The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. DSM contains descriptions, symptoms and other criteria for diagnosing mental disorders. It provides a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in research on mental disorders. It also provides a common language for researchers to study the criteria for potential future revisions and to aid in the development of medications and other interventions.
DSM-5-TR is a text revision of DSM-5 and includes fully revised text and new references, clarifications to diagnostic criteria, and updates to ICD-10-CM codes since DSM-5 was published in 2013. It features a new disorder, prolonged grief disorder, as well as codes for suicidal behavior. It was developed with the help of more than 200 subject matter experts, and text updates are based on current scientific literature. More information about its development is provided in the DSM-5-TR “Introduction” in Section I.
APA recruited more than 200 of the top researchers and clinicians from around the world to be members of our DSM-5-TR review groups. These are experts in neuroscience, biology, genetics, statistics, epidemiology, social and behavioral sciences, nosology, and public health. These members participate on a strictly voluntary basis and encompass several medical and mental health disciplines including psychiatry, psychology, pediatrics, nursing, and social work.
APA’s goal in revising DSM-5 was to thoroughly update the text of the manual to incorporate new research findings that have appeared since DSM-5 was published in 2013. Text changes were proposed by subject matter experts and then reviewed by the DSM-5-TR editors and the DSM Steering Committee. The DSM-5-TR also includes changes to criteria sets generated through the iterative revision process in place that allows mental health professionals to propose evidence-based additions or deletions of diagnostic categories, or changes to existing criteria. In some cases, adjustment to the wording of diagnostic criteria were made because of issues identified during the text revision process. All changes to diagnostic criteria were approved by the DSM Steering Committee and APA Assembly and Board of Trustees.
DSM-5-TR, like DSM-5, is a manual for assessment and diagnosis of mental disorders and does not include information or guidelines for treatment of any disorder. That said, determining an accurate diagnosis is the first step toward being able to appropriately treat any medical condition, and mental disorders are no exception. DSM-5-TR will also be helpful in measuring the effectiveness of treatment, as dimensional assessments will assist clinicians in assessing changes in severity levels as a response to treatment.
Since DSM-5-TR is completely compatible with the HIPAA-approved ICD-10-CM coding system now in use by insurance companies, the revised criteria for mental disorders can be used immediately for diagnosing mental disorders.
DSM-5-TR and the ICD should be thought of as companion publications. DSM-5-TR contains the most up-to-date criteria for diagnosing mental disorders, along with extensive descriptive text, providing a common language for clinicians to communicate about their patients. The ICD contains the code numbers used in DSM-5-TR and all of medicine, needed for insurance reimbursement and for monitoring of morbidity and mortality statistics by national and international health agencies. APA works closely with staff from the WHO, CMS and CDC-NCHS to ensure that the two systems are maximally compatible.
There are no DSM codes. The codes appearing in DSM-5 in addition to the ICD-10-CM codes were ICD-9 codes. These codes are no longer valid since ICD-10-CM codes replaced them in the United States starting October 1, 2015. Clinicians should use ICD-10-CM codes to submit claims.
For more information on DSM–5-TR including fact sheets, videos, highlights of changes, and order information, please visit DSM–5-TR Education Resources.
The most extensively updated sections of the text were Prevalence, Risk and Prognostic Factors, Culture-Related Diagnostic Issues, Sex- and Gender-Related Diagnostic Issues, Association with Suicidal Thoughts or Behavior, and Comorbidity. In addition, the entire DSM text has been reviewed and revised by the Ethnoracial Equity and Inclusion Work Group to ensure appropriate attention to risk factors such as the experience of racism and discrimination, as well as to the use of non-stigmatizing language.
During the DSM-5-TR review process, steps were taken to address the impact of culture, racism, and discrimination on psychiatric diagnosis in the text of the disorder chapters. A Cross-Cutting Review Committee on Cultural Issues, composed of U.S.-based and international experts in cultural psychiatry, psychology and anthropology, reviewed the texts for cultural influences on disorder characteristics, incorporating relevant information in the sections on culture-related diagnostic issues. A separate Ethnoracial Equity and Inclusion Work Group, composed of mental health practitioners from diverse ethnic and racialized backgrounds with expertise in disparity-reduction practices, reviewed references to race, ethnicity, and related concepts to avoid perpetuating stereotypes or including discriminatory clinical information.