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DSM IV or DSM4 - Diagnostic and Statistical Manual of Mental Disorders


The Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (American Psychiatric Association, 1994) is the current reference used by mental health professionals and physicians to diagnose mental disorders. This publication is often referred to as the DSM or DSM4 or DSM iv, and we use such abbreviations here for convenience. The American Psychiatric Association began publishing the DSM in 1952, and it has since gone through several revisions before the most recent version, the fourth edition, was published in 1994. The current DSM iv lists over 200 mental health conditions and the criteria required for each one in making an appropriate diagnosis.

The International Statistical Classification of Diseases and Related Health Problems (ICD), produced by the World Health Organization (WHO), is the other commonly used manual for mental disorders. It is distinguished from the DSM in that it covers health as a whole. While the DSM is the official diagnostic system for mental disorders in the US, the ICD is used more widely in Europe and other parts of the world.

Drafts of DSM IV were circulated for discussion and comments before publication of the final manual in 1994 (American Psychiatric Association 1994a). The review material has been published in a series of DSM iv source books. A new version incorporating minor revisions of the explainatory text - DSM iv text revision (DSM - IV - TR) - was published in 2000. This aimed to update the classification as an educational tool. The changes are mainly small rewordings of the text and there is no alteration to the classifications itself or to the criteria (American Psychiatric Association 2000).

DSM iv for various disorder like major depression:

Diagnostic criteria for mental disorders are essentially descriptions of symptoms that fall into one of four categories.

  • In major depressive disorder for example, affective or mood symptoms include depressed mood and feelings of worthlessness or guilt.
  • Behavioral symptoms include social withdrawal and agitation.
  • Cognitive symptoms, or problems in thinking include difficulty with concentration or making decisions.
  • Finally, somatic or physical symptoms include insomnia or hypersomnia (sleeping too much).

The clinical usefulness of the DSM 4 is much more than a tool for making diagnoses of depression like major diosrder. It is used by mental health professionals and physicians as a guide for communicating about mental health conditions. When two clinicians discuss a diagnosis such as "major depressive disorder, single episode, severe with psychotic features," they both have the same conceptualization of various aspects of the illness. Without the DSM-IV, the two clinicians might have very different perceptions of the condition. The DSM 4 also allows mental health professionals to reach consensus on which symptoms or groups of symptoms should define which disorders. Such decisions are based on empirical evidence (research results), usually by a multidisciplinary staff of professionals. Further, the DSM 4 is used as an educational tool and a reference for conducting all types of research (e.g., clinical trials, prevalence studies, outcome research).

The DSM IV is not used to categorize people , but to categorize conditions or disorders that people have. This may be a subtle distinction, but it is a very important one. We do not say that a person is cancer, or is heart disease, or is an illness. A person has an illness. Likewise, we should not say that a person is a depressive, but that a person has clinical depression. Along the same lines, the value of diagnostic labels is often debated among mental health professionals and the general public. On the negative side, some people believe that making a diagnosis is simply the act of labeling a person. Once a person is labeled he or she may have difficulty overcoming the label, may lose hope of recovery, or may come to believe that he or she is the label. On the positive side, some people are relieved when they finally learn that the symptoms they are experiencing have a name. This often offers a sense of hope and personal control over the illness as more can be learned about its treatment, causes, and outcome.

The doctor will compare your symptoms to the diagnostic criteria in the DSM iv to determine if you do have depression, and if so, which form. A good mental health professional will not rely solely on the DSM iv, however. If a patient is displaying four instead of five of the criteria, that does not mean that he or she does not need treatment. Depressive disorders occur along a continuum from mild to severe, and it's possible to fall somewhere between them.


Experience with Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) revealed a number of inconsistencies in the system and a number of instances in which the criteria were not entirely clear. Therefore, the American Psychiatric Association appointed a work group to revise DSM-III, which developed the revisions and corrections that led to the publication of DSM-III-R in 1987.

Multi-axial system

The DSM-IV organizes each psychiatric diagnosis into five dimensions relating to different aspects of disorder or disability:

  1. All psychological diagnostic categories except mental retardation and personality disorder.
  2. Personality disorders and mental retardation.
  3. General medical condition; acute medical conditions and physical disorders.
  4. Psychosocial and environmental factors contributing to the disorder.
  5. Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18.


When the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released at the American Psychiatric Association’s Annual Meeting in 18 May 2013, it marked the end of more than a decade’s journey in revising the criteria for the diagnosis and classification of mental disorders. Although DSM-5 is now complete, a great deal of work remains, and we are hopeful that once again you will play an active role in this next important phase of refining the manual.

If you think you have depression, or know someone who does, it is important that you know as much as possible about the different kinds of depression to determine whether the doctor is diagnosing it properly.

Depression Diagnosis criteria and tool other than dsm4 The diagnosis of depression begins with a physical exam by a doctor. There are several factors at work here.

DSM iv and ICD-10 - The two classifications are complementary rather than competing. DSM has been designed for use in a single country - it is a national classification - whereas ICD has been designed for use in all countries with their varied cultures and needs and was subjected to international field trials.

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I think that dsm 4 is the best book of analisis of upheavals mentale written until fecha (2006), its revision, this of but. - ps.haroldperez

Is PAS (parential alienation syndrome) a valid diagnosis recongnized by the Canadian Medical & Psychiatric Association? Is it lited in the DSM 4? --Susan Roy

Just serfed in. Great site, guys!c - Nicole

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