Since its first edition, the Diagnostic and Statistical manual of Mental disorders (DSM) has had a great impact on the scientific community and the public opinion as well. In 2013, the American Psychiatric Association released the fifth edition of the manual and – as for the previous versions – several criticisms raised. In particular, the persistence of the categorical approach to mental disorders represents one of the main debated topics, as well as the introduction of new diagnostic syndromes, which are not based on an adequate evidences. Moreover, the threshold of diagnostic criteria for many mental disorders has been lowered, with the consequence that the boundaries between “normality” and “pathology” is not so clear. In this paper, we will: 1) report the historical development of the DSM from the publication of its first edition; 2) describe the main changes introduced in the DSM-5; 3) discuss critical elements in the DSM-5. The current debate regarding the validity of diagnostic manuals and its criteria is threatening the psychiatric discipline, but a possible solution should be represented by the integration of diagnostic criteria with the in-depth description of patient’s psychopathological experiences.

Fin dalla pubblicazione della prima edizione, il Diagnostic and Statistical Manual of mental disorders (DSM) ha suscitato grande interesse e curiosità nella comunità scientifica e nell’opinione pubblica. La pubblicazione della quinta edizione del manuale nel 2013 ha tuttavia sollevato numerose criticità e perplessità. In particolare, le principali critiche al DSM-5 riguardano l’approccio generale ai disturbi mentali, che di fatto è rimasto categoriale, e l’introduzione di un numero cospicuo di nuove diagnosi non supportate da adeguate evidenze scientifiche. Inoltre, l’abbassamento della soglia di sensibilità diagnostica per alcuni disturbi già presenti nelle precedenti edizioni del manuale ha causato un ampliamento dei confini diagnostici per i più comuni disturbi mentali, rendendo meno chiaro il limite tra normalità e patologia, con il rischio di medicalizzare condizioni che non meriterebbero attenzione clinica. In questo lavoro, vengono analizzate le principali novità introdotte dal DSM-5 e vengono discusse le implicazioni per la diagnosi psichiatrica alla luce delle critiche mosse al DSM-5 dalla comunità scientifica.

Critical evaluation of current diagnostic classification systems in psychiatry: the case of DSM-5

NANNI, Maria Giulia;
2016

Abstract

Since its first edition, the Diagnostic and Statistical manual of Mental disorders (DSM) has had a great impact on the scientific community and the public opinion as well. In 2013, the American Psychiatric Association released the fifth edition of the manual and – as for the previous versions – several criticisms raised. In particular, the persistence of the categorical approach to mental disorders represents one of the main debated topics, as well as the introduction of new diagnostic syndromes, which are not based on an adequate evidences. Moreover, the threshold of diagnostic criteria for many mental disorders has been lowered, with the consequence that the boundaries between “normality” and “pathology” is not so clear. In this paper, we will: 1) report the historical development of the DSM from the publication of its first edition; 2) describe the main changes introduced in the DSM-5; 3) discuss critical elements in the DSM-5. The current debate regarding the validity of diagnostic manuals and its criteria is threatening the psychiatric discipline, but a possible solution should be represented by the integration of diagnostic criteria with the in-depth description of patient’s psychopathological experiences.
2016
Luciano, M; Sampogna, G; Del Vecchio, V; De Rosa, C; Albert, U; Carra, G; Dell'Osso, B; Di Lorenzo, G; Ferrari, S; Martinotti, G; Nanni, Maria Giulia; Pinna, F; Pompili, M; Volpe, U; Catapano, F; Fiorillo, A.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/2352827
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