Weak Field Trials Scuttle DSM-5 Diagnoses

“Mixed anxiety-depressive disorder,” “attenuated psychosis syndrome,” “obsessive-compulsive personality disorder,” “antisocial personality disorder,” and “nonsuicidal self-injury” were among diagnoses that met with disappointing results in field trials for the new DSM-5. Either low interrater reliability (a lack of sufficient agreement between clinicians), or a lack of sufficient examples of people with a proposed diagnosis in the real world meant that these diagnoses could not be included in this round of the APA’s official list of disorders. One architect of the trials said that a goal of the DSM-5 was to test diagnoses “with real clinicians and real patients,” a goal that may explain why even “major depressive disorder” was found to be surprisingly unreliable, possibly because the previous version of the DSM excluded patients with complicated “psychiatric comorbidities.”

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Related Items:
Newsflash from APA Meeting: DSM-5 Has Flunked Its Reliability Tests (Huffington Post)
Updates to Psychiatric Guide Spur Controversy (Washington Post)
First DSM-5 Field Trials Generate Mixed Results (Medscape Today)

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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