DSM-5 Series Part 3: Mood and Anxiety Disorders

December 19th, 2012 | Add a Comment

Today, we are going to discuss some of the drama surrounding mood and anxiety disorders.

Disruptive Mood Dysregulation Disorder:

Disruptive mood dysregulation disorder officially makes its debut as a mental disorder in the DSM 5, and it is already stirring up a ton of controversy. Children who exhibit persistent irritability and frequent episodes of behavioral outbursts three or more times a week for more than a year will now be diagnosed with this disorder. Critics are outraged by this addition and fear that otherwise normal children will now have the stigma of being diagnosed with a mental disorder.

The DSM-5 task force argues that the diagnosis is intended to address concerns about potential over-diagnosis and overtreatment of bipolar disorder in children. The hope is that children will not be misdiagnosed with bipolar and put on powerful drugs for having frequent outbursts. Of course, this could also backfire and prompt drug companies to come out with new unnecessary drugs for this disorder.

Posttraumatic Stress Disorder (PTSD):

PTSD, which used to be listed among the class of anxiety disorders, will now be in a new chapter, Trauma- and Stressor-Related Disorders, in the DSM 5. The three clusters of the DSM-IV symptoms will be divided into four clusters in the DSM-5: intrusion symptoms, avoidance symptoms, arousal/reactivity symptoms, and negative mood and cognitions. It is proposed that a few symptoms will be added and some revised.

Excoriation Disorder:

Excoriation disorder, a form of dermatillomania, is new to the DSM 5. It is a disorder in which individuals excessively pick at their skin. It will be included in the Obsessive-Compulsive and Related Disorders chapter.

Hoarding Disorder:

Hoarding disorder, formerly considered a subset of obsessive-compulsive disorder, is also a new addition to the DSM 5. Its addition to the DSM 5 is supported by extensive scientific research on hoarding. Hoarding disorder will help characterize people with persistent difficulty discarding or parting with possessions, regardless of their actual value. The behavior usually has harmful effects—emotional, physical, social, financial, and even legal—for the hoarder and family members.

Check out our article on hoarding: http://www.treatment4addiction.com/blog/conditions-and-disorders/hoarding-gets-its-own-definition-in-the-dsm/

Major Depressive Disorder:

The biggest and most controversial change to major depressive disorder is the removal of the bereavement exclusion. In the DSM-IV-TR, the bereavement exclusion states that individuals who have depressive symptoms lasting within two months of a death of a loved one cannot be diagnosed with major depressive disorder.

The current debate over the bereavement exclusion has two competing views. One side argues that the bereavement exclusion confuses clinicians and interferes with the diagnosis and treatment of potentially serious depression, while the other side insists that eliminating the bereavement exclusion will “medicalize normal grief” and lead to over-prescription of antidepressants.

Hopefully the removal of the bereavement exclusion will be beneficial, because a good clinician will be able to distinguish the difference between normal grief and major depression.

Once again, we will have to wait until the DSM 5 publication in May 2013 to see just how big of an impact these changes will have. Don’t forget to stay tuned tomorrow for more DSM drama!

Works Cited:

DSM 5. American Psychiatric Association. n.d. Web. 11 December 2012.
Falco, Miriam. Psychiatric Association Approves Changes to Diagnostic Manual. CNN. 3 December 2012. Web. 14 December 2012.
Grohol, John PsyD. Final DSM 5 Approved by American Psychiatric Association. Psych Central. n.d. Web. 18 December 2012.
Pies, Ronald MD. Bereavement and the DSM-5, One Last Time. Psychiatric Times. 11 December 2012. Web. 18 December 2012.