title: DSM-5 reviewed from different angles: goal attainment, rationality, use of evidence, consequences--part 1: general aspects and paradigmatic discussion of depressive disorders.
abstract: DSM-5 was published in 2013 after about 10 years of preparation. Part 1 of this paper discusses several more general aspects of DSM-5 and offers a detailed, paradigmatic analysis of changes made to the chapter on depressive disorders. The background for the changes is analysed on the basis of a PubMed search and review papers on the classification of mental disorders in general and on empirical knowledge about individual disorders. Contrary to the original plans, DSM-5 has not introduced a primarily dimensional diagnostic system but has widely preserved the categorical system of disorders. Also, it has not adopted a more neurobiological approach to disorders by including biological markers to increase the objectivity of psychiatric diagnoses but has maintained the primarily symptom-based, descriptive approach. The criteria for some disorders have been changed, including affective, schizophrenic and addiction disorders, and a few new disorders have been added. A minimal version of the dimensional approach was realised through the introduction of several transnosological specifiers and the option to make symptom- or syndrome-related severity and dimensional assessments. These specifiers and assessments might allow a more individualised description of a patient's psychopathological state and more personalised treatment. However, most of the symptom- and syndrome-related assessments are not mandatory and therefore may not be used in clinical practice.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany, hans-juergen.moeller@med.uni-muenchen.de.
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Borwin
authors.initials: B
authors.lastname: Bandelow
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.forename: Harald
authors.initials: H
authors.lastname: Hampel
authors.forename: Sabine C
authors.initials: SC
authors.lastname: Herpertz
authors.forename: Michael
authors.initials: M
authors.lastname: Soyka
authors.forename: Utako B
authors.initials: UB
authors.lastname: Barnikol
authors.forename: Simone
authors.initials: S
authors.lastname: Lista
authors.forename: Emanuel
authors.initials: E
authors.lastname: Severus
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
mesh_terms: D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D063189:Symptom Assessment