DSM-IV - IMPLICATIONS FOR DRUG-THERAPY

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is est ablished as one of the most important systems for the diagnosis and cl assification of psychiatric disorders. The widespread use of DSM-III a nd DSM-III-R criteria promoted greater specificity in matching therape utic agents with psychiatric syndromes in both research and clinical p ractice. The fourth edition of this manual, DSM-IV, was published in 1 994. Various procedures in the development of DSM-IV were intended to make the new classification criteria representative of findings of cli nical research, generalisable to the larger and more diversified gener al practice populations, and to be conservative so minimising disrupti on to existing research efforts. The new criteria are, for the most pa rt, similar to DSM-III-R. However, the importance of the criteria of g eneral medical conditions, substance abuse disorders and medication-in duced side effects in causing psychiatric symptomology is emphasised. New guidelines are provided for the assessment of bereavement in major depression and for the distinction of bipolar I and II disorders and antidepressant-induced mania. Panic disorder and generalised anxiety d isorder are made more distinct in the new criteria, while the scope of brief psychotic disorder and adjustment disorders are broadened.