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