DSM-IV refers to the Diagnostic and Statistical Manual, which is the standard criterion of classifying mental disorders. This classification is done by trained mental health professionals mostly in the United States. The purpose of this classification is to use it in various contexts. For instance, researchers and clinicians such as psychodynamic, behavioral, biological and cognitive specialists use this classification in their areas of specialization. The DSM-IV is designed to be used in almost all clinical settings like outpatient, inpatient, clinic, partial hospital, primary care, private care and consultation liaison, all of which deal with community populations. The classification can be used by mental health specialists like psychiatrists, psychologists, physicians, nurses, social workers, rehabilitation and occupational therapists as well as counselors. Therefore, DSM-IV is an important tool for communicating and gathering accurate statistics on public health.
DSM-IV is made up of three main components, a diagnostic classification, diagnostic criterion set and a descriptive text. The diagnostic classification is made up of a list of mental disorders that are recognized by the DSM system. When making diagnosis using the DSM model, one has to select disorders from the classification that are best reflected in symptoms exhibited by the patient who is being evaluated. A diagnostic code is associated with diagnostic labels, and they are used by agencies and institutions in collecting and billing data. The diagnostic codes are obtained through the use of a coding system by health specialists.
The next component is the diagnostic criteria sets. In every disorder in a DSM model, there is a set of diagnostic criteria that show its symptoms that must be seen, including the period they are seen, as well as the conditions and disorders that are not present for a disorder to qualify for a given diagnosis. Most users of the DSM-IV these set to make concise and accurate descriptions of every disorder. It also raises the diagnostic reliability. However, the criteria are only guidelines based on informed clinical judgments.
Lastly, the descriptive text accompanies every disorder. It describes every disorder based on features, subtype, procedures, culture, age, gender, pattern and gender. This part of the DSM model helps medical experts to compare the symptoms in the records with those of the patient in order to make an accurate but informed diagnosis. It makes the work of experts easier since it provides an easy and elaborate guide on the various disorders, their characteristics, mostly affected groups and the symptoms portrayed.
The DSM-IV model is known to have several advantages because it has been used effectively for the last 18 years. It is built on sound principles because investigations are done scientifically and ethically leading to reliable and understandable results on mental disorders. All the results are based on the evidence, which are the symptoms exhibited by the patient.
On the other hand, this approach has been subject to criticism for various reasons. First, there are some pieces of information as well as some perceptions that do not match or fit into the diagnostic system. This implies that some crucial aspects of information are overlooked hence questioning the reliability of this criteria in diagnosing mental patients. There are also doubts on whether creating distinct lines in classifying mental disorders is justified. This is because through these distinctions, some disorders end up unrecognized because they exhibit mixtures of various classifications. This classification has also been subject to medical and financial conflicts, cultural bias and political conflicts.
Therefore, DSM-IV has been quite a useful model of classifying mental illnesses and diagnosing them. It has been relatively reliable over the 17 years it has been in use. However, there have been doubts over the reliability and accuracy of this model when diagnosing patients. It has also been subjected to debate because of personal interests by some groups of people like politicians.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®. 4, revised, illustrated, reprint. New York: American Psychiatric Pub, 2000.
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Frances, Allen and Ruth Ross. Dsm-Iv-Tr Case Studies: A Clinical Guide to Differential Diagnosis. New York: American Psychiatric Pub, 2001.
Livesley, W John. The Dsm-IV Personality Disorders. illustrated. New York: Guilford Press, 1995.
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