In 2013, the American Psychiatric Association will release an updated edition of the Diagnostic and Statistical Manual of Mental Disorders. Known as DSM5 for short, this manual is going to be the fifth edition of a guide that helps health professionals diagnose mental disorders, including depression, by providing consistent criteria for each state.
As with any frequently updated book, some changes are in store for the latest version of the DSM. Based on Jan Fawcett, MD, chair of the APA’s mood disorders work group on the DSM-5 Task Force, several changes that are planned will make subtle distinctions between different types of mental disorders. “We wish to incorporate some new dimensions to the investigations we are making,” Dr. Fawcett says.
Below are some of the changes which could influence depression treatment when DSM-5 is released:
- More curiosity to anxiety in depressed patients. The new DSM may support mental health professionals to consider symptoms of stress in people with depression by adding an “anxiety dimension” to the DSM’s mood disorders class. Quite simply, physicians will likely be able to rate the intensity of the depressed patient’s stress. “We don’t desire to change the standards [for melancholy], but we would like to add a mention of the severity of stress to the diagnosis of major depression,” Fawcett says. “There’s lots of evidence that anxiety symptoms are typical in depression. When they are acute, they could predict an undesirable outcome and suicide risk in response. We’re expecting this can boost the treatment of those anxiety symptoms and bring focus on better methods of treating those symptoms.”
More attention to suicide threat. Fawcett says his task force will also propose that DSM-5 incorporate a fresh suicide risk assessment scale that doctors should use when valuing people for mental disorders, like depression. “This isn’t to indicate that any physician can call exactly what a patient’s going to do,” Fawcett says. “But there are particular risk factors for suicide that we think needs to be evaluated.” Included in these are previous suicide attempts, being identified as having a mental illness that is major, and having high degrees of anxiety.
Having a suicide evaluation scale may help guide mental health professionals on depression treatment to keep patients from harming themselves. “It may help them decide whether to hospitalize a patient or whether to address symptoms like agitation and stress, which are immediate risk factors for suicide in a depressed patient,” Fawcett says.
- More easy diagnosis in grieving folks. The present version of the DSM excludes patients from being identified as having major depression should they have recently experienced the loss of a loved one, but DSM-5 would lose that exclusion. The task force is suggesting this change because studies have shown that grief isn’t any distinct from every other depression-causing stressor when it comes to depression symptoms and depression treatment. “There’s evidence that whether or not a person has lost [someone], the treatment consequences would be exactly the same as people who have major depression — if the grieving person is treated,” Fawcett says.
The DSM 5 will not be published for three more years. In the interim,, the public is invited to review all of the changes that the new manual will include at http://www.dsm5.org. A comment can be sent by anyone through this Web site on some of the revisions that are planned, Fawcett says, explaining that most of the revisions are subject to change before the APA approves the final version in the year 2012. “It’s like Congress,” Fawcett notes. “You never know exactly what the final approved version is going to be.”