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Advancing DSM

Dilemmas in Psychiatric Diagnosis

Edited by Katharine A. Phillips, M.D., Michael B. First, M.D., and Harold Alan Pincus, M.D.

  • ISBN 978-0-89042-293-9
  • Item #2293

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In Advancing DSM, leading psychiatric clinicians and researchers contribute case studies that are unresolved, are rife with controversy, and illuminate limitations of the current diagnostic system. Along with analysis of clinical cases, the contributors recommend broad changes to DSM to incorporate new knowledge from psychiatry and neuroscience and findings from new methods of diagnostic testing.

Advancing DSM is a rich treasury of intriguing information for all clinicians and researchers. You will

  • Develop an understanding of some of the shortfalls of the current system that will help you make better clinical decisions. Accurate diagnosis is the foundation for selecting the best treatment, determining prognosis, and enhancing our understanding of patients. With the help of real-world case examples, you'll develop a solid understanding of the complexities involved in making clinical diagnoses.
  • Learn about developments that will advance future editions of DSM. Find out how new developments in psychiatry and neuroscience and new diagnostic testing tools such as functional MRI are changing the face of psychiatric diagnosis and will inform future editions of DSM.
  • Be alerted to some of the vital questions that must be answered before a new DSM is developed. Each chapter raises important questions to answer if we are to develop new, more accurate, and more reliable diagnoses. For example, how do we determine the causes of mental disorders? How do we define a mental disorder? How should the groupings of disorders be revised to reflect information on etiology and pathophysiology? What are the implications of laboratory testing and neuroimaging for psychiatric diagnosis and practice? and many more.

DSM has been a landmark achievement for the field. By allowing reliable diagnosis, it has brought order out of chaos and fostered groundbreaking advances in research and clinical care. Advancing DSM will brief you on exciting changes in psychiatry today that will impact the DSM of tomorrow.


  • Contributors
  • Foreword
  • Acknowledgments
  • Introduction
  • Chapter 1. Determining Causation in Psychiatry
  • Chapter 2. Clarifying the Distinction Between Disorder and Nondisorder: Confronting the Overdiagnosis (False Positives) Problem in DSM-V
  • Chapter 3. Should the DSM Diagnostic Groupings Be Changed?
  • Chapter 4. Laboratory Testing and Neuroimaging: Implications for Psychiatric Diagnosis and Practice
  • Chapter 5. Insights From Neuroscience for the Concept of Schizotaxia and the Diagnosis of Schizophrenia
  • Chapter 6. Subthreshold Mental Disorders: Nosological and Research Recommendations
  • Chapter 7. Multiaxial Assessment in the Twenty-First Century
  • Chapter 8. Diagnostic Dilemmas in Classifying Personality Disorder
  • Chapter 9. Relationship Disorders Are Psychiatric Disorders: Five Reasons They Were Not Included in DSM-IV
  • Index

About the Authors

Katharine A. Phillips, M.D., is Associate Professor of Psychiatry and Human Behavior at Brown University School of Medicine and Director of the Body Dysmorphic Disorder Program at Butler Hospital in Providence, Rhode Island.

Michael B. First, M.D., is Research Psychiatrist at the New York State Psychiatric Institute and Associate Professor of Clinical Psychiatry at Columbia University College of Physicians and Surgeons in New York, New York.

Harold Alan Pincus, M.D., is Professor and Executive Vice Chairman of the Department of Psychiatry in the Western Psychiatric Institute and Clinic at the University of Pittsburgh School of Medicine, and Senior Scientist and Director of RAND at the University of Pittsburgh Health Research Institute in Pittsburgh, Pennsylvania.

Written by nationally recognized researchers in the field, the book is an important and timely contribution to psychiatry. . . . This is an excellent book on the critical conceptual issues of psychiatric diagnosis. I highly recommend it.—Michael J. Schrift, D.O., Doody's Health Science Review

In summary, Advancing DSM provides a thorough overview of the many issues that must be addressed as we move toward DSM-V. Although the ideas presented are at times controversial, the authors have taken great care to summarize the pertinent research literature and have drawn conclusions based on scientific data, to the extent possible, with clear calls for research in areas in which data are lacking. Advancing DSM is a valuable contribution that will stimulate research and provoke discussion on a number of important topics that must be addressed before DSM-V. In reading Advancing DSM, it has been reassuring to learn that scholars are already devoting considerable effort toward this end.—Karen K. Saules, Ph.D., The Journal of Nervous and Mental Disease, 2/1/2004

This book is recommended for those willing to look critically at the DSM-IV foundation on which they are standing.—Roger Peele, M.D., American Journal of Psychiatry, 2/1/2004

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