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 ====== History of the DSM ======
 {{INLINETOC}}
 ===== Primer =====
-The DSM, or the Diagnostic and Statistical Manual of Mental Disorders has a long and storied history in the history of psychiatry. As the cornerstone of psychiatry and guide for millions of clinicians and healthcare providers, it has been the most significant advance in the diagnosis and treatment of mental disorders. However, in the midst of its success, criticisms of its role have also developed.
+<WRAP group>
+<WRAP half column>
+The **DSM (Diagnostic and Statistical Manual of Mental Disorders)** has a long and storied role in the [[teaching:history|history of psychiatry]]. As the cornerstone of Western psychiatry and guide for millions of clinicians and healthcare providers, it has been the most significant advance in the diagnosis and treatment of mental disorders. However, in the midst of its success, important criticisms of its role have also arisen.
+<callout>
+//"[The] DSM[-IV] does none of its jobs perfectly and its awkward fit certainly creates a variety of problems. Some clinicians refuse to learn DSM and stick to their own personal prototypes of disorders. Many epidemiological researchers ignore the requirement for clinical significance before making a psychiatric diagnosis and therefore report ridiculously high rates of mental illness in the general population. Some students take the DSM descriptions too literally and lose the patient as they evaluate the criteria. Lawyers often find loopholes because the language of DSM is frustratingly below legal requirements for precision. And so on.
+\\ \\
+But the unifying and synthesizing whole of DSM-IV is still worth much more than would be the accumulated sum of its individual parts. However imperfect, the DSM's special value is as a common denominator that avoids a Babel and is good enough (if admittedly not best) at each of its jobs."//
+\\
+-- Allen Frances, MD, Chair of the DSM-IV Task Force
+</callout>
+</WRAP>
+<WRAP half column>
+<HTML>
+<div id="amazon">
+<div class="ribbon"><i class="fa fa-star"></i> Recommended Reading</div>
+<a href="https://amzn.to/4aWVlYx" target="_blank"><img style="max-width: 50%" border="0" src="https://www.psychdb.com/amazon_aff/dsm5tr.jpg" ></a>
+<p>
+<span class="bs-wrap bs-wrap-button" data-btn-type="default" data-btn-size="lg" data-btn-icon="fa fa-amazon"><a href="https://amzn.to/4aWVlYx" rel="nofollow" role="button">Buy on Amazon</a></span>
+</p>
+<small>
+PsychDB is an Amazon Associate and earns from qualifying purchases. Thank you for supporting our site!
+</small>
+</div>
+</HTML>
 <callout title="The Cycle of Classification: DSM I through DSM-5" type="info">
-[[https://www.annualreviews.org/doi/10.1146/annurev-clinpsy-032813-153639|Blashfield, R. K., Keeley, J. W., Flanagan, E. H., & Miles, S. R. (2014). The cycle of classification: DSM-I through DSM-5. Annual review of clinical psychology, 10, 25-51.]]
+[[https://www.annualreviews.org/doi/10.1146/annurev-clinpsy-032813-153639|Blashfield, R. K. et al. (2014). The cycle of classification: DSM-I through DSM-5. Annual review of clinical psychology, 10, 25-51.]]
 </callout>
+</WRAP>
+</WRAP>
+<alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See also main article: **[[teaching:history|]]**</alert>
 ===== Pre-DSM Era =====
+The origins of the DSM starts in the 1800s, when first official attempts were made to try to gather information about mental health in the United States. Government officials tried to record the frequency of “idiocy/insanity” in the 1840 census. By the late 1800s, mental health categories included mania, melancholia, monomania, paresis, dementia, dipsomania, and epilepsy.[([[https://www.psychiatry.org/psychiatrists/practice/dsm/history-of-the-dsm|APA DSM History]])]
+In 1921, the American Medico–Psychological Association became what is now known as the American Psychiatric Association (APA), and developed the //American Medical Association’s Standard Classified Nomenclature of Disease//. This early classification system was designed for diagnosing inpatients with severe psychiatric and neurological disorders.
