogantes acerca de la validez que se pretende mejorar en el diagnóstico, en esta ocasión, asumiendo un planteamiento más cercano a la neurología y la genética que a la psicopatología clínica.

Comparison of Children with Autism Spectrum Disorder with and without Schizophrenia Spectrum Traits: Gender, Season of Birth, and Mental Health Risk Factors

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Gadow, Kenneth D.; DeVincent, Carla J.

2012-01-01

Children with autism spectrum disorder (ASD) with and without co-occurring schizophrenia spectrum traits (SST) were examined for differences in co-occurring psychiatric symptoms, background characteristics, and mental health risk factors. Participating mothers and teachers completed a DSM-IV-referenced rating scale and a background questionnaire…

The quality of severe mental disorder diagnoses in a national health registry as compared to research diagnoses based on structured interview.

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