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DSM-5® Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders. 5th edn. Edited by Donald W. Black and Jon E. Grant (567 pp., ISBN 9781585624652). American Psychiatric Association Publishing: Arlington, Virginia, 2014.

Published online by Cambridge University Press:  29 September 2015

C. Carey*
Affiliation:
BST 1 on the TCD scheme, Central Mental HospitalDundrum, Dublin, Ireland (Email: corneliacarey1@gmail.com)
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Abstract

Type
Book Reviews
Copyright
© College of Psychiatrists of Ireland 2015 

In the acknowledgements section of this guide, the writers describe themselves as ‘influenced by our own experiences in providing patient care’. They detail their own backgrounds and relationship to the history of operational classification. This gives a basis to the authors’ interest in the area, thus lending the guide an authenticity that allows for a much more involved read than many such guide books. This added relevance also distinguishes it as a valuable learning tool for trainees in psychiatry. Black and Grant provide a clear historical backdrop to the DSM classification system. They not only describe the expansion of classification; they also describe the major theoretical transitions that have influenced classification over time. They trace the evolution of psychiatric classification from ‘phases of the moon’ to the most recent revision of the DSM. In doing so, a sense of momentum and advancement is created at the outset before moving on to the main body of the book. Arguably parts of the chapter ‘The March to DSM 5’ may at times seem laborious; nevertheless, it gives a rich description of the innovation required to restructure the DSM.

This guidebook focusses on criteria and change. Some really interesting and novel aspects of the DSM 5 are highlighted for the reader including the approach to life span development; gender and cross-cultural issues and the psychiatric/general medicine interface. The guide follows the structure of the full manual but excludes most of the epidemiological and aetiological data. At the beginning of each chapter, there is a thorough explanation of the broad changes to the corresponding chapter in the DSM 5. The criteria for each disorder are then laid out clearly. Key points are provided at the end of each chapter and the benefits of DSM 5 over and above DSM IV are clarified. To my mind, the guide actually explains the functionality of certain additions, for example, ‘overweight or obesity’ and the discontinuation of the multi-axial system better than the DSM 5 itself.

Given the controversy surrounding the DSM 5, it sometimes feels as though the authors are apologists for the manual rather than being objective reviewers. In doing so, the authors sometimes appear to range beyond the scope of the book and, on one occasion, even defend the very concept of diagnosis itself. However, they admit early on that they are from the ‘“invisible college” of neo-Kraepelinian whose members were responsible for the first useful criteria sets in psychiatry’ and it may be argued that such conceptual arguments are the very thing that makes this guide so engaging. Despite their own views they also give voice to critics. For instance, in the description of the change to autism spectrum disorder they mention the concerns of parents and individuals with Asperger’s disorder. I myself would have liked this to be addressed more thoroughly, but admittedly this is not the function of the guide. The final three chapters correspond with section III of the DSM 5. There is no summary but this could easily have resulted in a repetition of the opening chapters. Looking to the future with ‘Conditions for further study’ is a fitting end to the guide given its emphasis on change and progression.

As a trainee, I found the idea of approaching the DSM 5 manual with its numerous changes, daunting. The fact that this guidebook halves the volume of the DSM 5 is the least important aspect of its appeal. Its clarification of diagnostic changes and personalisation of the material makes this guide vital and it is definitely a tool that could be used in training. It does not attempt to replace the DSM. Instead, it breathes life into the DSM manual and confers an importance on the changes that I might not have otherwise appreciated.