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DSM5577 - SECTION 6: DIAGNOSTIC TERMS AND CATEGORIES NO LONGER TO BE USED IN THE DSM-5

Section VI: Diagnostic Terms and Categories No Longer to Be Used in the DSM-5 

Polysubstance Dependence Replaced as Diagnostic Terms

 

Deleted in DSM-5:

Polysubstance dependence (DSM-IV-TR 304.80)

 

Replaced by:

The use of each individual substance must be written as a separate diagnosis denoting a specific Substance Use Disorder

 

Overview

In the DSM-IV-TR, there was a diagnosis to denote the use/misuse of multiple substances, with no single substance preferentially used. This diagnosis was dropped in the DSM-5, and now each individual substance that is used/misused is identified separately to provide a more detailed picture of the behaviors of the client.

Please also note that there was a change in terminology concerning substance dependence and substance abuse. The DSM-5 does not separate out these two different levels of substance misuse, but rather combines them into the larger category of substance use disorders, with specifiers to rate the level of severity from mild to severe. This topic is covered in more detail in a later section.

 

Mental Retardation to be Replaced as a Diagnostic Term

Deleted in DSM-5:

Mental Retardation, Severity Unspecified (DSM-IV-TR: 319)

Mild Mental Retardation (DSM-IV-TR: 317)

Moderate Mental Retardation (DSM-IV-TR: 318.0)

 

Replaced by:

Intellectual Developmental Disorder Mild (ICD-10: F70)

Intellectual Developmental Disorder Moderate (ICD-10: F71) 

Intellectual Developmental Disorder Severe (ICD-10: F72)

Intellectual Developmental Disorder Profound (ICD-10: F73)

Global Developmental Delay (ICD-10: F88)

Unspecified Intellectual Developmental Disorder (ICD-10: F79)

 

Overview

The term “mental retardation” has been deleted from use as a diagnostic category, and replaced by the term “intellectual disability” under the ICD-10-CM system, and by “intellectual development disorder” under the ICD-11 System that will be released in the year 2015. These replacement terms are viewed as both more respectful to the clients who suffer from these disorders and more clarifying in terms of their meaning.

 

Asperger’s and other Sub-types of Autism Spectrum Disorders No Longer to be Used as Diagnostic Terms

Deleted in DSM-5:

Autistic Disorder (DSM-IV-TR: 299.00)

Asperger’s Disorder (DSM-IV-TR: 299.80) 

Childhood Disintegrative Disorder (DSM-IV-TR: 299.10)

Pervasive Developmental Disorder Not Otherwise Specified (DSM-IV-TR: 299.80)

 

Replaced by:

Autism Spectrum Disorder (ICD-10: F84.0)

 

Overview 

Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified have all been identified as falling into a single unifying condition now named Autism Spectrum Disorder (ICD-9: 299.00; ICD-10: F84.0).  The four previously separate conditions are now conceptualized as being manifestations of different levels of symptom severity within this single disorder characterized by “1) deficits in social communication and social interaction and 2) restricted repetitive behaviors, interests and activities (RRBs).” (APA, 2013)

There are three major specifiers when using this diagnosis: 1) If the disorder is associated with a) a known medical or genetic condition or environmental factor, or b) other neurodevelopmental, mental or behavioral disorder; 2) the level of severity; and 3) whether the disorder is accompanied by intellectual impairment.

The decision to move in this direction is explained as follows: “Autism spectrum disorder is a new DSM-5 name that reflects a scientific consensus that four previous separate disorders are actually a single condition with different levels of severity in two core domains . . . 1) deficits in social communication and social interaction and 2) restricted repetitive behaviors, interests, and activities (RRBs).” (APA, 2013) 

Feeding Disorder of Infancy or Early Childhood No Longer to Be Used as a Diagnostic Term 

Deleted in DSM-5:

Feeding Disorder of Infancy or Early Childhood (DSM-IV-TR 307.59)

 

Replaced by:

Avoidant/Restrictive Food Intake Disorder (ICD-10: F50.8)

 

Overview

There is a broad category of feeding disorders involving food restriction that does not rise to the level of a diagnosis of Anorexia Nervosa. This new diagnosis has been created to incorporate these other kinds of eating difficulties, which may include children or adolescents who avoid food due to the taste, smell, feel or appearance of the food, or individuals of any age who avoid or restrict their food intake due to apparent disinterest in eating or concerns about the aversive effects of eating. For the diagnosis to be used, associated physiological or psychological problems present must be present.

According to the APA, “the DSM-IV disorder was rarely used and limited information is available on the characteristics, course, and outcome of children with this disorder.”

 

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