DSM-V: Mood Disorders, Part 1

Mood disorders, including Depression and Bipolar Disorder, are tentatively slated for a number of changes in the DSM-V. You can read an overview of the proposed changes on the DSM-V web site, and follow the links to specific disorders to see the proposed diagnostic criteria and the rationale for any changes. One of the most contentious proposals involves an attempt to decrease what is perceived to be over-diagnosis (or misdiagnosis) of Bipolar Disorder in young children.  Over the past few years, a number of studies have looked at severe mood dysregulation (SMD) in children and what happens to these children as they mature — do they develop depression or Bipolar Disorder, or neither? As a result of the studies, two DSM-V work groups collaborated and proposed a new diagnosis called "Temper Dysregulation Disorder with Dysphoria" (TDD).  You can read the proposed diagnostic criteria on the DSM-V web site or here. If you are interested in this condition or the issue of childhood-onset mood disorders, you may find it helpful to read two articles that the work groups produced to explain the research and their rationale for proposing TDD as a new diagnosis:   Issues Pertinent to a Developmental Approach to Bipolar Disorder and Justification for Temper Dysregulation Disorder with Dysphoria. In subsequent posts, I will try to summarize more of the controversy and provide statements by different groups of stakeholders who are pro and con the proposal.

DSM-V: Additions to childhood-onset disorders

Among the many changes proposed for the DSM-V are the inclusion of disorders not currently listed in the DSM-IV-TR. Clicking on the links below will take you the related sections of the DSM-V web site where you can read the proposed diagnostic criteria for these new diagnoses as well as the rationale for proposing each one:

• Posttraumatic Stress Disorder in Preschool Children
• Temper Dysregulation Disorder with Dysphoria
• Callous and Unemotional Specifier for Conduct Disorder
• Learning Disabilities
• Non-Suicidal Self Injury
• Non-Suicidal Self Injury Not Otherwise Specified

The Temper Dysregulation Disorder with Dysphoria proposal is particularly controversial and will be discussed in a separate post when we consider changes affecting children with mood disorders.

How will DSM-V changes affect you?

The DSM (Diagnostic and Statistical Manual) is a product of the American Psychiatric Association that provides diagnostic criteria for mental health disorders.  The APA is currently in the process of revising the DSM and has published its proposed recommendations for review and feedback.    The proposed changes include changes to Tourette’s Disorder, Attention Deficit Hyperactivity Disorder, Asperger’s Disorder, and many other disorders.   Two of the most controversial proposals concern creating a new childhood-onset diagnosis, Temper Dysregulation Disorder with Dysphoria (TDD) and eliminating the diagnosis of Asperger’s Disorder.

Diagnostic criteria affect the diagnosis you, your child, or family member will have.  They may affect your insurance coverage, and they may impact the types of accommodations or services your child gets in school or that you can access in the workplace.

I will be posting more about the proposed changes in the weeks and months to come, with separate posts devoted to each proposed change  of concern.

If you would like to read the proposed changes, the DSM-V has its own web site. In future posts, I will provide links to particular sections that may be of interest or concern to parents, educators, and clinicians.

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