DSMs

The DSMs, or Diagnostic and Statistical Manual of Mental Disorders, are handbooks published by the American Psychiatric Association that provide standardized criteria for the classification and diagnosis of mental disorders. The DSMs are used by clinicians and researchers in the United States and in many other countries to ensure consistent communication, treatment planning, and eligibility for clinical services and research enrollment. They are distinct from but often used alongside the International Classification of Diseases (ICD) system.

Since the first edition published in 1952, the DSM has evolved through several revisions, including DSM-II (1968), DSM-III (1980) with major changes to diagnostic criteria and reliability, DSM-III-R (1987), DSM-IV (1994) and DSM-IV-TR (2000), DSM-5 (2013), and DSM-5-TR (Text Revision, 2022). Each edition reflects advances in research, changes in clinical practice, and shifts in diagnostic philosophy.

The DSM organizes disorders into broad groups such as neurodevelopmental, mood, anxiety, psychotic, eating and sleep disorders, and trauma- and stressor-related disorders, among others. For each disorder, the DSM provides diagnostic criteria, associated features, prevalence information, and differential diagnoses. The DSM also includes coding and specifiers to describe severity, course, and accompanying features.

The DSM is developed by task forces, field trials, and revisions guided by research and expert consensus. DSM-5 introduced structural changes, including the removal of the multi-axial system and the addition or revision of disorders. The DSM-5-TR adds textual updates and refinements to criteria and language to reflect current evidence and reduce bias.

Critics raise concerns about reliability and validity for some disorders, cultural and contextual biases, medicalization of normal variation, and impacts on stigma and access to care. The DSM remains a central reference in psychiatry and psychology, though clinicians also consider alternative systems, such as ICD guidelines and culturally informed assessments.