The next (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was approved by the Board of Trustees of the American Psychiatric Association on December 1, 2012. The new DSM-5 will be published in May 2013 and will be the first significant update to the manual in nearly two decades. A set of updates, revisions and changes to the reference manual used to diagnose mental disorders will provide healthcare providers with new guidelines regarding their practice.

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The first draft diagnostic criteria for DSM-5 has now been released and includes the following revisions:

1. The recommendation of new categories for learning disorders and a single diagnostic category, “autism spectrum disorders” that will incorporate the current diagnoses of autistic disorders, Asperger syndrome, pervasive developmental disorder, and childhood disintegrative disorder.

2. Eliminating the current categories substance abuse and dependence, replacing them with the new category “addiction and related disorders”, which will include substance use disorders, with each drug identified in its own category.

3. Creating a new category of “behavioral addictions”, in which gambling will be the sole disorder. Internet addiction was also considered for this category, but there was insufficient data to incorporate it, so it will be included in the manual’s appendix instead.

4. New suicide scales for adults and adolescents to help clinicians identify those individuals most at risk, with a purpose of enhancing interventions across a broad range of mental disorders; those scales include research-based criteria such as impulsive behavior and heavy drinking in teenagers.

5. A proposed new diagnostic category, temper dysregulation with dysphoria (TDD), within the Mood Disorders section of the manual. This may help clinicians better differentiate children with these symptoms from those with bipolar disorder or oppositional defiant disorder.

6. Consideration of a new “risk syndromes” category, with information to help clinicians identify earlier stages of some serious mental disorders, such as psychosis and dementia.

7. New recognition of binge eating disorder and improved criteria for anorexia nervosa and bulimia nervosa, as well as recommended changes in the definitions of some eating disorders.

DMS-5 will also include some proposed changes to DSM-IV diagnoses, for conditions such as asperger syndrome, attention deficit hyperactivity disorder (ADHD), bipolar disorder, depression, dissociative identity disorder, gender identity disorder, hypersexual disorder, oppositional defiant disorder, personality disorders, pica, post-traumatic stress disorder, schizophrenia, and somatoform disorder.

Proposed DSM-5 new diagnoses include the following:

• compulsive hoarding;
• depressive personality disorder;
• olfactory reference syndrome;
• skin picking disorder;
• complex post-traumatic stress disorder;
• binge eating;
• negativistic (passive-aggressive) personality disorder;
• sluggish cognitive tempo;
• relational disorder.

Outside sources have also proposed conditions for inclusion in the DMS-5. These include:

• Apathy Syndrome;
• Body Integrity Identity Disorder
• Complicated Grief Disorder
• Developmental Trauma Disorder
• Disorders of Extreme Stress Not Otherwise Specified
• Fetal Alcohol Syndrome
• Internet Addiction Disorder
• Male-to-Eunuch Gender Identity Disorder
• Melancholia
• Parental Alienation Syndrome
• Seasonal Affective Disorder
• Sensory Processing Disorder

Until the new DMS-5 final version is released in May 2013, those who are interested in the manual can follow APA’s website, where information on its development and draft versions are posted on a regular basis. APA is also listing sections of DSM-5 for review and discussion, so check it out if you want to learn more on the new Diagnostic and Statistical Manual of Mental Disorders.

Bulimia nervosa, usually known as bulimia is an eating disorder. People who suffer from it, eat huge amounts of food and then they purge, feeling guilty and trying to get rid of extra calories. Some may exercise intensely, while others may force themselves to vomit. Sometimes, they purge even if they have eaten a small meal.

