DSM-IV - IMPLICATIONS FOR DRUG-THERAPY

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is established as one of the most important systems for the diagnosis and classification of psychiatric disorders. The widespread use of DSM-III and DSM-III-R criteria promoted greater specificity in matching therapeutic agents with psychiatric syndromes in both research and clinical practice. The fourth edition of this manual, DSM-IV, was published in 1994. Various procedures in the development of DSM-IV were intended to make the new classification criteria representative of findings of clinical research, generalisable to the larger and more diversified general practice populations, and to be conservative so minimising disruption to existing research efforts. The new criteria are, for the most part, similar to DSM-III-R. However, the importance of the criteria of general medical conditions, substance abuse disorders and medication-induced side effects in causing psychiatric symptomology is emphasised. New guidelines are provided for the assessment of bereavement in major depression and for the distinction of bipolar I and II disorders and antidepressant-induced mania. Panic disorder and generalised anxiety disorder are made more distinct in the new criteria, while the scope of brief psychotic disorder and adjustment disorders are broadened.