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Big Changes in Psychiatry's 'Bible' of Disorders

WebMD Health News
Reviewed by Louise Chang, MD

Dec. 3, 2012 -- A major revision to the diagnostic "bible" -- which defines what is and what is not a mental illness -- has the final approval of the American Psychiatric Association (APA).

The approval means the final draft of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, will be official when it is published in May 2013.

Ten years in the making, the rewritten manual has been embroiled in controversy. One outspoken critic is Allen J. Frances, MD, chair of the task force that developed the previous edition, DSM-IV.

In a critique published online by Psychology Today, Frances calls the DSM-5 "deeply flawed," with "changes that seem clearly unsafe and scientifically unsound."

The APA defends the DSM-5 as the work of more than 1,500 experts in all fields of psychiatry and psychology from 39 countries.

"We have produced a manual that best represents the current science and will be useful to clinicians and the patients they serve," Dilip Jeste, MD, president of the APA, says in a news release.

Something called "psychotic risk syndrome," one of the most controversial proposed diagnoses, was dropped from the final draft. "Hypersexual disorder" (sex addiction) was also rejected, although the new manual opens the door to "behavioral addictions."

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