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In other words, bulimia is a life-threatening easting disorder that has three primary symptoms such as:

• regular intake of huge amounts of food
• losing control over eating
• inappropriate and compensatory behaviors including vomiting, laxative and diuretic abuse, as well as compulsive exercise
• exaggerated concern with body weight and shape

Warnings

Bulimia can become very severe if it’s not treated soon. The main warnings are:

• binge eating, meaning that food in large amounts is eaten very fast
• purging behaviours, such as frequent trips to the bathroom after meals, smells and signs of vomiting, as well as wrappers or packages of diuretics and laxatives
• swelling of the cheeks and jaw area
• rigid exercise regimen-despite weather, fatigue, illness, injury, the deep need to burn off calories as fast as taken in
• discoloration or staining of the teeth
• social withdraw even from close friends and family
• calluses on the back of knuckles and hands from self-indulged vomiting
• creating rituals to make time for eat a lot food and purge sessions
• generally, any other attitudes, behaviours that indicate weight loss, dieting, are sometimes the main concerns

Consequences

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This disorder can harm your body very much. The first thing that happens is a damage of the entire digestive system and purge behaviors that lead to chemical and imbalances in the body. Then, this starts to affect other organs. The main consequences are:

• inflammation and potential rupture of the esophagus from frequent vomiting
• irregular heartbeats caused by electrolyte imbalances that can lead to heart failure and so, to death
• dehydration and loss of potassium
• tooth decay
• staining from stomach acids released during vomiting
• gastric rupture is less common, but not impossible, being caused by binge eating

Bulimia is also characterized by panic, which emerges when people include vomiting or start to take various laxatives and diuretics. Bulimia also means going on extreme diets, which also harms the body very much.

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If you want to know if you’re bulimic, ask yourself a few questions such as:
1. Are you obsessed with your body weight?
2. 2. Is it food so important in your life that actually dominates it?
3. Are you afraid that once you start eating, you won’t be able to stop?
4. Do you eat very much and continually, even when you are sick?
5. Do you take laxatives or induce vomiting after eating to control your weight?
6. Do you feel ashamed or depressed after you eat?

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Bulimia is difficult to overcome because it’s not related only to food, but more to self-image, Fortunately, an effective people and psychotherapy can help you avoid complications.

Depression is a serious condition that causes damage to the brain. About 20 million people in the United States suffer from depression nowadays. This mental disorder can have numerous causes, including genetic and environmental factors. Treating depression is a must, as otherwise it may lead to the development of a series of other conditions.

Symptoms of depression

Depression can cause numerous symptoms. Below are listed some of them:

• Sadness;
• Pessimism;
• Feeling of guilt and hopelessness;
• Change in weight;
• Loss of interest in all type of activities;
• Difficulty sleeping or oversleeping;
• Severe energy loss;
• Difficulty concentrating;
• Poor memory;
• Fatigue;
• Anxiety, agitation, irritability;
• Suicide thoughts;
• Feeling that life is not worth it.

Naturally, symptoms can vary from one patient to another. Some patients can experience more symptoms, while some can only feel some of them. 

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Causes

What causes depression is not known completely today. However, there are some risk factors which can lead to the development of this condition.

• Patients who have been diagnosed with depression appear to have physical changes in their brains.
• Changes in the body’s balance of hormones may also lead to the development of this disease.
• Certain traumatic events, including the death of someone dear, can also lead to depression.
• High stress can cause depression, too.
• Traumatic events during childhood, including abuse, can determine permanent damage to the brain.

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Risk factors

People of all ages can be diagnosed with depression. However, the disease is commonly found in people aged between 20 and 30. Risk factors of depression include:

• Having relatives suffering from depression;
• Having traumatic experiences as a child;
• Not socializing;
• Being lonely;
• Having few friends;
• Leading a stressful life;
• Experiencing stressful events;
• Having a serious illness;
• Abusing alcohol or drugs.

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Diagnosis

Depression is usually diagnosed by health care providers after a physical exam. Doctors may ask questions about mood, thoughts and daily routine. Through various physiological tests, doctors can find out if you are suffering from depression.

They may also recommend the following tests for diagnosis:

1. Physical exam during which your general state of health is checked.
2. Laboratory tests are recommended to test your thyroid.
3. Psychological evaluation checks for signs of depression. Patients will be asked about symptoms and various other aspects linked their general state of health.

