The Future of DSM-5-TR with Nitin Gogtay, MD, Maria Oquendo, MD, PhD, and Jonathan Alpert, MD, PhD

The DSM-5-TR approach introduced a dimensional approach to addressing psychiatric conditions rather than a categorical approach like in the DSM-4-TR. The dimensional approach puts psychiatric symptoms on a dimensional spectrum for all the different disorders. DSM-5-TR approach also introduced a cross-cutting measure, a tool or a diagnostic screening questionnaire to help think about mental health symptoms across several dimensions.

“So that was significantly different approach to addressing mental health conditions compared to the previous iterations of the DSM,” Nitin Gogtay, MD, from the American Psychiatry Association (APA), told HCPLive at the annual APA conference in New York.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) was published in 2022, encompassing ≥ 200 experts, many whom were involved in creating DSM-5 over 10 years ago. The DSM-5-TR includes information on prolonged grief disorder, as well as new symptom codes clinicians can use to indicate the presence or history of suicidal behavior and non-suicidal self-injury.

HCPLive sat down with Gogtay, Maria Oquendo, MD, PhD, the chair of the department of psychiatry at Penn Medicine and past president of APA, and Jonathan Alpert, MD, PhD, the psychiatry and behavioral sciences department chair at Montefiore Medical Center, Albert Einstein College of Medicine and the chair of the APA council on research, to discuss how the DSM-5-TR classifies psychiatric disorders in a different manner than previous classification systems.

“I think this question relates to what are the different approaches in terms of diagnosing psychiatric disorders, and what are the different perspectives?” Gogtay said. “I think DSM-5-TR now has been the gold standard way of standardizing and the criteria for mental health conditions so that everybody pretty much across the world can speak the same language and understand the same illnesses so that it will facilitate research as well as clinical work.”

Oquendo later mentioned how it is exciting the identification of biomarkers for psychiatry symptoms can be addressed through medication or psychotherapy.

“Over the coming decade, we expect continuing progress in identifying biomarkers whether for Alzheimer's disease or schizophrenia or mood disorders, other areas of keen interest to all of psychiatry and the patients that we serve,” Alpert added. “And we're very excited about the possibility of anticipating the incorporation of biomarkers into our classification system.”

Relevant disclosures for Oquendo include payments for Alkermes, Inc and Sage Therapeutics, Alpert's disclosures include payments for Alkermes, Inc., and Gogtay has no relevant disclosures.

References

1. ^{Clarke, D and Gogtay, N. The Future of the DSM: A Comparison of the Categorical, Dimensional, and Perspectives of Psychiatry Approaches. Session presented at: American Psychiatric Association (APA) 2024 Annual Meeting. New York, NY. May 7, 2024.}
2. ^{About DSM-5-TR. American Psychiatric Association. https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm#:~:text=The%20Diagnostic%20and%20Statistical%20Manual,TR)%20was%20published%20in%202022. Accessed May 7, 2024.}