 ===== DSM-I =====
+<alert type="info" icon="fa fa-book fa-lg fa-fw">See also: **[[https://doi.org/10.1002/9781118625392.wbecp012|Horwitz, A. V. (2014). DSM‐I and DSM‐II. The encyclopedia of clinical psychology, 1-6.]]**</alert>
+The **DSM-I** owes it origins to post-war America. After World War II, the World Health Organization (WHO) published the 6th edition of International Classification of Diseases (ICD-6), which had a section on mental disorders for the first time. The ICD–6 was heavily based on the U.S. Veteran's Administration classification and included 10 categories for psychoses and psychoneuroses, and 7 categories for disorders of character, behaviour, and intelligence. Shortly after, the APA developed a variant of the ICD–6 that was published in 1952, the first edition of the DSM (DSM-I). The DSM-I became the first official manual and glossary of mental disorders with a focus on clinical use.
 ===== DSM-II =====
-Even though the DSM II was published in 1968 (!) the following excerpt is sage advice even (and especially) today.
+The **DSM–II**, published in 1968, was similar to DSM-I with its basis in psychoanalytic theory, but eliminated the term "reaction." Even though the DSM II was published in more than half a century ago, the following excerpt is sage advice even (and especially) today.
 <callout title="A Tip From the DSM-II..." type="info" icon="true">
-//The diagnostician, however, should not lose sight of the rule of parsimony and diagnose more conditions than are necessary to account for the clinical picture. The opportunity to make multiple diagnoses does not lessen the physician's responsibility to make a careful differential diagnosis.//
+//"The diagnostician, however, should not lose sight of the rule of parsimony and diagnose more conditions than are necessary to account for the clinical picture. The opportunity to make multiple diagnoses does not lessen the physician's responsibility to make a careful differential diagnosis."//
 </callout>
 ===== DSM-III =====
+<alert type="info" icon="fa fa-book fa-lg fa-fw">See also: **[[https://doi.org/10.1176/appi.ajp.2009.09081155|Kendler, K. S. et al. (2010). The development of the Feighner criteria: a historical perspective. American Journal of Psychiatry, 167(2), 134-142.]]**</alert>
+The **DSM–III**, published in 1980, initiated the start of "modern psychiatric diagnosis." Unlike the DSM-II, it took an agnostic approach to the etiology (causes) of mental disorders and instead focused on explicit diagnostic criteria. Attempts were made to construct and validate diagnostic criteria so that diagnoses could be reliably made between different clinicians. The DSM-III was heavily based on several influential papers, first by the //Feighner Criteria//, published in 1972 by Dr. John Feighner, which described diagnostic criteria for depression, schizophrenia, anxiety neurosis and antisocial personality disorder.[([[https://pubmed.ncbi.nlm.nih.gov/5009428/|Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of general psychiatry, 26(1), 57-63.]])] These criteria in turn greatly influenced the development of the Research Diagnostic Criteria (RDC), developed by psychiatrist Dr. Robert Spitzer.[([[https://pubmed.ncbi.nlm.nih.gov/655775/|Spitzer, R. L., Endicott, J., & Robins, E. (1978). Research diagnostic criteria: rationale and reliability. Archives of general psychiatry, 35(6), 773-782.]])] Many of the diagnostic criteria familiar in the DSM-5 has its origins in these two influential papers.
+The DSM-III can arguably be said to be the document responsible for ushering in the biological psychiatry era by standardizing diagnostic reliability. The ability to reliably diagnose the same disorders between clinicians made randomized control trials for medications and biological treatments much easier (for better or for worse).
 ===== DSM-IV =====
+The **DSM–IV**, published in 1994, continued to build on the etiology-agnostic framework of the DSM-III. The APA working groups attempted to create a firm empirical basis for making modifications to existing criteria. At the same time, the authors of the DSM–IV also attempted to harmonize the diagnostic criteria with the 10th edition of the ICD (ICD-10).
