Current Psychiatry Reports

, Volume 13, Issue 4, pp 248–250

Meta-structure Issues for the DSM-5: How Do Anxiety Disorders, Obsessive-Compulsive and Related Disorders, Post-Traumatic Disorders, and Dissociative Disorders Fit Together?

  • Dan J. Stein
  • Michelle G. Craske
  • Matthew J. Friedman
  • Katharine A. Phillips
Invited Commentary

DOI: 10.1007/s11920-011-0207-1

Cite this article as:
Stein, D.J., Craske, M.G., Friedman, M.J. et al. Curr Psychiatry Rep (2011) 13: 248. doi:10.1007/s11920-011-0207-1


The question of how to optimally organize into chapters and label the different categories of mental disorders is an important one for DSM-5 and ICD-11. The grouping of mental disorders, or meta-structure, should arguably reflect knowledge on the validity of different conditions and their relationships, and should ideally contribute to improving the clinical utility of the nosology by guiding clinical assessment and management. The DSM-5 Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders Workgroup has reviewed the nature of anxiety disorders, the possibility of including a new category of obsessive-compulsive spectrum disorders in the DSM-5, and the concept of traumatic stress disorders. It is difficult to devise a perfect nosology that dissects nature at her joints; instead, any particular approach to the meta-structure would seem to have pros and cons that must be carefully weighed. Despite the imperfections of any meta-structure, we are hopeful that each revision of the nosology will bring with it greater diagnostic validity and clinical utility.


DSM-5 ICD-11 Anxiety disorders Obsessive-compulsive disorder Post-traumatic disorders Dissociative disorders Classification Stereotypic disorders Pathophysiology Etiology Category Nosology 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Dan J. Stein
    • 1
  • Michelle G. Craske
    • 2
  • Matthew J. Friedman
    • 3
  • Katharine A. Phillips
    • 4
  1. 1.University of Cape Town Department of Psychiatry, Groote Schuur Hospital J-2Cape TownSouth Africa
  2. 2.Department of Psychology and Department of Psychiatry and Biobehavioral SciencesUCLALos AngelesUSA
  3. 3.National Center for PTSD, US Department of Veterans Affairs, and Departments of Psychiatry and Pharmacology and ToxicologyDartmouth Medical SchoolHanoverUSA
  4. 4.Rhode Island Hospital and the Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityProvidenceUSA

Personalised recommendations