What's in a WORD?

Mental health clinicians the world over regularly check psychiatry’s “big book,” the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short. Published by the American Psychiatric Association (APA), this manual is the critical reference that helps practioners—psychiatrists, psychologists, and other mental health professionals—define the illnesses or syndromes affecting their patients.
 

Now that book is being revised. New terms, new definitions for old terms, all based on the latest research will be included in a sweeping, multiyear overhaul. Two pioneering clinician-researchers and faculty members from the UND School of Medicine and Health Sciences are among an elite team editing the the fifth edition of this celebrated mental health manual, dubbed DSM-V.
 

James Mitchell, M.D., and Stephen Wonderlich, Ph.D., leaders of the Fargo-based and nationally recognized Neuropsychiatric Research Institute (NRI), which is affiliated with the UND medical school, were selected for the committee by their professional peers.
 

“This is a both an honor and huge responsibility,” says Wonderlich, a psychologist who has developed a global reputation as an expert in eating disorders. 
 

Mitchell and Wonderlich have developed new diagnostic tools and innovative treatments for people with disorders such as anorexia nervosa. Their place on the DSM-V editorial committee underscores the value of their experience and research not only to the mental health community but also to the many medical students and residents that they teach.
 

Mitchell explains that the DSM is an American handbook for mental health professionals that lists different categories of mental disorders and the criteria for diagnosing them. It is used worldwide by clinicians and researchers as well as insurance companies, pharmaceutical companies, and policy makers.
 

Leaders from the American Psychiatric Association, the United Nations World Health Organization, and the World Psychiatric Association determined the previous edition of the DSM needed to be revised and that additional information needed to be included. Thirteen work groups have been set up to revise the DSM. The revised DSM will reflect the diagnostic categories of psychiatric disorders described in previous editions of the manual, but also it will reflect new scientific understanding.
 

This revision is going to take several years, note Wonderlich and Mitchell, who hold teaching and research appointments at SMHS and are mentors, as well, to psychiatric residents in the residency program at the School of Medicine’s Fargo campus.
 

In a real sense, this is a labor of love for Mitchell, Wonderlich, and their colleagues on the DSM-V committee. As part of the APA’s concerted effort to avoid conflicts of interest and ensure transparency with the development of DSM-V, the organization set up strict guidelines for participants in the review process. The No. 1 criterion is that they all serve without pay (with the exception of the DSM-V Task Force chair). There are other tight financial guidelines, including limits on how much cash or other payments each committee member can get from pharmaceutical and other health care-related companies.
 

A release of the final, approved DSM-V is expected in May, 2012.