 ===== DSM-5 =====
+<alert type="info" icon="fa fa-book fa-lg fa-fw">See also: **[[http://www.psychiatrictimes.com/dsm-5/requiem-dsm|Ghaemi, S. N. (2013). Requiem for DSM. Psychiatric Times, 30(7), 16-16.]]** and **[[http://www.psychiatrictimes.com/cultural-psychiatry/why-dsm-iii-iv-and-5-are-unscientific|Ghaemi, S. N. (2013). Why DSM-III, IV, and 5 are unscientific. Psychiatric Times.]]**</alert>
-==== Interrater Reliability ====
+Work on the **DSM-5** began in 2000, with its publication finally occurring in 2013. One of the initial goals of the DSM-5 was to finally include biomarkers in its diagnostic criteria. However, this did not become a reality. The DSM-5 was in general criticized for expanding diagnostic criteria and labels.
+==== Field Trials and Interrater Reliability ====
 <WRAP group>
 <WRAP half column>
-<imgcaption image1|>{{ :teaching:advanced:dsm-5-field-trials-kappa-adults.png?nolink&600 |Interrater Reliability of Diagnoses From the Initial DSM-5 Field Trials (Adult Diagnoses)}}
+The DSM-5 field trials showed the inherent limitations of the DSM's etiologically agnostic approach to diagnosing mental disorders. Some disorders had good interrater reliability (e.g. - [[cl:2-major-neurocog-disorder|major neurocognitive disorder]] and [[trauma-and-stressors:ptsd|posttraumatic stress disorder]]), while others were very poor. The most prominent example is for [[mood:1-depression:home|major depressive disorder]], which has a very poor kappa = 0.28 (questionable agreement). One common reason is because the criteria covers a wide range of illness severity, and is a heterogenous condition.[([[https://pubmed.ncbi.nlm.nih.gov/23288382/|Freedman, R., Lewis, D. A., Michels, R., Pine, D. S., Schultz, S. K., Tamminga, C. A., ... & Shrout, P. E. (2013). The initial field trials of DSM-5: new blooms and old thorns.]])]
-</imgcaption></WRAP>
-<WRAP half column>
-<imgcaption image2|>{{ :teaching:advanced:dsm-5-field-trials-kappa-child-adol.png?nolink&600 |Interrater Reliability of Diagnoses From the Initial DSM-5 Field Trials (Child Diagnoses)}}
-</imgcaption></WRAP>
-</WRAP>
-  * [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900052/|McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia medica: Biochemia medica, 22(3), 276-282.]]
+<callout title="What is the Kappa Statistic?" icon="true" type="question">
+Many medical diagnostics (e.g. - physical exams, imaging, and other diagnostic tests) often depend on some subjective interpretation by the observers. This is especially true in psychiatry where there are no objective diagnostics, and the //clinician// is the the diagnostic tool. Thus, the kappa statistic (or kappa coefficient) is the most commonly used statistic to measure the agreement between two or more observers. A kappa of 1 indicates perfect agreement between observers, whereas a kappa of 0 indicates agreement equivalent to chance. As an example, if an illness appears in 10% of a clinic's patients and two clinicians agree on its diagnosis 85% of the time, the kappa statistic is 0.46 (this is similar to the weighted composite statistic for schizophrenia in this DSM-5 Field Trial).[([[https://pubmed.ncbi.nlm.nih.gov/23288382/|Freedman, R., Lewis, D. A., Michels, R., Pine, D. S., Schultz, S. K., Tamminga, C. A., ... & Shrout, P. E. (2013). The initial field trials of DSM-5: new blooms and old thorns.]])][([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900052/|McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia medica: Biochemia medica, 22(3), 276-282.]])]
