Author: Abimbola Farinde, PhD., PharmD
The Diagnostic and Statistical Manual of Mental Disorder (DSM) is largely synonymous with the practice of psychiatry and has been utilized by many mental health professionals as a guide when it comes to mental diagnosis of mental conditions (Regier et al., 2013). The DSM was first introduced in the 1800s in an attempt to gather information about mental health in the United States. Over the course of time it has undergone a number of iterations and revisions with the most recent version being the DSM-V.
The updates on the American Psychiatric Association DSM-5 started in 2000 and were able to be finally published in 2013 (American Psychiatric Association., 2013). The current DSM is used as a guidance to identify signs and symptoms of mental conditions that may warrant a diagnosis. The current DSM-5 contains biomarkers in its diagnostic criteria and has allowed for greater expansion and labels to be included. It covers a wide range of diagnoses that can include depressive disorders, eating and feeding disorders, personality disorder, and trauma and stressor related disorders (Bailey, 2022). The advent of the current DSM has brought greater awareness of the importance of the proper identification and diagnosis of mental health disorders.
For any provider that is engaged in the process of making the diagnosis of a mental condition it is important that there is accuracy with this process because this can mean the difference a correct and incorrect diagnosis. The DSM can be viewed as a standardized guide or references that many professionals use when it comes to mental disorders and the ability to properly utilize this tool when communicating with others can determine the type of therapeutic interventions that a patient does receive (Möller, 2018).
The symptoms and duration of a mental disorder are key findings that need to be taken into consideration when making a diagnosis so this should be communicated as clearly as possible in an understandable manner. If the DSM is not used correctly a person may be given an incorrect diagnosis which can delay the time to the management and control of the symptoms. In addition, the DSM has specific criteria in place when it comes to making a diagnosis and healthcare professionals should seek to remain consistent when it comes to the process that they have in place within the community health care organization (Gulati et al., 2019). An inaccurate diagnosis can prove to be detrimental to the care of an individual so it is important that the DSM is used properly every single time it is considered for diagnosis (Wakefield, 2016).
It is well known that there can be the potential for trial and error when it comes to the diagnosis of mental disorders. Psychiatry is not an absolute field and there is still so much that is unknown. The ramifications that can be associated with using the terminology inaccurately is the potential for misdiagnosis and inaccurate therapeutic approaches that are applied to patients (Nasrallah,2015). Many people go several years before they are given a formal diagnosis and when they are given a diagnosis it is important that it is as accurate as possible.
The delay in receiving proper care can be a significant ramification from using the terminology inaccurately so there should be checks and balances in place to prevent this occurrence. Another potential ramification is the miscommunication that can occur among healthcare professionals that may have different definitions of a particular terminology and as a result can negatively impact the care that is provided to a patient. There should be clear communication and understanding of the terminology across the board when it comes to the use of the DSM.
As healthcare services and its delivery continue to evolve with the changing time, a significant change that can be observed is the adoption of the multidisciplinary team approach when it comes to the management of patients (Clark, 2021). Within a multidisciplinary team a number of healthcare professionals are able to come together and discuss the best method to provide care to patients. This allows for different perspectives to be heard but also allow for confusion to be removed through the process of having detailed discussions about a patient care.
When it comes to the use of the DSM and formulating a diagnosis a group of healthcare professionals are able to come together to discuss the reasons for or against a particular diagnosis which can bring clarity to the issue at hand. The ability to engage in discussions within the multidisciplinary team allows for the removal of bias or inaccurate interpretations when there is a forum in place to help remove all of this prior to making a final diagnosis.
The DSM is considered to be a premier tool when it comes to the diagnosis of mental disorders and many providers dependent on it as a solid guide. The accuracy of the diagnosis that comes from the DSM is based on clarity and minimization of any confusion that might exist. Health care professional highly depend on the use of DSM along with other resources to make sound diagnoses because this can also help to guide the therapeutic interventions that will be applied to a given patient.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5thed.).https://doi.org/10.1176/appi.books.9780890425596
Bailey, A. (2022). The overview of the DSM-5.Verywell Health.https://www.verywellhealth.com/an-overview-of-the-dsm-5-5197607
Clark W. (2021). Teamwork: A Multidisciplinary Review. Child and Adolescent Psychiatric Clinics of North America, 30(4), 685–695. https://doi.org/10.1016/j.chc.2021.05.003
Gulati, S.et al. (2019). Development and validation of DSM-5 based diagnostic tool for children with autism spectrum disorder. PLOS ONE. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0213242
Möller H. J. (2018). Possibilities and limitations of DSM-5 in improving the classification and diagnosis of mental disorders. Możliwości i ograniczenia DSM-5 w polepszeniu klasyfikacji i diagnozy zaburzeń psychicznych. Psychiatria Polska, 52(4), 611–628. https://doi.org/10.12740/PP/91040
Nasrallah H. A. (2015). Consequences of misdiagnosis: inaccurate treatment and poor patient outcomes in bipolar disorder. The Journal of Clinical Psychiatry, 76(10), e1328. https://doi.org/10.4088/JCP.14016tx2c
Regier, D. A., Kuhl, E. A., & Kupfer, D. J. (2013). The DSM-5: Classification and criteria changes. World Psychiatry :Official Journal of the World Psychiatric Association (WPA), 12(2), 92–98. https://doi.org/10.1002/wps.20050
Wakefield J. C. (2016). Diagnostic Issues and Controversies in DSM-5: Return of the False Positives Problem. Annual Review of Clinical Psychology, 12, 105–132. https://doi.org/10.1146/annurev-clinpsy-032814-112800