What is the DSM-5?

The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), shortened to DSM-5, is the guide used by clinicians to diagnose mental health conditions. It’s published by a professional body called the American Psychiatric Association (APA) and updated as new research emerges. The fifth edition is the most current iteration and was released in 2013.

The handbook contains descriptions, classifications, and criteria (or symptoms) that must be present for a reliable diagnosis of each mental health condition. It is intended for diagnostic use by trained and experienced mental health professionals.

How many diagnoses are there?

The DSM-5 contains criteria and codes for 20 diagnostic categories. Each category contains a number of diagnoses and subtypes, meaning that the actual total number of diagnoses in the DSM depends on how you count them. The diagnostic categories are:

  1. Neurodevelopmental Disorders
  2. Schizophrenia Spectrum and Other Psychotic Disorders
  3. Bipolar and Related Disorders
  4. Depressive Disorders
  5. Anxiety Disorders
  6. Obsessive-Compulsive and Related Disorders
  7. Dissociative Disorders
  8. Somatic Symptom Disorders
  9. Feeding and Eating Disorders
  10. Elimination Disorders
  11. Sleep-Wake Disorders (such as insomnia)
  12. Sexual Dysfunctions
  13. Gender Dysphoria
  14. Disruptive, Impulse-Control, and Conduct Disorders
  15. Substance-Related and Addictive Disorders
  16. Neurocognitive Disorders
  17. Personality Disorders
  18. Paraphilic Disorders
  19. Medication-Induced Movement Disorders and Other Adverse Effects of Medication
  20. Other Conditions That May Be a Focus of Clinical Attention

What is the DSM-5 used for?

The DSM-5 is used for a wide range of treatment, research, and educational purposes.

Therapists use the DSM-5 to:

The DSM is also a learning tool for students of psychology, counseling, and social work, and provides a standardized framework for researchers to classify, gather data, and talk about mental health conditions.

Do all therapists use the DSM-5?

The DSM-5 is widely used in clinical practice in the US and internationally but is not the only manual in use.

A second diagnostic handbook is called the ICD, or The International Classification of Diseases. The ICD is released by the World Health Organization and is soon to be updated to the eleventh version (ICD-11). Unlike the DSM, which describes mental health conditions only, the ICD captures diagnostic criteria for the breadth of medical conditions. The ICD is the official system used to code medical conditions in the US. However, the DSM and ICD are closely aligned, and the APA suggests that clinicians use them as companion guides.

Some clinicians are opposed to using the DSM altogether out of concern for its limitations, which are discussed below.

Do I need a diagnosis to see a therapist?

No, you don’t need to have a formal diagnosis to see a therapist. That said, having a formal diagnosis is likely to affect the kind of financial assistance you will receive from your health insurance. Check your plan details with your insurance provider, as they are allowed to exclude specific diagnoses.

What are the pros and cons of treatment using a diagnostic model?

The DSM-5, given its wide clinical use, is also closely scrutinized and debated. Using a diagnostic model such as the DSM-5 has both pros and cons:

Pros

Cons

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