+</callout>
+<alert type="info" icon="fa fa-book fa-lg fa-fw">See also:
+  * **[[https://www.ncbi.nlm.nih.gov/pubmed/23288382|Freedman, R. et al. (2013). The initial field trials of DSM-5: new blooms and old thorns.]]**
+  * **[[https://www.ncbi.nlm.nih.gov/pubmed/25116891|Vanheule, S. et al. (2014). Reliability in psychiatric diagnosis with the DSM: old wine in new barrels. Psychotherapy and psychosomatics, 83(5), 313.]]**
+  * **[[https://dxrevisionwatch.com/2012/05/09/more-kappa-data-from-dsm-5-field-trials/|Dx Revision Watch: More Kappa data from DSM-5 field trials]]**
+  * **[[https://www.psychiatrymargins.com/p/traditional-dsm-disorders-dissolve|Psychiatry at the Margins: DSM Disorders Disappear in Statistical Clustering of Psychiatric Symptoms]]**
+</alert>
+</WRAP>
+<WRAP half column>
+<imgcaption image1|>{{ :teaching:advanced:dsm-5-field-trials-kappa-adults.png?direct&600 |Interrater Reliability of Diagnoses From the Initial DSM-5 Field Trials (Adult Diagnoses)}}
+</imgcaption>
+<imgcaption image2|>{{ :teaching:advanced:dsm-5-field-trials-kappa-child-adol.png?direct&600 |Interrater Reliability of Diagnoses From the Initial DSM-5 Field Trials (Child Diagnoses)}}
+</imgcaption>
+</WRAP>
+</WRAP>
+==== Research ====
+<alert type="info" icon="fa fa-book fa-lg fa-fw">
+See also: **[[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369644/|Fried, E. I. (2015). Problematic assumptions have slowed down depression research: why symptoms, not syndromes are the way forward. Frontiers in psychology, 6, 309.]]**
+</alert>
 ==== Quotes ====
 <WRAP group>
 <WRAP half column>
 <callout title="The DSM-5 on Boundaries Between Disorders" type="info" icon="true">
-Although some mental disorders may have well-defined boundaries around symptom clusters, scientific evidence now places many, if not most, disorders on a spectrum with closely related disorders that have shared symptoms, shared genetic and environmental risk factors, and possibly shared neural substrates (perhaps most strongly established for a subset of anxiety disorders by neuroimaging and animal models). **In short, we have come to recognize that the boundaries between disorders are more porous than originally perceived.** \\ \\ //-- (DSM-5, Introduction, page 5)//
+"//Although some mental disorders may have well-defined boundaries around symptom clusters, scientific evidence now places many, if not most, disorders on a spectrum with closely related disorders that have shared symptoms, shared genetic and environmental risk factors, and possibly shared neural substrates (perhaps most strongly established for a subset of anxiety disorders by neuroimaging and animal models). **In short, we have come to recognize that the boundaries between disorders are more porous than originally perceived.**//"
+\\ \\
+-- (DSM-5, Introduction, page 5)
 </callout>
@@ Line 49: / Line 110: @@
 <WRAP half column>
 <callout title="The DSM-5 on Checklist Diagnoses" type="info" icon="true">
-The case formulation for any given patient must involve a careful clinical history and concise summary of the [[teaching:biopsychosocial-case-formulation|social, psychological, and biological factors]] that may have contributed to developing a given mental disorder. **Hence, it is not sufficient to simply check off the symptoms in the diagnostic criteria to make a mental disorder diagnosis**. \\ \\ //-- (DSM-5, Use of the Manual, page 19)//
+"//The case formulation for any given patient must involve a careful clinical history and concise summary of the [[teaching:biopsychosocial-case-formulation|social, psychological, and biological factors]] that may have contributed to developing a given mental disorder. **Hence, it is not sufficient to simply check off the symptoms in the diagnostic criteria to make a mental disorder diagnosis**//."
+\\ \\
+-- (DSM-5, Use of the Manual, page 19)
 </callout>
 <callout type="info" icon="true">
-"A single diagnostic interview, regardless of how reliable, does not capture the essence of what is happening....Accurate diagnosis must be part of the ongoing clinical dialogue with the patient."
