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DSM-5 reviewed from different angles: goal attainment, rationality, use of evidence, consequences—part 1: general aspects and paradigmatic discussion of depressive disorders

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Abstract

DSM-5 was published in 2013 after about 10 years of preparation. Part 1 of this paper discusses several more general aspects of DSM-5 and offers a detailed, paradigmatic analysis of changes made to the chapter on depressive disorders. The background for the changes is analysed on the basis of a PubMed search and review papers on the classification of mental disorders in general and on empirical knowledge about individual disorders. Contrary to the original plans, DSM-5 has not introduced a primarily dimensional diagnostic system but has widely preserved the categorical system of disorders. Also, it has not adopted a more neurobiological approach to disorders by including biological markers to increase the objectivity of psychiatric diagnoses but has maintained the primarily symptom-based, descriptive approach. The criteria for some disorders have been changed, including affective, schizophrenic and addiction disorders, and a few new disorders have been added. A minimal version of the dimensional approach was realised through the introduction of several transnosological specifiers and the option to make symptom- or syndrome-related severity and dimensional assessments. These specifiers and assessments might allow a more individualised description of a patient’s psychopathological state and more personalised treatment. However, most of the symptom- and syndrome-related assessments are not mandatory and therefore may not be used in clinical practice.

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Acknowledgments

The authors thank Jacquie Klesing, Board-certified Editor in the Life Sciences (ELS), for editing assistance with the manuscript.

Conflict of interest

H.H. is supported by the AXA Research Fund (AXA RF) and the Fondation pour la Recherche sur Alzheimer (FRA), Paris, France. All other authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany

    Hans-Jürgen Möller & Michael Soyka

  2. Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany

    Borwin Bandelow

  3. Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

    Michael Bauer & Emanuel Severus

  4. Department of Neurology, The Institute of Memory and Alzheimer’s Disease, Pitié-Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France

    Harald Hampel & Simone Lista

  5. Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany

    Sabine C. Herpertz

  6. Private Hospital Meiringen, Meiringen, Switzerland

    Michael Soyka

  7. Department of Stereotactic and Functional Neurosurgery, Center for Neurosurgery, Albertus Magnus University of Cologne, Cologne, Germany

    Utako B. Barnikol

  8. Department of Child and Adolescent Psychiatry and Psychotherapy, Albertus Magnus University of Cologne, Cologne, Germany

    Utako B. Barnikol

  9. Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

    Wolfgang Maier

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  1. Hans-Jürgen Möller
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Möller, HJ., Bandelow, B., Bauer, M. et al. DSM-5 reviewed from different angles: goal attainment, rationality, use of evidence, consequences—part 1: general aspects and paradigmatic discussion of depressive disorders. Eur Arch Psychiatry Clin Neurosci 265, 5–18 (2015). https://doi.org/10.1007/s00406-014-0520-x

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