The review process of the DSM 5: is gender a cultural or diagnostic category?

Objective: To consider the use of the diagnostic category ‘complex posttraumatic stress disorder’ (c-PTSD) as detailed in the forthcoming ICD-11 classification system as a less stigmatising, more clinically useful term, instead of the current DSM-5 defined condition of ‘borderline personality disorder’ (BPD). Conclusions: Trauma, in its broadest definition, plays a key role in the development of both c-PTSD and BPD. Given this current lack of differentiation between these conditions, and the high stigma faced by people with BPD, it seems reasonable to consider using the diagnostic term ‘complex posttraumatic stress disorder’ to decrease stigma and provide a trauma-informed approach for BPD patients.

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Should skin picking disorder be considered a diagnostic category? A systematic review of the evidence

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867419834347 ◽

2019 ◽

Vol 53 (9) ◽

pp. 866-877

Author(s):

Zoe Jenkins ◽

Hyacinta Zavier ◽

Andrea Phillipou ◽

David Castle

Keyword(s):

Systematic Review ◽

Empirical Studies ◽

Diagnostic Category ◽

Clinical Samples ◽

Case Control Studies ◽

Obsessive Compulsive ◽

Skin Picking ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

Skin Picking Disorder

Objectives: The aim of this study was to conduct a systematic review of the literature to collect, analyse and synthesise the evidence on skin picking disorder as defined by Arnold’s criteria or the Diagnostic and Statistical Manual of Mental Disorders – fifth edition (DSM-5) and to examine whether skin picking disorder warrants inclusion in the DSM-5 as a distinct disorder. Method: The databases CINAHL, Medline, Embase and PsycINFO were searched for articles published between January 2008 and May 2018. Eligible articles were empirical studies that used Arnold’s or DSM-5 criteria to diagnose skin picking disorder, published in English, with participants aged 18 years or older. The methodological quality of included studies was assessed according to the National Health and Medical Research Council’s guidelines and suggested nosological classification of skin picking disorder were summarised. Eligible studies were assessed against the five criteria proposed by Blashfield and colleagues to determine the validity of the inclusion of skin picking disorder in the DSM-5. Results: A total of 20 studies were considered eligible out of 1554. Most of the papers were case-control studies with small clinical samples. Only one out of Blashfield’s five criteria was met; there were commonly accepted diagnostic criteria and assessment scales present in the literature. However, at the time of review, the criterion of 50 published articles (25 of which are required to be empirical) was not met; there had been no publication specifically assessing the clinical utility or validity of skin picking disorder and no studies addressing the differentiation of skin picking disorder from other obsessive-compulsive and related disorders. Conclusion: Only a small proportion of published studies on skin picking disorder have employed validated criteria. The current literature fulfills only one of Blashfield’s five criteria for the inclusion of skin picking disorder as a specific entity in psychiatric diagnostic manuals. Further empirical studies on skin picking disorder are needed in order to substantiate skin picking disorder as a disorder distinct from related disorders under the obsessive-compulsive and related disorders category.

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The medicalization and demedicalization of kink: Shifting contexts of sexual politics

Sexualities ◽

10.1177/1363460716651420 ◽

2016 ◽

Vol 20 (3) ◽

pp. 302-323 ◽

Cited By ~ 7

Author(s):

Kai Lin

Keyword(s):

Sexual Behaviors ◽

Qualitative Data ◽

Diagnostic Category ◽

Sexual Politics ◽

Social Contexts ◽

Power Dynamics ◽

Multiple Sources ◽

Dsm 5 ◽

The Past ◽

Definition Of

BDSM (also known as kink) has been stigmatized through medicalization since the late 19th century. However, the recent publication of the DSM-5 has significantly changed the definition of Paraphilia, which used to be the catch-all diagnostic category for atypical sexual behaviors. In this study, I examined multiple sources of qualitative data to tap into the ever-changing social contexts and power dynamics of the medicalization and demedicalization of kink. The analyses of this study reveal how both activist strategies as well as approaches to social control evolve in the context of increasing reflexivity cultivated amidst sexual politics of the past few decades.