+"//A single diagnostic interview, regardless of how reliable, does not capture the essence of what is happening ... Accurate diagnosis must be part of the ongoing clinical dialogue with the patient.//"
 \\ \\
--- [[https://www.ncbi.nlm.nih.gov/pubmed/23288382|Freedman, R., Lewis, D. A., Michels, R., Pine, D. S., Schultz, S. K., Tamminga, C. A., ... & Shrout, P. E. (2013). The initial field trials of DSM-5: new blooms and old thorns.]]
+-- Freedman, Robert, et al. "The initial field trials of DSM-5: new blooms and old thorns." (2013): 1-5.[([[https://www.ncbi.nlm.nih.gov/pubmed/23288382|Freedman, R., Lewis, D. A., Michels, R., Pine, D. S., Schultz, S. K., Tamminga, C. A., ... & Shrout, P. E. (2013). The initial field trials of DSM-5: new blooms and old thorns.]])]
 </callout>
 </WRAP>
 </WRAP>
-==== Readings ====
-  * [[https://www.ncbi.nlm.nih.gov/pubmed/23288382|Freedman, R., Lewis, D. A., Michels, R., Pine, D. S., Schultz, S. K., Tamminga, C. A., ... & Shrout, P. E. (2013). The initial field trials of DSM-5: new blooms and old thorns.]]
-  * [[https://www.ncbi.nlm.nih.gov/pubmed/25116891|Vanheule, S., Desmet, M., Meganck, R., Inslegers, R., Willemsen, J., De Schryver, M., & Devisch, I. (2014). Reliability in psychiatric diagnosis with the DSM: old wine in new barrels. Psychotherapy and psychosomatics, 83(5), 313.]]
-  * [[https://www.psychotherapy.net/interview/allen-frances-interview#section-where-dsm-5-went-wrong|Psychotherapy.net: Allen Frances on the DSM-5, Mental Illness and Humane Treatment]]
-  * [[https://dxrevisionwatch.com/2012/05/09/more-kappa-data-from-dsm-5-field-trials/|dx revision watch: More Kappa data from DSM-5 field trials]]
-  * [[https://www.psychiatrictimes.com/couch-crisis/conversations-critical-psychiatry-allen-frances-md/page/0/1|PsychiatricTimes: Conversations in Critical Psychiatry: Allen Frances, MD]]
-===== ICD-10 and ICD-11 =====
+===== Beyond the DSM =====
-In non-North American circles (i.e. - outside of Canada and the United States), countries use the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, also known as the ICD-10.
+<alert type="info" icon="fa fa-book fa-lg fa-fw">
+See also:
+  * **[[https://pubmed.ncbi.nlm.nih.gov/33047992/|Aftab, A., & Ryznar, E. (2020). Conceptual and historical evolution of psychiatric nosology. International Review of Psychiatry, 1-14.]]**
+  * **[[https://ghaemi.substack.com/p/why-dsm-is-mostly-false|Ghaemi, Nassir: Why DSM is mostly false]]**
+</alert>
-The diagnostic criteria for the ICD-10 varies from the DSM-5 for a variety of mental disorders. See [[http://apt.rcpsych.org/content/20/4/280|Tyrer, P. (2014). A comparison of DSM and ICD classifications of mental disorder. Advances in psychiatric treatment, 20(4), 280-285.]]
+<callout>
-===== Future =====
+//"If we re‐run the tape of history over and over again, the DSM and ICD would not likely have the same categories on every iteration."// -- Kenneth S. Kendler[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780286/|Kendler, K. S. (2016). The nature of psychiatric disorders. World Psychiatry, 15(1), 5-12.]])]
-==== Future of Psychiatry ====
+</callout>
-  * [[https://www.ncbi.nlm.nih.gov/pubmed/28946952|Bhugra, D., Tasman, A., Pathare, S., Priebe, S., Smith, S., Torous, J., ... & First, M. B. (2017). The WPA-Lancet Psychiatry Commission on the Future of psychiatry. The Lancet Psychiatry, 4(10), 775-818.]]
