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DSM IV

DSM IV

I am pleased to be able to join the dialogue on science, psychiatric diagnosis, and the DSMs that Dr James Knoll initiated with the posts of Drs

Undoubtedly there will be problems with some of the additions to DSM-5, with some of the combinations, with some of the new nomenclature, and with some of the new criteria sets. But practitioners will find most of DSM-5 to be well considered and well written. It is unfortunate, however, that much of its nomenclature is out of sync with the rest of medicine.

This psychiatrist's wish is that in one more generation, our profession will learn to go beyond DSM to the truths of science.

All psychiatry, anywhere in the world, is American psychiatry. This is both good and bad.

It is clear that the leadership of DSM-IV, and of DSM-III before it, views psychiatric diagnosis in the DSM system as something that should be based on “pragmatism.”

Identification of atypical features is important in the treatment of depression for both treatment selection and prognosis, especially when initial measures prove ineffective. The concept of atypical depression has evolved over many years, and now it appears timely for a further revision.

Accurate diagnosis is absolutely crucial in SVP hearings because the potential outcome is so consequential—involuntary incarceration in a psychiatric hospital that may well last a lifetime. In no other clinical or forensic situation does so much ride on the presence or absence of a psychiatric diagnosis.

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