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Revised psychiatric manual gets final approval

After years of controversy, the latest edition of the Diagnostic and Statistical Manual of Mental Disordersthe DSM-5 — has been cleared for publication. On 1 December, the American Psychiatric Association (APA) board of trustees approved proposed revisions to the tome, which is extensively used in the clinic and for research.

The manual will include some hotly debated changes (see ‘Diagnostic tome comes under fire‘). Asperger’s syndrome will be removed as a separate diagnosis and placed under the umbrella of autism spectrum disorder. And patients can now be diagnosed with major depressive disorder even if they are mourning the death of a loved one within two months of the diagnosis. This proposed change raised concerns that depression would be over-diagnosed and confused with ordinary grief. The APA says this ‘bereavement exclusion’ has been replaced by notes clarifying the difference between grief and depression, and that the change was necessary to “reflect the recognition that bereavement is a severe psychosocial stressor that can precipitate a major depressive episode beginning soon after the loss of a loved one”.

The APA plans to release the DSM-5 at its annual meeting in May 2013.

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