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Since it was first published in 1952, the DSM has been the has been the diagnostic bible for many psychiatrists. Each time the manual is updated, new conditions are introduced, often amid much controversy. DSM-5, the latest edition published on Saturday, is one of the most controversial yet.
Many conditions we’re now familiar with were codified in the DSM, including body dismorphic disorder, schizophrenia and bipolar.
Inclusions and removals can be hugely controversial. Autism is in the manual, for example, but Asperger’s isn’t. Homosexuality was only removed in 1974.
Below, five experts explain some of the most noteworthy new additions, and why they’ve been included.
Hoarding disorder
David Mataix-Cols: Most children have collections at some point and approximately 30% of British adults define themselves as collectors. This is a pleasurable, highly social and benign activity, which contrasts with another disabling form of object accumulation: hoarding disorder.
The symptoms include persistent difficulty in discarding possessions due to a strong perceived need to save items and distress in discarding them. This results in the accumulation of a large number of possessions that fill up and clutter key living areas of the home, to the extent that their intended use is no longer possible.
Symptoms are often accompanied by excessive acquiring, buying or even stealing of items that are not needed or for which there is no available space.
Using DSM-5, hoarding disorder can only be diagnosed once other mental disorders have been ruled out.
With a prevalence of at least 1.5% of the UK population, the disorder is associated with substantial functional disability, family conflict, social isolation, risk of falls and fires, evictions and homelessness.
Binge eating disorder
Christopher Fairburn: The inclusion of binge eating disorder in DSM-5 was expected and uncontroversial for the deciding committee. It’s already listed as a provisional diagnosis in DSM-IV.
The disorder is characterised by recurrent over-eating episodes and a sense of loss of control at the time. Sufferers don’t have the extreme dieting, vomiting and laxative misuse seen in people who have bulimia. It is the loss of control over eating that is the distressing feature of binge eating disorder, or BED. Continue reading
Sources
- The Conversation
- Image: Sergei Yolkin’s World, Voices from Russia
- See also: “Medicine’s big new battleground: does mental illness really exist?” in The Guardian
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