The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication of the American Psychiatric Association (APA). The DSM which contains sets of diagnostic criteria (symptoms being experienced) grouped into categories (disorders) to assist clinicians with effective diagnoses and care of people with mental health disorders. There are several diagnostic criteria manuals used worldwide, but the DSM is the one used most commonly in Australia.
Who uses it?
Following an assessment doctors (GPs and psychiatrists) are usually the people who will use the criteria from the DSM to match against an individual’s symptoms. This matching process will help them to decide whether the individual meets the diagnosis for a mental health disorder.
This diagnostic information can then be passed on to clinicians who will be treating the individual, such as a psychologist or dietitian. In some ways the DSM criteria are a form of shorthand between people like clinicians, and between clinicians funding providers, to briefly summarise what problems a person is experiencing. This information is then used to assist the treating clinicians in selecting the treatments with the best evidence for good outcomes that are associated with the disorder symptoms.
Why is there a revised edition?
Periodically the APA update the information in the DSM based on feedback from working people within mental health treatment, and following extensive working committee discussions with specialists who diagnose/treat the various disorders. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released in May 2013.
How does this affect people diagnosed with eating disorders?
The DSM-5 includes changes from the previous DSM, which aim to better represent the behaviours and symptoms of people dealing with eating disorders. In order to do this there are updated clinical classification categories for eating disorders, and changes to diagnostic criteria (symptom lists).
One of the most notable changes is that Binge Eating Disorder (BED) has been acknowledged as a separate diagnosis for the first time. This will help increase awareness of the differences between Binge Eating Disorder and the more common issue of overeating.
Additionally, the category that was known as Eating Disorder Not Otherwise Specified (EDNOS), has been removed. There are two new categories; Other Specified Feeding or Eating Disorder (OSFED) and Unspecified Feeding or Eating Disorder (UFED). These new categories are intended to more appropriately recognise and categorise conditions that do not more accurately fit into Anorexia Nervosa, Bulimia Nervosa, BED, or the other eating and feeding disorders. It is important to note that these new categories are not an indication of a less severe eating disorder, simply a different constellation of symptoms.
Another significant change is the inclusion of some types of ‘Feeding Disorders’ that were previously listed in other chapters of the DSM, and now listed together with eating disorders.