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Treatment

Depression need to be treated as soon as possible. To overcome this condition, patients can undergo a series of therapies. Both medication and support are needed. Actually, the most effective treatment for depression is considered to be the combination between medication and psychotherapy. Treatment will vary from one case to another, depending on the needs of each patient. Support can be offered to both patient and his family.

Overcoming depression is a complex process that will most likely take months. It requires time and commitment. Even though the patient starts feeling better, the treatment has to continue until the specialist tells you that you have managed to cure your health problem.

The Diagnostic and Statistical Manual of Mental Disorders (4th Ed; DSM-IV) is an important book used by mental health professionals to diagnose those people with such problems. The book is published by the American Psychiatric Association and describes the symptoms for all mental disorders.

GAD or generalised anxiety is one of the anxiety disorders included in DSM IV. Generalized anxiety disorder is characterized by excessive anxiety and worry about many topics such as school, life, work and many other things. GAD is also known as “chronic anxiety neurosis” and is also characterized by “free-floating anxiety” and autonomic symptoms such as:

• tachycardia

• diaphoresis

• tremor

• nausea

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Onset takes place in adolescence or childhood years, but sometimes, it may also appear in early adult years. The symptoms of generalised anxiety evolve gradually and insidiously.

Clinical features include:

• the patient complains with anxiety

• he is jumpy and startled

• sudden movements or noises may be alarming for him

• the patient is unable to relax and it’s difficult for him to sleep

• he complains a sense of shakiness and a fine tremor of his hands

• indigestion

• cramping

• diarrhea

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• constipation

• a fear that he may faint

• frequent urination

• light-headedness

• exhaustion

• the inability to concentrate

• tension in muscles

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 If symptoms are mild, there will be little interference in a patient’s life, but in severe cases, he can become “paralysed” by anxiety and unable to function in almost any capacity.

Treatment:

• cognitive behaviour therapy

• antidepressants

• buspirone

• hydroxyzine

• propranolol

• benzodiazepines

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It’s difficult to control the anxiety and worry, but some people with the aforementioned symptoms manage to cope with them well enough to have a normal daily life.

DSM IV stands for Diagnostic and Statistical Manual of Mental Disorders and is a manual published by the American Psychiatric Association which includes all recognised health disorders. Its coding system corresponds with codes from the International Codification of Disease, also known as ICD. This important book includes a large variety of mental disorders from retardation to eating disorders, so it’s an important  standard classification of mental disorders used by many health professionals in the United States. This manual is also used by researchers and clinicians that work in psychodynamic, behavioural, interpersonal or biological systems and is also used across clinical settings such as consultation-liaison, clinic, private practice, as well as primary care and  partial hospital. Additionally, it’s also useful for social workers, nurses, counselors, physicians, psychologists, but also for occupational and rehabilitation therapists. The manual is divided into three main parts, including the diagnostic classification, the diagnostic criteria sets, as well as the descriptive text.

Its first part, called the diagnostic classification, includes a long list with the mental disorders that are officially part of the DSM system. Making a diagnosis means that a specialist has to select a certain disorder that reflects the symptoms and signs that are found in an individual. Each diagnostic label is associated with a diagnostic code that is used by institutions for billing and data collection. The second part, the diagnostic criteria sets refers to a set of criteria that indicate which symptoms are present for each disorder, but also what symptoms and disorders must not be present. This way, it’s easier and more reliable to diagnose someone, but these criteria are only guidelines.

The third part of the DSM IV manual is called the descriptive text and is related to each disorder, describing and explaining each mental disease, including various headlines such as Diagnostic Features”; “Subtypes and/or Specifiers”; “Recording Procedures”; “Associated Features and Disorders”; “Specific Culture, Age, and Gender Features”; “Prevalence”; “Course”; “Familial Pattern”; and “Differential Diagnosis.” Diagnostic Features”; “Subtypes and/or Specifiers”; “Recording Procedures”; “Associated Features and Disorders”; “Specific Culture, Age, and Gender Features”; “Prevalence”; “Course”; “Familial Pattern”; and “Differential Diagnosis.”  DSM IV is also useful for those people who have someone in their family who suffers from a mental or personality disorder and they want to find out how to behave when they spend time together. Plus, by reading this interesting book, they will be able to understand what is going on with someone who has such a problem.

