The DSM is a reference handbook that most U.S. mental health professionals use to reach an accurate diagnosis. The latest version of the manual is the DSM-5-TR.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) was released on March 18, 2022 by the American Psychiatric Association (APA).

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a formal classification of mental health disorders, featuring symptoms, diagnostic criteria, culture and gender-related features, and other important diagnostic information. The DSM does not include treatment guidelines.

In other words, the DSM is a tool and reference guide for mental health clinicians to diagnose, classify, and identify mental health conditions.

The DSM also includes “specifiers.” These are extensions to the formal diagnoses that specify one or more particular features, like onset or severity. A diagnosis can have one or more specifiers to make it more precise.

In other words, because a mental health condition doesn’t always present itself in the same way, a DSM specifier can better describe particular scenarios.

The DSM has had many revisions, to clarify, add, or remove mental health diagnoses according to the latest research and clinical consensus.

It took more than 13 years to update and finalize the book’s fifth edition and about 10 years to release the current text revision.

The DSM-5 was released in 2013 and the current version released in 2022 is the DSM-5-TR.

The difference between a new edition and a text revision is that the first one is released when new research supports the need to create, remove, or significantly revise key aspects of existing diagnoses.

A text revision, on the other hand, refers to editing the existing text to clarify some concepts, introduce inclusive language, or update statistics and references. Sometimes, like it’s the case with the DSM-5-TR, a new diagnosis might be introduced.

The first edition of the DSM was published in 1952 following an increased need to classify and define mental conditions, especially in veterans returning home after World War II.

The DSM was created to catalog mental health conditions similar to its counterpart, the International Classification of Disease (ICD).

The ICD is published by the World Health Organization (WHO) and catalogs both physical and mental conditions.

The DSM-II was released in 1968 and focused on broadening terms and definitions from the original DSM to diagnose mental health conditions better.

The biggest shift in the history of the DSM came as a result of the DSM-III, published in 1980.

This edition listed 265 categories — a big increase from 182 in the previous edition. This jump was due to an expansion of disorder subtypes, which allowed for more accurate classifications and options for a diagnosis.

The DSM-III also saw the removal of “homosexuality” as a mental condition category.

The DSM-III would later receive an update and be revised and renamed in 1987 as the DSM-III-R.

The next edition, the DSM-IV, was published in 1994 and was created alongside the WHO’s International Classification of Disease, 10th edition. This aimed to decrease inconsistencies in terminology between the two manuals.

The DSM-IV would see one final revision in 2000, named the DSM-IV-TR before the DSM-5 was released in 2013.

The latest text revision of the DSM-5 was released in 2022.

One of the biggest changes in the DSM-5 is the removal of the multiaxial assessment system to categorize diagnoses.

This evaluation method was based on multiple factors, specifically five “axes”:

  • clinical disorders
  • personality disorders
  • general medical disorders
  • psychosocial and environmental factors
  • global assessment of functioning

The system was removed and replaced with a streamlined diagnostic method that combines axes I, II, and III into 1.

Additional changes in the DSM-5 include broadening the definitions to clarify certain conditions.

For example, the diagnostic label autism spectrum disorder now comprises four previously separate conditions:

  • autistic disorder
  • Asperger’s disorder
  • childhood disintegrative disorder
  • pervasive developmental disorder

The DSM-5 is organized into three sections and an appendix.

Section II of the DSM-5 is the lengthiest because it lists all of the mental health disorders.

Here are the DSM sections:

Section I: DSM-5 Basics

This section includes an “Introduction” and “Use of the Manual” chapters, as well as a “Cautionary Statement for Forensic Use of DSM-5” chapter.

Section II: Diagnostic Criteria and Codes

This section includes classifications and definitions of mental health disorders.

These conditions are organized alphabetically and developmentally, with all childhood conditions listed before adult on-set conditions.

Section III: Emerging Measures and Models

This section comprises chapters that discuss applying the newest mental health information — for example, assessment measures and how to account for cultural influences.

It also includes newer conditions that require further study before entering the general diagnostic classification — for example, caffeine use disorder and internet gaming disorder.

Appendix

The final section contains supplemental information such as a list of changes from the DSM-4 to the DSM-5, a glossary of technical terms, and a list of DSM-5 advisors.

Major changes in the DSM-5 from the DSM-IV

Below are links to explore additional updates and changes to the DSM-5:

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) is an edit of the DSM-5 that includes:

  • a revision of the original descriptive text in the DSM-5, specifically under these headings:
    • recording procedures
    • specifiers
    • diagnostic features
    • associated features
    • prevalence
    • development and course
    • risk and prognostic factors
    • culture-related diagnostic issues
    • sex and gender-related diagnostic issues
    • association with suicidal thoughts or behavior
    • functional consequences
    • differential diagnosis
    • comorbidity
  • new and updated references to include more recent literature
  • new text regarding the impact of discrimination and racism on mental health diagnoses
  • a list of updated diagnostic codes from the International Classification of Diseases, 10th revision, clinical modification (ICD-10-CM), including codes related to suicidal behavior and nonsuicidal self-harm
  • one new diagnosis (prolonged grief disorder) in section II, under trauma- and stressor-related disorders
  • changes in language in the gender dysphoria chapter, going from “desired gender” to “experienced gender”
  • changes in language to refer to gender-related procedures, going from “cross-sex medical procedure” to “gender-affirming medical procedure”
  • changes in language in sex-related assignments, going from “natal male” or “natal female” to “individual assigned male at birth” and “individual assigned female at birth”

This is how the DSM-5-TR is indexed:

  • DSM-5-TR Classification
  • Preface
  • Section I: DSM-5-TR Basics
    • Introduction
    • Use of the Manual
    • Cautionary Statement for Forensic Use of DSM-5-TR
  • Section II: Diagnostic Criteria and Codes
    • Neurodevelopmental Disorders
    • Schizophrenia Spectrum and Other Psychotic Disorders
    • Bipolar and Related Disorders
    • Depressive Disorders
    • Anxiety Disorders
    • Obsessive-Compulsive and Related Disorders
    • Trauma- and Stressor-Related Disorders
    • Dissociative Disorders
    • Somatic Symptom and Related Disorders
    • Feeding and Eating Disorders
    • Elimination Disorders
    • Sleep-Wake Disorders
    • Sexual Dysfunctions
    • Gender Dysphoria
    • Disruptive, Impulse-Control, and Conduct Disorders
    • Substance-Related and Addictive Disorders
    • Neurocognitive Disorders
    • Personality Disorders
    • Paraphilic Disorders
    • Other Mental Disorders and Additional Codes
    • Medication-Induced Movement Disorders and Other Adverse Effects of Medication
    • Other Conditions That May Be a Focus of Clinical Attention
  • Section III: Emerging Measures and Models
    • Assessment Measures
    • Culture and Psychiatric Diagnoses
    • Alternative DSM-5 Model for Personality Disorders
    • Conditions for Further Study
  • Appendix
  • Alphabetical Listing of DSM-5-TR Diagnoses and Codes (ICD-10-CM)
  • Numerical Listing of DSM-5-TR Diagnoses and Codes (ICD-10-CM)
  • DSM-5 Advisors and Other Contributors
  • Index

More than 200 mental health experts contributed to the DSM-5-TR.

The DSM-5 offers an extensive list of conditions and symptoms that can aid mental health professionals in reaching accurate diagnoses. The latest version is the DSM-5-TR.

The manual has come a long way since its first edition and now provides diagnostic criteria for 193 mental health conditions.

The DSM is a living document that continues to change over time as we learn more about human cognition and behavior.