Latest Edition of the Diagnostic and Statistical Manual of Mental Disorders
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is the current and latest edition, published in May 2013 by the American Psychiatric Association. 1, 2
Key Information About DSM-5
Publication Details
- DSM-5 was officially published in May 2013, marking the first major revision since DSM-IV in 1994 1, 2
- This represents approximately a 19-year gap between major editions 1
- The DSM-5 remains the current standard as of 2025, with no DSM-6 published to date 1
Major Changes from DSM-IV
The DSM-5 introduced several significant revisions that directly impact clinical practice:
Substance Use Disorders:
- Combined the previous separate diagnoses of "abuse" and "dependence" into a single "substance use disorder" diagnosis 1
- Dropped the "legal problems" criterion and added "craving" as a new diagnostic criterion 1
- Added cannabis and caffeine withdrawal syndromes 1
- Reduced the diagnostic threshold for bulimia nervosa from twice weekly to once weekly for 3 months 1
Eating Disorders:
- Eliminated the 85% expected body weight threshold for anorexia nervosa 1
- Removed the amenorrhea requirement for anorexia nervosa diagnosis 1
- Officially recognized binge eating disorder as a distinct disorder (at least once weekly for 3 months without compensatory behaviors) 1, 3
Neurocognitive Disorders:
- Changed terminology from "mental retardation" to "intellectual disability (intellectual developmental disorder)" 1
- Introduced "neurocognitive disorders" as a category, replacing older terminology like "dementia" in some contexts 1, 4
- Specified delirium criteria with disturbance in attention and awareness as essential diagnostic features 1
Obsessive-Compulsive Disorder:
- Moved OCD from anxiety disorders to a new chapter on "Obsessive-Compulsive and Related Disorders" 1
- Added insight specifiers: good/fair insight, poor insight, and absent insight/delusional beliefs 1, 5
- Maintained the requirement that symptoms must be time-consuming (>1 hour daily) and cause clinically significant distress 1, 5
Clinical Implications
Current Usage in Practice
Multiple specialty guidelines from 2018-2025 continue to reference DSM-5 as the current diagnostic standard:
- European Society for Medical Oncology uses DSM-5 criteria for delirium diagnosis in cancer patients 1
- Anesthesiology and perioperative medicine guidelines align cognitive disorder nomenclature with DSM-5 1
- Alzheimer's Association clinical practice guidelines reference DSM-5 criteria for major neurocognitive disorder 1
- American Academy of Pediatrics guidelines cite DSM-5 criteria for eating disorders 1
Important Caveats
The DSM-5 represents a descriptive categorical approach rather than an etiologically-based paradigm shift, despite initial aspirations for more radical changes 2, 6, 7. The classification system remains fundamentally similar to DSM-IV's structure, with incremental improvements rather than revolutionary changes 6, 7.
Alignment with ICD-11: The DSM-5 development process emphasized harmonization with the World Health Organization's International Classification of Diseases, 11th edition (ICD-11), which was expected in 2018 1, 2. This international compatibility was a major driver of DSM-5 revisions 2.
Bottom Line for Clinical Practice
The DSM-5, published in 2013, remains the current edition over a decade later and serves as the reference standard for psychiatric diagnosis across all medical specialties 1. Clinicians should be familiar with its major changes from DSM-IV, particularly the less stringent criteria for eating disorders, the combined substance use disorder diagnosis, and the new neurocognitive disorder terminology 1.