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Recent Updates to Proposed Revisions for DSM-5 

Below is a list of updates made to this Web site, including changes in draft criteria and other proposed revisions, since the end of the last open commenting period (July 2011). Between now and June 15, 2012, we welcome your comments and questions on these changes. Work group members will review all comments, and in conjunction with results from the recently completed DSM-5 Field Trials, will begin making final revisions to their proposed changes for DSM-5. This will represent the final time this Web site will be updated before publication of DSM-5 in May 2013.

 DSM Changes

 

Disorder-Specific Changes

Neurodevelopmental Disorders

Communication Disorders - Restructured to now include Social Communication Disorder plus two diagnostic categories: Language Disorders and Speech Disorders. These categories each contain appropriate subtypes to cover all seven of the disorders previously proposed for this diagnostic category (Language Emergence; Specific Language Impairment; Social Communication Disorder; Voice Disorder; Speech-Sound Disorder; Motor Speech Disorder; Child Onset Fluency Disorder).

Learning Disorder has been changed to Specific Learning Disorder and the previous types of Learning Disorder (Dyslexia, Dyscalculia, and Disorder of Written Expression) are no longer being recommended. The type of Learning Disorder will instead be specified as noted in the diagnosis.

Social Communication Disorder has undergone some moderate wording changes for consistency with wording of other DSM-5 Neurodevelopmental Disorders

Attention-Deficit/Hyperactivity Disorder - minor wording changes

Chronic Tic Disorder, Tic Disorder Not Elsewhere Classified, and Tic Disorder Associated With Another Medical Condition - minor wording changes

Addition of criteria for Attention-Deficit/Hyperactivity Disorder Not Elsewhere Classified

 

Schizophrenia Spectrum and Other Psychotic Disorders

Attenuated Psychosis Syndrome - proposed for Section III, a section of DSM-5 in which conditions that require further study will be included

Schizoaffective Disorder - updated rationale for proposed changes to this disorder

Reorganization of the disorders within this category to reflect a gradient of psychopathology, from least to most severe

Psychotic Disorder Not Elsewhere Classified renamed from Psychotic Disorder Not Otherwise Specified

Psychotic Disorder Associated with Another Medical Condition renamed from Psychotic Disorder Associated With a Known General Medical Condition

Updated severity dimensions for these disorders

 

Bipolar and Related Disorders

Hypomanic Episode -- Criterion A revised to include increased energy/activity as a core symptom

Manic Episode -- Criterion A revised to include increased energy/activity as a core symptom

Major Depressive Episode - proposed removal of the bereavement exclusion and addition of a footnote to clarify for clinicians how to differentiate bereavement and other loss reactions from Major Depression

 

Depressive Disorders

Mixed Anxiety/Depression - proposed for Section III, a section in DSM-5 in which conditions that require further research will be included

Major Depressive Episode - proposed removal of the bereavement exclusion and addition of a footnote to clarify for clinicians how to differentiate bereavement and other loss reactions from Major Depression

Disruptive Mood Dysregulation Disorder - additional information provided to assist in differentiation from Oppositional Defiant Disorder.

 

Anxiety Disorders

Adjustment Disorder – addition of a 6-month requirement for children for the bereavement related subtype and minor wording changes, including changes to the bereavement related subtype.

Specific Phobia - duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”) and minor  wording changes

Social Anxiety Disorder (Social Phobia) – duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”) and minor wording changes

Generalized Anxiety Disorder – the number of associated physical symptoms has been reduced from six to two; minor wording changes

Panic Attack - minor wording changes

Panic Disorder - minor wording changes 

Agoraphobia - duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”) and minor wording changes

Separation Anxiety Disorder - duration criterion changed (from “The duration is at least 6 months” to “The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months”; age of onset requirement has been dropped; and minor wording changes

Addition of criteria for Substance-Induced Anxiety Disorder

Addition of criteria for Anxiety Disorder Attributable to Another Medical Condition

Addition of criteria for Anxiety Disorder Not Elsewhere Classified

 

Obsessive-Compulsive and Related Disorders

Obsessive Compulsive Disorder - minor wording changes

Hoarding Disorder- minor wording changes

Olfactory Reference Syndrome - minor wording changes

Skin Picking Disorder - addition of a new criterion that addresses attempts to resist skin picking

Hair-Pulling Disorder (Trichotillomania) - addition of a new criterion that addresses attempts to resist hair pulling

Body Dysmorphic Disorder - minor wording changes

Addition of criteria for Substance-Induced Obsessive-Compulsive or Related Disorders

Addition of criteria for Obsessive-Compulsive or Related Disorder Attributable to Another Medical Condition

Addition of criteria for Obsessive-Compulsive or Related Disorder Not Elsewhere Classified

 

Trauma and Stressor Related Disorders

Posttraumatic Stress Disorder - wording changes (e.g., adding “directly” in criterion A1); PTSD in preschool children proposed as a subtype of PTSD instead of a separate diagnosis; and proposal of a dissociative symptoms subtype

