Publication of the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for publication in May 2013. This is an important document, you might even call it hugely important, for a number of reasons. The manual’s effects are such that its revisions can have a rippling impact for decades to come and this extends far beyond the psychiatric community of professionals that oversees its publication.
The DSM-5 is a listing of ALL psychiatric disorders in the USA and effects treatment regimens, how doctors approach diagnoses, how insurance coverage is defined, how health care is delivered, how labels are meted out for those who suffer with a covered diagnosis, and for every constituency in the medical field and many educational fields. Organizations and industries that use the DSM as a basis for their operating guidelines include the Food and Drug Administration (FDA), National Institutes of Health (NIH), insurance companies, medical companies, pharmaceutical companies, doctors, pyschiatrists, psychologists, learning pathologists, researchers, developmental specialists, clinical administrators, lawyers, judges and any group that interacts with special education and psychiatric disorders in any fashion.
Some of the headlines that are coming out of the proposed changes in this iteration of the DSM are:
• Asperger’s Syndrome is out – everyone’s going to have an “autistic spectrum disorder” identification instead
• Personality Disorders are out – kind of. In their place, there’s five Personality Disorder types, each of which you can have to varying degrees, and also six Personality Traits, each of which you can have to varying degrees
• Hyperactive Sexual Desire Disorder is out, and is to be replaced with a definition of Sexual Interest and Arousal Disorder
• Binge Eating Disorder, Hypersexuality Disorder, and Gambling Addiction are in
There are more detailed and difficult to interpret things in the DSM that have to do with diagnostic approaches, classifications, assessment standards and structural frameworks for a range of clinical definitions; and many other things that go beyond our simple observations listed here.
There are a few “DSM revision petition” sites out there and the one we are watching is at the SPD Foundation which is working to have sensory processing and sensory integration topics formally included in the DSM for the first time.
Inclusion in the DSM means a lot of things. It would serve as validation of decades of work by skilled sensory development specialists (like Frank Belgau) and open the way for Sensory Processing Disorder (SPD) to become formally recognized as a DSM-qualified disorder treatment. This would impact regulation and open the doors for countless people to have their sensory challenges treated with a level of scrutiny and resources that has not existed previously. It means pediatricians and others will have standardized criteria for making a correct diagnosis of Sensory Processing Disorder. It means treatment opportunities, funding and research priorities will be identified and propelled forward. It also means that children with Sensory Processing Disorder will be more likely to receive school accommodations and public services. In this context, “hugely important” is probably a very fair characterization.