+==== ICD-10 and ICD-11 ====
-  * [[https://pubmed.ncbi.nlm.nih.gov/32372044/|Marshall, M. (2020). The hidden links between mental disorders. Nature, 581(7806), 19.]]
+<alert type="info" icon="fa fa-book fa-lg fa-fw">
-  * [[https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2764602|Caspi, A., Houts, R. M., Ambler, A., Danese, A., Elliott, M. L., Hariri, A., ... & Rasmussen, L. J. H. (2020). Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study. JAMA Network Open, 3(4), e203221-e203221.]]
+See also:
-  * [[https://www.amazon.ca/Diagnostic-System-Classification-Psychiatric-Disorders/dp/0231178069|The Diagnostic System: Why the Classification of Psychiatric Disorders Is Necessary, Difficult, and Never Settled]]
+  * **[[http://apt.rcpsych.org/content/20/4/280|Tyrer, P. (2014). A comparison of DSM and ICD classifications of mental disorder. Advances in psychiatric treatment, 20(4), 280-285.]]**
-  * [[http://www.psychiatrictimes.com/dsm-5/requiem-dsm|Ghaemi, S. N. (2013). Requiem for DSM. Psychiatric Times, 30(7), 16-16.]]
+  * **[[https://pubmed.ncbi.nlm.nih.gov/33432742/|First, M. B. et al. (2021). An organization‐and category‐level comparison of diagnostic requirements for mental disorders in ICD‐11 and DSM‐5. World Psychiatry, 20(1), 34-51.]]**
-  * [[http://www.psychiatrictimes.com/cultural-psychiatry/why-dsm-iii-iv-and-5-are-unscientific|Ghaemi, S. N. (2013). Why DSM-III, IV, and 5 are unscientific. Psychiatric Times.]]
+</alert>
-  * [[http://www.nybooks.com/articles/2011/07/14/illusions-of-psychiatry/|The Illusions of Psychiatry]]
-  * [[https://www.amazon.ca/Unhinged-Trouble-Psychiatry-Revelations-Profession/dp/141659079X|Unhinged: The Trouble with Psychiatry - A Doctor's Revelations about a Profession in Crisis]]
-==== Beyond the Kraepelinian dichotomy ====
-  * [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815936/|Craddock, N., & Owen, M. J. (2010). The Kraepelinian dichotomy–going, going... but still not gone. The British Journal of Psychiatry, 196(2), 92-95.]]
-  * [[http://bjp.rcpsych.org/content/186/5/364|Craddock, N., & Owen, M. J. (2005). The beginning of the end for the Kraepelinian dichotomy.]]
-  * [[http://www.psychiatrictimes.com/blogs/couch-crisis/psychiatry-new-brain-mind-and-legend-chemical-imbalance|Pies, R. (2011). Psychiatry’s new brain-mind and the legend of the “chemical imbalance.”. Psychiatric Times, 11, 1.]]
-===== Research Domain Criteria (RDoC) =====
-[[https://www.nimh.nih.gov/about/strategic-planning-reports/highlights/highlight-what-is-rdoc.shtml|RDoC]] is a research framework proposed by the National Institute for Mental Health (NIMH) for new ways of studying mental disorders. It integrates many levels of information (from genomics to self-report) to better understand basic dimensions of functioning underlying the full range of human behaviour from normal to abnormal.
+<WRAP group>
+<WRAP half column>
+The **International Statistical Classification of Diseases and Related Health Problems**, also known as the ICD-10 is published by the World Health Organization, and commonly used outside of North America. The diagnostic criteria for the ICD-10 varies from the DSM-5 for a variety of mental disorders. The eleventh edition (ICD-11) is due to officially come into effect in January 2022.