Acute Stress Disorder - minor wording changes

Addition of criteria for Persistent Complex Bereavement Disorder - this is being proposed for Section III, a section of DSM-5 in which conditions that require further research will be included

Addition of criteria for Trauma- or Stressor- Related Disorder Not Elsewhere Classified

 

Dissociative Disorders

Dissociative Amnesia - minor wording changes and revisions to the subtype

Depersonalization /Derealization Disorder - minor wording changes

Dissociative Identity Disorder - minor wording changes and revisions to the specifiers

 

Somatic Symptom Disorders

Somatic Symptom Disorder - formerly proposed as a singular disorder that combines the previously proposed diagnoses Complex Somatic Symptom Disorder and Simple Somatic Symptom Disorder

Conversion Disorder (renamed Functional Neurological Symptoms) – renamed Conversion Disorder (Functional Neurological Symptom Disorder)

Factitious Disorder - proposed for removal from the section Other Disorders and instead be placed in the section Somatic Symptom Disorders

 

Feeding and Eating Disorders

Avoidant/Restrictive Food Intake Disorder - minor wording changes

 

Sleep-Wake Disorders

Reclassification of Hypersomnolence Disorders to include subtypes of Narcolepsy/Hypocrein Deficiency Syndrome; Narcolepsy Without Cataplexy/Hypocretin Deficiency Syndrome; Periodic Hypersomnolence, Kleine-Levin Subtype; Major Somnolence Disorder; and Hypersomnia Not Elsewhere Classified

Circadian Rhythm Sleep-Wake Disorders renamed from Circadian Rhythm Sleep Disorders

Rationales have now been provided for all of these disorders

 

Gender Dysphoria

Gender Incongruence renamed Gender Dysphoria

 

Disruptive, Impulse Control, and Conduct Disorders

Oppositional Defiant Disorder – frequency will be addressed via a coding note, rather than in Criterion B

Intermittent Explosive Disorder criteria were added. One of the major changes is that the age at which the diagnosis can be made is now 18.

Conduct Disorder had minor wording changes

The Callous and Unemotional Specifier has clarified wording and some additional guidance on use

Pyromania and Kleptomania were removed, as there is insufficient evidence to retain them as distinct disorders.  The behaviors are better accounted for by other disorders, such as fire-starting in Conduct Disorder, or compulsive stealing as a symptom of a depressive disorder or impulse control disorder.

 

Substance Use and Addictive Disorders

Chapter order and numbering designations have been reorganized according to substance (whereas these were previously organized according to the diagnosis [i.e., use, intoxication, withdrawal])

Hallucinogen Disorders have now subsumed Phencyclidine Disorders

Sedative/Hypnotic-Related Disorders renamed from Sedative, Hypnotic, or Anxiolytic Disorders

Stimulant Disorders renamed from Amphetamine and Cocaine Disorders

Updated the Severity Specifiers

Updated the Remission Specifiers

Removal of Substance-Induced Dissociative Disorder

Minor wording changes to most of the criteria

Addition of criteria for Hallucinogen Persisting Perception Disorder

Addition of criteria for Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure - proposed for Section III, a section of DSM-5 in which conditions that require further research will be included

Addition of criteria for Caffeine Use Disorder - proposed for Section III, a section of DSM-5 in which conditions that require further research will be included

Addition of criteria for Internet Use Disorder - proposed for Section III, a section of DSM-5 in which conditions that require further research will be included

Addition of criteria for Drug Specific "Not Elsewhere Classified" diagnoses

 

Neurocognitive Disorders

Major and Mild Neurocognitive Disorder – diagnostic criteria are now added for each of the following subtypes of Major and Mild Neurocognitive Disorder: Vascular Neurocognitive Disorder; Frontotemporal Neurocognitive Disorder; Neurocognitive Disorder due to Lewy Body Dementia; Neurocognitive Disorder due to Parkinson’s Disease; Neurocognitive Disorder due to HIV Infection; Substance-Induced Neurocognitive Disorder; Neurocognitive Disorder due to Huntington’s Disease; Neurocognitive Disorder due to Prion Disease; Neurocognitive Disorder due to Another Medical Condition

Neurocognitive Disorder due to Alzheimer’s Disease was modified to maintain consistency with newly published consensus criteria 

Addition of criteria for Neurocognitive Disorder Not Elsewhere Classified

 

Personality Disorders

Addition of more extensive rationale for proposed changes in the diagnosis and classification of Personality Disorders

Minor wording changes to all diagnostic criteria

 

Paraphilic Disorders

All Paraphilic Disorders now include two new specifiers: In a Controlled Environment and In Remission

Paraphilias chapter renamed Paraphilic Disorders

Pedophilic Disorder - addition of a Hebephilic Subtype

Hypersexual Disorder - proposed for Section III, a section of DSM-5 in which conditions that require further research will be included

Paraphilic Coercive Disorder - proposed for Section III, a section of DSM-5 in which conditions that require further research will be included

 

Other Disorders

Addition of criteria for Suicidal Behavior Disorder

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