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Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey

Psychological Medicine ◽

10.1017/s0033291711000754 ◽

2011 ◽

Vol 41 (12) ◽

pp. 2475-2484 ◽

Cited By ~ 20

Author(s):

D. Mataix-Cols ◽

L.. Fernández de la Cruz ◽

T. Nakao ◽

A. Pertusa

Keyword(s):

Diagnostic Criteria ◽

Sensitivity And Specificity ◽

Diagnostic Category ◽

High Sensitivity ◽

Obsessive Compulsive ◽

Hoarding Disorder ◽

Compulsive Disorder ◽

Dsm 5 ◽

The Individual ◽

Development And Validation

BackgroundThe DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested.MethodObsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual.ResultsAltogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80–90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did.ConclusionsThe proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

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On Perception and Consciousness in HPPD: A Systematic Review

Frontiers in Neuroscience ◽

10.3389/fnins.2021.675768 ◽

2021 ◽

Vol 15 ◽

Author(s):

Pieter J. Vis ◽

Anneke E. Goudriaan ◽

Bastiaan C. ter Meulen ◽

Jan Dirk Blom

Keyword(s):

Diagnostic Criteria ◽

Case Reports ◽

Diagnostic Category ◽

Case Series ◽

Future Research ◽

Dsm 5 ◽

States Of Consciousness ◽

Original Case ◽

Nosological Entity ◽

Psychedelic Drug

Hallucinogen-persisting perception disorder (HPPD) features as a diagnostic category in the DSM-5, ICD-11, and other major classifications, but our knowledge of the phenomenology of the perceptual symptoms involved and the changes in consciousness during the characteristic “flashbacks” is limited. We systematically evaluated original case reports and case series on HPPD to define its phenomenology, associated (psycho)pathology, and course. Our search of PubMed and Embase yielded 66 relevant publications that described 97 people who, together, experienced 64 unique symptoms of HPPD. Of these, 76% concerned symptoms characteristic of Alice in Wonderland syndrome, over 50% non-visual symptoms, and 38% perceptual symptoms not clearly linked to prior intoxication states. This is in contrast with the DSM-5 diagnostic criteria for HPPD. Even though less than half of the patients showed a protracted disease course of over a year, a third achieved remission. However, in patients with co-occurring depression (with or without anxiety) HPPD symptoms persisted longer and treatment outcomes were more often negative. Thus, unlike the acute stages of psychedelic drug intoxication, which may be accompanied by altered states of consciousness, HPPD is rather characterized by changes in the content of consciousness and an attentional shift from exogenous to endogenous phenomena. Since HPPD is a more encompassing nosological entity than suggested in the DSM-5, we recommend expanding its diagnostic criteria. In addition, we make recommendations for clinical practice and future research.

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Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803–2017

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.504157 ◽

2021 ◽

Vol 11 ◽

Author(s):

Lukas Bergner ◽

Hubertus Himmerich ◽

Kenneth C. Kirkby ◽

Holger Steinberg

Keyword(s):

Anorexia Nervosa ◽

Eating Disorder ◽

Disordered Eating ◽

Eating Behavior ◽

Depressive Disorders ◽

Diagnostic Category ◽

High Morbidity ◽

Dsm 5 ◽

Wide Range ◽

Disordered Eating Behavior

The most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category “anorexia nervosa,” introduced by Ernest-Charles Lasègue and William Gull in 1873, first appears a century later in a German textbook of psychiatry, authored by Gerd Huber in 1974. However, disordered eating behavior has been described and discussed in German psychiatric textbooks throughout the past 200 years. We reviewed content regarding eating disorder diagnoses but also descriptions of disordered eating behavior in general. As material, we carefully selected eighteen German-language textbooks of psychiatry across the period 1803–2017. Previously, in German psychiatry, disordered eating behaviors were seen as symptoms of depressive disorders, bipolar disorder or schizophrenia, or as manifestations of historical diagnoses no longer used by the majority of psychiatrists such as neurasthenia, hypochondria and hysteria. Interestingly, 19th and early 20th century psychiatrists like Kraepelin, Bumke, Hoff, Bleuler, and Jaspers reported symptom clusters such as food refusal and vomiting under these outdated diagnostic categories, whereas nowadays they are listed as core criteria for specific eating disorder subtypes. A wide range of medical conditions such as endocrinopathies, intestinal or brain lesions were also cited as causes of abnormal food intake and body weight. An additional consideration in the delayed adoption of eating disorder diagnoses in German psychiatry is that people with EDs are commonly treated in the specialty discipline of psychosomatic medicine, introduced in Germany after World War II, rather than in psychiatry. Viewed from today's perspective, the classification of disorders associated with disordered eating is continuously evolving. Major depressive disorder, schizophrenia and physical diseases have been enduringly associated with abnormal eating behavior and are listed as important differential diagnoses of EDs in DSM-5. Moreover, there are overlaps regarding the neurobiological basis and psychological and psychopharmacological therapies applied to all of these disorders.

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