+</WRAP>
+<WRAP half column>
+<HTML>
+<div id="amazon">
+<div class="ribbon"><i class="fa fa-star"></i> Recommended Reading</div>
+<a href="https://amzn.to/3O85wQ2" target="_blank"><img style="max-width: 50%" border="0" src="https://www.psychdb.com/amazon_aff/icd10.jpg" ></a>
+<p>
+<span class="bs-wrap bs-wrap-button" data-btn-type="default" data-btn-size="lg" data-btn-icon="fa fa-amazon"><a href="https://amzn.to/3O85wQ2" rel="nofollow" role="button">Buy on Amazon</a></span>
+</p>
+<small>
+PsychDB is an Amazon Associate and earns from qualifying purchases. Thank you for supporting our site!
+</small>
+</div>
+</HTML>
+</WRAP>
+</WRAP>
+==== Psychodynamic Diagnostic Manual (PDM) ====
+<alert type="info" icon="fa fa-book fa-lg fa-fw">See also: **[[https://www.psychiatrictimes.com/view/psychodynamic-diagnostic-manual-clinically-useful-complement-dsm|McWilliams, N. (2008). The Psychodynamic Diagnostic Manual: A clinically useful complement to DSM. Psychiatric Times, 25(6), 1-8.]]**</alert>
+<WRAP group>
+<WRAP half column>
+The **Psychodynamic Diagnostic Manual (PDM)** is a diagnostic handbook that approaches mental disorders through a psychodynamic and humanistic lens. The 2nd version (PDM-2) was published in 2017.
+</WRAP>
+<WRAP half column>
+<HTML>
+<div id="amazon">
+<div class="ribbon"><i class="fa fa-star"></i> Recommended Reading</div>
+<a href="https://amzn.to/3Spewmj" target="_blank"><img style="max-width: 50%" border="0" src="https://www.psychdb.com/amazon_aff/pdm2.jpg" ></a>
+<p>
+<span class="bs-wrap bs-wrap-button" data-btn-type="default" data-btn-size="lg" data-btn-icon="fa fa-amazon"><a href="https://amzn.to/3Spewmj" rel="nofollow" role="button">Buy on Amazon</a></span>
+</p>
+<small>
+PsychDB is an Amazon Associate and earns from qualifying purchases. Thank you for supporting our site!
+</small>
+</div>
+</HTML>
+</WRAP>
+</WRAP>
-<callout>
-‘Mental illness’ is terribly misleading because the ‘mental disorders’ we diagnose are no more than descriptions of what clinicians observe people do or say, not at all well established diseases.
-// — Allen Frances, DSM-IV Task Force Chairman, 2015 //
-</callout>
-<callout>
+==== Research Domain Criteria (RDoC) ====
-While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
+The **Research Domain Criteria (RDoC)**[([[https://www.nimh.nih.gov/about/strategic-planning-reports/highlights/highlight-what-is-rdoc.shtml|RDoC]])] is a research framework proposed by the National Institute for Mental Health (NIMH) for new ways of studying and understanding mental disorders. It integrates many levels of information (from genomics to self-report) to better understand basic dimensions of functioning underlying the full range of human behaviour from normal to abnormal.
-// — Thomas Insel, National Institute of Mental Health Director, 2013//
+<callout>
+"//While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
+//"
+\\ \\
+-- Thomas Insel, National Institute of Mental Health Director, 2013
 </callout>
+==== Hierarchical Taxonomy of Psychopathology (HiTOP) ====
+<alert type="info" icon="fa fa-book fa-lg fa-fw">
+See also: **[[https://psyarxiv.com/9rx6f/|Conway, C., & Krueger, R. (2020). Rethinking mental disorder diagnosis: Data-driven psychological dimensions, not categories, as a framework for mental health research, treatment, and training.]]**
+</alert>
+**Hierarchical Taxonomy of Psychopathology (HiTOP)** is an alternative diagnostic system in development that deconstructs traditional diagnostic categories and recasts them in terms of a profile of dimensions. It remains underdevelopment at this time.
