Envisioning a New Diagnostic Manual: Insights From the Vice Chair of the Future DSM Strategic Committee

CONFERENCE REPORTER

At the American Society of Clinical Psychopharmacology (ASCP) Annual Meeting in Miami, FL, Jonathan E. Alpert, MD, PhD, the vice chair of the Future DSM Committee, elaborated on their vision for the future of psychiatric diagnosis.

Earlier this year, 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.^1-6 The last major update was DSM-5 in 2013, with a revision in 2022. Notably, the new edition will undergo a name change, going from the Diagnostic and Statistical Manual of Mental Disorders to the Diagnostic and Scientific Manual. The future DSM will include 4 domains—contextual factors that can influence diagnostic formulation, diagnoses, biomarker and biological factors, and transdiagnostic features.

The goal of the Committee, shared Alpert, is to ensure the future DSM advances treatment and research by incorporating contextual factors like socioeconomic, cultural, and environmental influences, and by recognizing the heterogeneity within psychiatric disorders.

Additionally, the future DSM will include socioeconomic, cultural, environmental, developmental, and functional assessments. Alpert recognized these factors were missing in DSM-5 and need to be brought to the foreground. The goal is to capture the broader context in which psychiatric disorders develop and affect daily life. This approach aims to provide a more comprehensive understanding of mental health conditions. The new version will address the heterogeneity within DSM categories by focusing on cross-cutting dimensions. Examples of these dimensions include irritability, fear, and sleep disturbance, which can cut across multiple DSM diagnoses.

Alpert also shared that the future DSM will include a placeholder for emerging biological information relevant to psychiatric disorders. Despite the complexity of psychiatric conditions, biology plays a significant role, and new neurobiological insights are being discovered. The aim is to incorporate biomarkers that may help in making diagnoses and individualizing treatments. As biomarkers become available, the future DSM will provide a framework for evaluating and incorporating them into clinical practice.

Dr Alpert is chair of the Department of Psychiatry and Behavioral Sciences and professor of psychiatry and behavioral sciences, neuroscience, and pediatrics at the Montefiore Medical Center and Albert Einstein College of Medicine in Bronx, New York.

References

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

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

3. 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.

4. 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.

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

6. Duerr HA. A new and improved DSM? The American Psychiatric Association shares strategy and roadmap. Psychiatric Times. January n28, 2026. https://www.psychiatrictimes.com/view/a-new-and-improved-dsm-the-american-psychiatric-association-shares-strategy-and-roadmap