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Changes from DSM-IV to DSM-5
Published in Anka A. Vujanovic, Sudie E. Back, Posttraumatic Stress and Substance Use Disorders, 2019
Aisling V. Henschel, Stephanie M. Jeffirs, Isabel F. Augur, Julianne C. Flanagan
SUD criteria were modified from the DSM-IV-TR to improve the reliability of diagnoses and clinical evaluation. Namely, the DSM-5 combined the previously distinct diagnostic subcategories of substance abuse and dependence into one overarching SUD category. SUD diagnosis is now further specified by the substance of choice (e.g., alcohol use disorder, cocaine use disorder) and severity of the disorder (e.g., mild, moderate, severe). Furthermore, the DSM-5 Substance-Related Disorders Work Group implemented criteria changes, both additions and retractions, and severity scoring. To begin, we will review the obsolete DSM-IV-TR SUD criteria and subsequently review the current DSM-5 criteria, elaborating on the revisions and providing evidence for the support of these principal changes.
Introduction: Probiotics and Psychopathology
Published in Martin Colin R, Derek Larkin, Probiotics in Mental Health, 2018
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is currently in its fifth edition (American Psychiatric Association, 2013) having superseded the DSM-IV-TR (American Psychiatric Association, 2000) in May 2013. The DSM is the standard reference manual for assessment, and diagnosis of neuropsychiatric conditions. The first edition of the DSM evolved out of the international classification of diseases (ICD-6) in 1952. Its goal ever since has been to map knowledge about the brain and psychopathologies, and to guide clinical professionals on the diagnosis of mental health disorders. One of the guiding principles of the DSM is to evaluate knowledge and to stay abreast of the changing times and the developments in causes and diagnosis of neuropsychiatric conditions.
Classification of eating disorders
Published in Stephen Wonderlich, James E Mitchell, Martina de Zwaan, Howard Steiger, Eric F van Furth, Annual Review of Eating Disorders Part 1 – 2007, 2018
Jill M Holm-Denoma, Kathryn H Gordon, Thomas E Joiner
Regarding the second criterion for a good classification system, Schmidt et al. (2004) proposed that the phenomena of interest should not be grouped in an arbitrary manner. Rather, classification systems should group phenomena in a way that accurately reflects nature or “carves nature at its joints” (Waller and Meehl 1998). Accurate classification systems enhance scientific and clinical understanding of phenomena, and should therefore be the goal of the DSM classification of psychiatric disorders (Clark et al. 1995). Researchers and clinicians have often questioned whether the DSM-IV-TR has fulfilled this second criterion. Thus, the current review addresses how well the DSM-IV-TR satisfies this criterion of a high-quality classification system.
Anxiety and Depression Mediate the Relationship of Medication-Resistant PTSD to Quality of Life in Service Members
Published in Military Behavioral Health, 2022
Maegan M. Paxton Willing, Larissa L. Tate, Patricia T. Spangler, David M. Benedek, David S. Riggs
Importantly, as data collection was initiated prior to the release of the CAPS for DSM-5 (CAPS-5), the present study utilized DSM-IV-TR diagnostic criteria. This decision allowed the use of the CAPS, considered the gold-standard PTSD assessment, and, we believe, better captured the diagnostic criteria used when the majority of our participants initiated the pharmacological treatment that failed to adequately address their PTSD symptoms. Although the CAPS-5 became available during data collection, we believed changing criteria and scoring mid-enrollment would have caused substantial complications to the analysis and interpretation of data. However, there were significant changes made in the diagnostic criteria of PTSD with the DSM-5 raising questions about the applicability of the present findings using the older criteria. Notably, the use of the CAPS as a continuous measure of PTSD (rather than producing a diagnostic determination) in the present study probably reduces this concern as many of the specific PTSD symptoms in the DSM-5 criteria are included in the CAPS used for this study. Keeping in mind these limitations, the present findings remain quite relevant to the care of military-affiliated patients with PTSD. In the wake of ineffective pharmacological treatment, retained PTSD symptoms, depression, and anxiety, were associated with lower QoL across a range of functional areas.
Dissociative Symptoms are Highly Prevalent in Adults with Narcolepsy Type 1
Published in Behavioral Sleep Medicine, 2022
Laury Quaedackers, Hal Droogleever Fortuyn, Merel Van Gilst, Martijn Lappenschaar, Sebastiaan Overeem
In this study we used the DSM-IV-TR criteria to assess the presence of dissociative disorders. The DSM-IV-TR was replaced by the DSM-5 in 2013, so the new system was not yet available during data collection. However, since the purpose of this study is to emphasize the presence of dissociative symptoms rather than diagnosis, in patients with narcolepsy, the precise diagnostic classification system is less relevant. Also, given the adult age of the narcolepsy patients included in this study, we have no information about the prevalence of dissociative symptoms in children or adolescents with narcolepsy. Another issue which could be addressed in future prospective studies is the lack of polysomnographic data and detailed information about the dose and timing of medication. While some studies have suggested an association between sleep deprivation or sleep fragmentation and the occurrence of dissociative symptoms, our data did not suffice to either confirm or refute this hypothesis. Future research could employ a prospective design with detailed registration of medication use and new technologies to monitor sleep architecture over longer time periods and correlate this to the presence of dissociative symptoms. Future studies could also consider contrasting narcolepsy type 1 versus type 2 with respect to the presence of dissociative symptoms, to gain more insight in the specific role of hypocretin deficiency. Assessing relation with the severity or frequency of cataplexy would need a longitudinal follow up design which would not be easy, but very interesting.
Construct validity and reproducibility of the Prescription Opioid Misuse And Abuse Questionnaire (POMAQ)
Published in Current Medical Research and Opinion, 2021
Karin S. Coyne, Alexandra I. Barsdorf, Brooke M. Currie, Stephen F. Butler, John T. Farrar, Jean-Yves Mazière, Renee F. Pierson, Harry J. Fisher, Ali A. Bukhari, Sidney H. Schnoll
The Structured Clinical Interview for DSM-IV-TR is a widely accepted diagnostic instrument to reliably determine Axis I disorders in non-patient and patient populations26. Several studies have generated valid and reliable data related to substance use and abuse with this instrument27–31. Patients were assessed for substance dependence and abuse using the Non-Alcohol Substance Use Disorder questions from the SCID-I Substance Abuse/Dependence interview module via a telephone interview by trained mental health experts within 10 days of completing the initial POMAQ survey. The SCID scoring algorithm was used to determine a diagnosis of abuse and dependence for substance use disorders. Concordance between responses to POMAQ items and participants’ SCID-I results to specific behaviors assessed in the SCID-I were assessed to examine the construct validity of the POMAQ. For example, participant report of marijuana use on the POMAQ was compared with the SCID-I assessment of marijuana use. Of note, the SCID-I does not distinguish misuse and abuse behaviors.