+==== Transdiagnostic Approaches ====
+<alert type="info" icon="fa fa-book fa-lg fa-fw">
+See also: **[[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027356/|Dalgleish, T., Black, M., Johnston, D., & Bevan, A. (2020). Transdiagnostic approaches to mental health problems: Current status and future directions. Journal of consulting and clinical psychology, 88(3), 179.]]**
+</alert>
 ===== Resources =====
-  * [[https://peh-med.biomedcentral.com/track/pdf/10.1186/1747-5341-7-2?site=peh-med.biomedcentral.com|A brief historicity of the Diagnostic and Statistical
+== Future of Psychiatry ==
-Manual of Mental Disorders: Issues and implications for the future of psychiatric canon and practice]] (Kawa and Giordano Philosophy, Ethics, and Humanities in Medicine 2012)
+  * [[https://www.ncbi.nlm.nih.gov/pubmed/28946952|Bhugra, D., Tasman, A., Pathare, S., Priebe, S., Smith, S., Torous, J., ... & First, M. B. (2017). The WPA-Lancet Psychiatry Commission on the Future of psychiatry. The Lancet Psychiatry, 4(10), 775-818.]]
-  * [[https://psychcentral.com/blog/archives/2011/07/02/how-the-dsm-developed-what-you-might-not-know/|How the DSM Developed: What You Might Not Know]]
+  * [[https://pubmed.ncbi.nlm.nih.gov/32372044/|Marshall, M. (2020). The hidden links between mental disorders. Nature, 581(7806), 19.]]
-  * [[http://apsychoserver.psych.arizona.edu/JJBAReprints/PSYC621/Blashfield_etal_2014_ARCP.pdf|The Cycle of Classification:DSM-I Through DSM-5]]
+  * [[https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2764602|Caspi, A., Houts, R. M., Ambler, A., Danese, A., Elliott, M. L., Hariri, A., ... & Rasmussen, L. J. H. (2020). Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study. JAMA Network Open, 3(4), e203221-e203221.]]
-  * https://blog.oup.com/2013/05/dsm-5-will-be-the-last/
+  * [[https://www.amazon.ca/Diagnostic-System-Classification-Psychiatric-Disorders/dp/0231178069|The Diagnostic System: Why the Classification of Psychiatric Disorders Is Necessary, Difficult, and Never Settled]]
+  * [[http://www.nybooks.com/articles/2011/07/14/illusions-of-psychiatry/|The Illusions of Psychiatry]]
+== Beyond the Kraepelinian Dichotomy ==
+  * [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815936/|Craddock, N., & Owen, M. J. (2010). The Kraepelinian dichotomy–going, going... but still not gone. The British Journal of Psychiatry, 196(2), 92-95.]]
+  * [[http://bjp.rcpsych.org/content/186/5/364|Craddock, N., & Owen, M. J. (2005). The beginning of the end for the Kraepelinian dichotomy.]]
+== Articles ==
   * [[http://www.spusa.org/pubs/health_med/mental_health/mh_point_counterpoint.html|Mental Health Point/ Counterpoint]]
   * [[http://www.psyweb.com/lifestyle/dsm/is-the-dsm-5-still-acceptable|Is the DSM-5 Still Acceptable?]]
+  * [[https://psychcentral.com/blog/archives/2011/07/02/how-the-dsm-developed-what-you-might-not-know/|How the DSM Developed: What You Might Not Know]]
+  * [[https://blog.oup.com/2013/05/dsm-5-will-be-the-last/|DSM-5 will be the last - Edward Shorter]]
-{{tag>ax-dx}}
+== Research ==
+  * [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403926/|Phillips, J., Frances, A., Cerullo, M. A., Chardavoyne, J., Decker, H. S., First, M. B., ... & LoBello, S. G. (2012). The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis. Philosophy, Ethics, and Humanities in Medicine, 7(1), 1-16.]]
+  * [[https://peh-med.biomedcentral.com/track/pdf/10.1186/1747-5341-7-2?site=peh-med.biomedcentral.com|A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: Issues and implications for the future of psychiatric canon and practice (Kawa and Giordano Philosophy, Ethics, and Humanities in Medicine 2012)]]
+{{tag>history}}