A New and Improved DSM? The American Psychiatric Association Shares Strategy and Roadmap

The American Psychiatric Association released plans for a new edition of the DSM, one that aims to address the shortcomings and critiques of previous editions, Marketa Wills, MD, MBA, said in a press conference. Wills, the chief executive officer and medical director of the APA, was joined by Maria Oquendo, MD, PhD, Jonathan Alpert, MD, PhD, Diana Clarke, PhD, and Nitin Gogtay, MD, highlighting the philosophy and roadmap for the new edition. To underscore the new philosophies and approaches, the new edition will also experience a name change, going from the Diagnostic and Statistical Manual of Mental Disorders to the Diagnostic and Scientific Manual.^1-6

Four Interacting Domains

The future DSM diagnostic model will include 4 domains—contextual factors that can influence diagnostic formulation, diagnoses, biomarker and biological factors, and transdiagnostic features, explained Oquendo, who serves as the chair of the Future DSM Strategic Committee. “We know and understand that all of these domains interact with each other. These are not independent,” she said. “And the idea behind having all of these domains is really to give a framework to the clinician to make a holistic evaluation of a patient to make their diagnosis and to determine a course of treatment.”

A Living Document

Because of the long intervals between editions, previous editions of the DSM quickly became outdated, the presenters noted. And, although previous DSM architects anticipated the digital versions would allow the APA to make updates, many clinicians adhered to the print version. “There's then inherent discrepancy between the print and digital formats for logistical reasons,” Gogtay said. “As a result, we feel clinicians and other stakeholders may lack uniform and timely access to the most current evidence, that might delay translation of new discoveries into the practice. At the rate at which the science is advancing, we want this process to be as current as possible. In response, what we are envisioning is a living DSM, a scientifically authoritative resource that is updated in a structured, deliberate manner as the new evidence becomes available.”

Gogtay made assurances that changes and updates would be made thoughtfully and judiciously. “We want it to still reflect a commitment to maintaining diagnostic guidance that is always current, accurate and aligned with peer-reviewed scientific evidence that meets the established standards of care,” he said.

Biomarkers and Biological Factors

Alpert explained 2 goals of the new DSM, especially in regards to biomarkers and biological factors in psychiatric disorders, is to integrate important information on biomarkers and biological factors associated with psychiatric disorders. “The first goal is the broadest goal, and that is to use DSM and the future DSM as a way to inform the field, as well as other stakeholders, patients and other groups, about promising areas of work that are poised to inform clinical care but may not yet be ready to be implemented within direct patient care,” said Alpert, vice chair of the Future DSM Strategic Committee. Examples of such include immune markers (eg, C-reactive protein, genetic markers, neurocircuitry-based measures, receptor-based measures).

“The second goal of biomarkers and biological factors within the future DSM is to develop a rigorous, standardized, evidence-based framework for helping to determine which tests are sufficiently validated—have reached a sufficient point of scientific maturity—to be able to advance clinical care and research,” he said. These tests may help predict risk for the disorder and the course of illness, monitor treatment effectiveness and safety, and individualize treatment (ie, precision psychiatry).

Social Determinants and Quality of Life

The new DSM will also focus on addressing socioeconomic, cultural, and environmental determinants of health as well as functioning and quality of life issues, explained Clarke, the senior director of research at the APA. In doing so, she said this edition will feature the inclusion of people with lived experiences and other stakeholders.

Although the designers of the new DSM believe addressing these factors will strengthen the DSM andbest support clinicians in helping their patients, Clarke noted the challenge will be in incorporating them, and shared the questions that the committee is grappling with: “Will it be part of the diagnostic criteria, or are we going to embed them into as nodes, into a structured clinical decision making so that we can actually use it to stratify risk? Or will it be used to determine clinical decision making?” She added that the information and process needs to be practical, too. “We also need to think about how do this in a feasible and useful way, so that clinician in busy practice can still benefit from it.”

Moving Ahead

Wills told the media that the committee is “firing on all 8 cylinders” in their efforts to “raise the bar on diagnoses for mental health and substance use disorders” while “staying very closely grounded to the science and the evidence,” which has always been a core tenet of the DSM. Although they could not specify an estimated date of release, Wills noted the committee has been very intentional about shaping the future of the DSM and that more information will be forthcoming, including journal articles detailing the strategies and roadmap.^1-6

How might this impact psychiatry and will these changes address the many critiques of the DSM? For expert perspectives and continued coverage, follow PsychiatricTimes.com.

References

1. Wills M, Oquendo M, Alpert J, et al. The Future of the DSM. APA Press briefing. January 20, 2026.

2. Oquendo MA, Abi-Dargham A, Alpert JE et al. Initial strategy for the future of the DSM. Am J Psychiatry. 2026.

3. Ongur D, Abi-Dargham A, Clarke DE, et al. The future of the DSM: Areport from the structure and dimensions subcommittee. Am J Psychiatry. 2026.

4. Wainberg ML, Alpert JE, Benton TD, et al. The future of DSM: A strategic vision for incorporating socioeconomic, cultural, and environmental determinants and intersectionality. Am J Psychiatry. 2026.

5. Drexler K, Alpert JE, Benton TD, et al. The future of DSM: Are functioning and quality of life essential elements of a complete psychiatric diagnosis? Am J Psychiatry. 2026.

6. Cuthbert B, Ajilore O, Alpert JE, et al. The future of DSM: Role of candidate biomarkers and biological factors. Am J Psychiatry. 2026.