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• Using the DSM

Using the Diagnostic and Statistical Manual

The Diagnostic and Statistical Manual of Mental Disorders (DSM) consists of three major components: the diagnostic classification, the diagnostic criteria sets, and the descriptive text.

Diagnostic Classification

The diagnostic classification is the list of the mental disorders that are officially part of the DSM system.  “Making a DSM diagnosis” consists of selecting those disorders from the classification that best reflect the signs and symptoms that are exhibited by  the individual being evaluated.  Associated with each diagnostic label is a diagnostic code, which is typically used by institutions and agencies for data collection and billing purposes.  These diagnostic codes are derived from the coding system used by all health care professionals in the United States, known as the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM).

Diagnostic Criteria Sets

For each disorder included in the DSM, a set of diagnostic criteria that indicate what symptoms must be present (and for how long) as well as symptoms, disorders, and conditions that must not be present in order to qualify for a particular diagnosis.  Many users of the DSM find these diagnostic criteria particularly useful because they provide a concise description of each disorder.  Furthermore, use of diagnostic criteria has been shown to increase diagnostic reliability (i.e., likelihood that different users will assign the same diagnosis to an individual).   However, it is important to remember that these criteria are meant to be used as guidelines informed by clinical judgment, and are not meant to be used in a cookbook fashion.

Descriptive Text

Finally, the third component of the DSM is the descriptive text that accompanies each disorder.  The text of DSM-IV systematically describes each disorder under the following headings: "Diagnostic Features"; "Subtypes and/or Specifiers"; "Recording Procedures"; "Associated Features and Disorders"; "Specific Culture, Age, and Gender Features"; "Prevalence"; "Course"; "Familial Pattern"; and "Differential Diagnosis."