The American Psychology Association voted to finalize entries for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders yesterday, ending the last of several commenting periods open to the public, so if you were hoping to send them any recommendations I hope yours got in under the wire. There hasn't been a new edition since the release of the DSM-IV in 1994, which may not seem that long ago, but consider that Adderall did not yet exist at the time and the A&E Channel was still years away from its hit "Watching People With Largely Untreated Mental Illness Suffer in Their Homes" series lineup.
The most significant changes have included removing Asperger's as a separate disorder and "collapsing" it under the autism spectrum, adding binge drinking and hoarding, and removing the "bereavement exception" from signs of clinical depression:
In DSM-IV, a diagnosis of depression could not be made in patients who had suffered the death of a loved one until two months had elapsed. Under DSM-5, such patients may be called clinically depressed sooner, although the criteria will include advice to clinicians about distinguishing normal grief from depression that should be treated.
DSM-5 will also add a diagnosis of "disruptive mood dysregulation disorder" for children older than 6 who show frequent bursts of anger along with chronic irritability.
If you are tempted now to say something along the lines of "but all children older than six have disruptive mood dysregulation disorder!" or "everyone is a binge drinker" please feel very free to do so, although it's not really necessary and perhaps it'd be just as nice to have a cup of tea and not say it after all.
These changes have not been made without significant controversy - especially from the autism advocacy group Autism Speaks, which says it remains "concerned" about the real-world implications of these changes - but then the revision of the DSM has never been a neutral process. The vote was the last step in finalizing the content of the manual, which will be released in May of 2013, when it will be used to, hopefully at least, improve the quality of care for countless mental health patients, and also as an excuse for laypeople to find new armchair diagnoses for their least favorite exes, which is also a very important part of American life.