Diagnostic and Statistical Manual of Mental Disorders, is a manual published by the American Psychiatric Association that includes all curently recognised mental health disorders. The coding system utilised by the DSM-IV is designed to correspond with codes from the international Classification of Disease, commonly referred to as the ICD. Many people suffer from personality disorder and the causes of this illness are the subject of considerable debate and controversy. Some experts believe that personality disorders are caused by early experiences that prevented the development of normal thought and behaviour patterns. Other researchers believe that biological or genetic influences are the root cause of personality disorders. In order to be diagnosed with a personality disorder, an individual must exhibit symptoms that meet the diagnostic criteria established in the DSM IV.

These patterns of behaviour must be chronic and pervasive, affecting many different of the individual’s life, including social functioning, work, school and close relationships. The individual must exhibit symptoms that affect two or more of the following areas: thoughts, emotions, interpersonal functioning, and impulse control. The pattern of behaviours must be stable across time and have an onset that can be traced back to adolescence or early childhood. These behaviours cannot be explained by any other mental disorders, substance abuse or medical conditions. Personality disorders are described on Axis II of the Diagnostic and Statistical Manual. The DSM-IV lists a total of ten different personality disorders. These disorders are classified into there separate clusters: cluster A -- odd or eccentric disorders, cluster B -- dramatic, emotional or erratic disorders and cluster C -- anxious or fearful disorders.

Before a clinician can diagnose a personality disorder, they must rule out other disorder or medical conditions that may be causing the symptoms. The symptoms that characterise personality disorders are often similar to those of other disorders and illnesses. Personality disorders also commonly co-occur with other illnesses. The following are potential differentials that must be ruled out before diagnosing an individual with a personality disorder: substance abuse, anxiety disorders, depression, dissociative disorders, social phobia, post traumatic stress disorder and schizophrenia.

The DSM has attracted praise for standardising psychiatric diagnostic categories and criteria. It has also attracted controversy and criticism. Some critics argue that the DSM represents an unscientific system that enshrines the opinions of a few powerful psychiatrists. There are ongoing issues concerning the validity and reliability of the diagnostic categories.

DSM IV, or the Diagnostic and Statistical Manual of Mental Disorders, the 4th edition, is an important manual which includes all the recognized mental conditions which have been traced until today. The DSM IV was published by the American Psychiatric Association and represents an important tool for both medicine students and professionals working in this domain. As imagined, one of the most important aspects of DSM IV is represented by the codes associated with all the mental diseases listed on this valuable resource. These DSM IV codes are internationally used, being set to correspond with the International Classification of Diseases. Naturally, DSM IV codes are used by specialists with the purpose to identify mental conditions and diagnose them properly. Diagnosing with DSM IV codes usage is mostly performed with the main purpose to simplify the general procedure.

Mental conditions are classified in DSM IV in metal retardation, learning disorders, motor skills disorders, communication disorders, but also pervasive developmental disorders, attention deficit and disruptive behavior, as well as feeding and eating disorders. For instance, DSM IV codes establish the following for eating disorders: attention-deficit hyperactivity disorder, codes between 314.01 and 314.9, conduct disorder, codes between 312.81 and 312.89 and the codes 313.81 for oppositional defiant disorder and 312.9 for disruptive behavior disorder NOS. When referring to pervasive developmental disorders, DSM IV establishes codes such as 299.00 for autistic disorder, 299.80 for Rett’s disorder, 299.10 for childhood disintegrative disorder, and 299.80 for Asperger’s disorder. Persuasive development disorder is listed with 299.80.

