DsM5 An Overview and Critique Grand Rounds DSM5的概述和批判的大查房.pptxVIP

A DSM-5 Primer: Overview and Major Changes  Professor, Vice Chair for Education Department of Psychiatry University of Iowa Carver College of Medicine Iowa City, IA 52242 2014 Jauch Memorial Educational Symposium May 16, 2014 donald-black@uiowa.edu Donald W. Black, MD Conflicts Grant support: AstraZeneca National Institute on Aging Nellie Ball Trust Royalties: American Psychiatric Publishing Oxford University Press UpToDate Objectives To improve the learners understanding of DSM-5 To describe the major changes and their rationale. To facilitate the transition from DSM-IV to DSM-5. What the DSM is and is not Is for: Diagnosis and classification Communication among professionals Coding/billing Research Is Not: An inerrant Bible Static: diagnoses are always evolving A guide to selection of appropriate treatments The DSM through Time The DSM Through Time DSM-I (1952) – 132 pages Mental disorders resulted from a “reaction” of personality to psychological factors, e.g. manic-depressive reactions. Definitions were simple and brief DSM-II (1968) – 134 pages Term “reaction” dropped; users encouraged to record multiple psychiatric diagnoses DSM-III (1980) – 494 pages DSM-III was transformative. Process led by Robert Spitzer, MD of Columbia University “Atheoretical” with regard to etiology. Introduced: diagnostic criteria multiaxial classification Diagnostic reliability Robert Spitzer, MD DSM-III-R, DSM-IV, and DSM-IV-TR DSM-III-R (1987) had few changes (567 pages) DSM-IV (1994) was much larger (886 pages): New disorders introduced (e.g., Acute Stress Disorder, Bipolar II Disorder, Asperger’s Disorder). DSM-IV-TR (2000) had text changes (943 pages) DSM-5: 2013 947 pp. The March to DSM-5 Psychiatrists Darrel Regier, MD (l) and David Kupfer, MD (r) appointed in 2006 to lead Task Force that led to DSM-5 The March to DSM-5 Guiding principles: Priority was given to clinical utility; that is, any changes had to be useful to clinicians; Changes