WHAT? A NEW DSM? New DSM-5 Text Revision Published
(by Barbara Griswold, LMFT August 12, 2022)
Am I the only one that missed this? With little fanfare, the folks who publish the DSM-5 published an updated edition to their humongous manual.
Back in March of this year, the American Psychiatric Association came out with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). I guess I was asleep at the switch!
The DSM-5-TR includes new references and clarifications to diagnostic criteria, and updates to ICD-10-CM codes. There was also an attempt to rewrite the text using more up-to-date terminology, and terms that were more sensitive to culture, race, and gender identity issues.
According to the APA and the NASW, the most significant changes from DSM-5 to DSM-5 TR include:
- the addition of one new disorder in the chapter Trauma and Related Stressors called prolonged grief disorder (F43.8). [Note: This is the only disorder that should be referred to as a DSM-5-TR disorder, because it is new to the text revision. All other disorders should be referred to as DSM-5 disorders.]
- restoration of Unspecified Mood Disorder (F39)
- a change in terminology from intellectual disability (previously mental retardation) to intellectual developmental disorder [(F70) mild; (F71) moderate; (F72) severe; (F73) profound].
- over 70 modified criteria sets with clarifications
- considerations of the impact of racism and discrimination on mental disorders integrated into the text
- a new category for Other Conditions That May Be a Focus of Clinical Attention – Suicidal behavior and non-suicidal self-injury (NSSI).
- codes for the initial encounter of someone with suicidal ideation or attempt (T14.91A), subsequent encounters (T14.91D), and a history (but not current) suicidal behavior (Z91.51).
- codes for current NSSI (R45.88) and a history (not current) of NSSI (Z91.52).
- coding updates for substance intoxication and withdrawal and other disorders
- updated text in the Gender Dysphoria chapter, including updates to the terminology to describe gender dysphoria based on updated culturally sensitive language
- revised text for many disorders with updated sections on associated features, prevalence, development and course, risk and prognostic factors, culture, diagnostic markers, suicide, and differential diagnosis
Should you run out and buy it? Well, from my first review of the changes, this text revision does not seem to be a major overhaul. There aren’t sweeping changes of a large number of the diagnoses that you use daily, that would make the purchase essential. However, the changes might be significant to you depending on the type of clients you work with. And since appropriate diagnosis and coding is important in treatment planning and billing, clinicians may want to obtain a copy to have the most up-to-date and accurate diagnostic information. Also, if you are studying for a licensing exam, this will be the manual you will likely need to know.
If you DON’T buy it (and even if you do), I suggest you orient yourself with the changes by reading
- this very good NASW article on the topic, which gives a deeper discussion of the changes that therapists need to know: click here
- The Fact Sheets from the APA with the details of changes in different diagnostic categories — click here and then scroll down the page to the list of Updated Disorders
The DSM-5-TR is available on the APA website and through other book vendors, such as Amazon and Barnes and Noble. Tip: If you really just want the codes and diagnostic criteria for each diagnosis, and want to save money, consider purchasing the Desk Reference to the Diagnostic Criteria From DSM-5-TR.