Learning disorders seem to be very common nowadays. They mostly include reading disorders, mathematics disorder and disorder of written expression. They will suppose codes from 315.00 to 315.9. However, the most serious mental conditions listed in DSM IV are retardation issues. DSM IV codes for these disease are: 317 for mild mental retardation, 318.0 for moderate mental retardation, 318.1 for severe mental retardation and 318.2 for profound mental retardation. The codes associated by DSM IV to mental retardation of an unspecified severity is 319. Knowing and understanding these codes is a must for doctors, but patients or their families should also have an idea on what they mean to be able to better understand diagnosis.

DSM IV is an acronym that stands for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. It is a manual published by the American Psychiatric Association that includes all currently recognised mental health disorders. The codes used in DSM IV are designed to correspond with the codes from the International Classification of Diseases, commonly referred to as ICD.

The DSM IV contains codes for every mental disease known to man, from mental retardation, delirium to substance-related disorders, schizophrenia, mood disorder, sleep and eating disorders. The DSM IV covers all mental health disorders for both children and adults. The DSM IV also includes the known causes of these disorders, statistics in terms of gender, age at onset, and prognosis as well as some research concerning the optimal treatment approaches.

The DSM IV has a specific multiaxial or multidimensional approach to diagnosing because rarely do other factors in the life of a person not impact their mental health. Regardless of the intensity of an event, it has serious consequences on the mental health of a person. There are five axes of mental health issues described in DSM IV.  The first axis of the DSM IV deals with clinical syndromes that refer to depression, schizophrenia and social phobia. The second axis refers to developmental disorders and personality disorders such as autism and mental retardation, as well as symptoms of paranoid, antisocial and borderline personality disorders.

The third axis of the DSM IV deals with physical conditions that play a role in the development or exacerbation of the first two axis disorders. The physical conditions that pertain to the Axis III such as brain injury, HIV/Aids can result in symptoms of severe mental illness. Axis IV of DSM IV deals with the high degree of psychosocial stressors. This means that the person suffers from the consequences of some events, such as death of a loved one, starting a new job, unemployment or even marriage. The fifth Axis of the DSM IV helps the specialist to better understand the effects and consequences of the previous four axes. More specifically, the way the four axes are affecting the person and what type of changes could be expected.

DSM IV is an acronym which stands for Diagnostic and Statistical Manual of Mental Disorders and it designates the 1994 version of this very useful manual. Prior to 1994, several other manuals of the type were released, but DSM IV is definitely the most comprehensive one, as it lists 297 disorders in its 886 pages. DSM IV was published by the American Psychiatric Association, with the help of numerous advisers and specialists. Currently, DSM IV is used worldwide, by a wide array of people, including students, researchers, clinicians, policy makers, health insurance companies, pharmaceutical companies, and psychiatric drug regulation agencies.

DSM IV is characterized by a multi-axial system, each of its five axes or dimensions being linked to different aspects of disorder and disability. The first axis covers clinical disorders, which are the major mental disorders, learning disorders, and Substance Use Disorders, such as depression, ADHD, bipolar disorder, anxiety disorders, autism, bulimia, anorexia, and schizophrenia. The second DSM IV axis refers to personality disorders and intellectual disabilities, including paranoid personality disorder, narcissism, schizoid or schizotypal personality disorder, dependent personality disorder, and many others. In the third axis, DSM IV describes acute medical conditions, as well as physical disorders, which can be brain injuries or other disorders that have the power of aggravating other existing diseases. Axis IV of DSM IV covers the psychosocial and environmental factors which contribute to the disorders.

Last, but not least, the fifth DSM IV axis is Global Assessment of Functioning or Children’s Global Assessment Scale for children and adolescents under the age of 18. While there has been some criticism to DSM IV, no one can really deny that it is very helpful. Apart from listing all mental and health disorders for children and adults alike, DSM IV also specifies their causes, statistics, treatment options and prognosis. In 2000, DSM IV TR has been released. This latest version is basically a revision of the previously existing one, DSM IV. No matter what version you wish to purchase, this manual is one of the two main classifying systems of mental disorders, so it is filled with useful, specific and accurate information.