DSM-IV Sourcebook, vol. 4

This is the last of four volumes that describe in detail the development of DSM-IV, begun in 1987 and completed in 1994. The first three volumes presented literature reviews of the full range of mental illness, including, among others, substance-related disorders, schizophrenia and other psychotic disorders, mood disorders, anxiety disorders, personality disorders, and childhood disorders. The fourth volume of the Sourcebook summarizes these reviews, analyzes data from field trials, and describes how the revision came about and why the changes made were considered necessary.

The most interesting parts of the book are the final reports from the DSM-IV work groups in which the arguments for changes from DSM-III to DSM-IV are presented, some more convincingly than others. For example, after restating the DSM-III criteria for multiple personality disorder, the members of one work group “felt” that the term should be replaced by “dissociative identity disorder,” a change still not accepted by some American psychiatrists and not agreed to by European psychiatrists, who continue to use the “old” term in ICD-10, with which DSM-IV is supposed to be compatible.

Past reviews of the first three Sourcebook volumes have been mixed. Volume 3 was considered to be “not for the casual reader because the mass of data presented does not make it reader-friendly” (1). Volume 2 was recommended for psychiatrists who wished “to plot their course through…our fascinating clinical domain” (2), and volume 1 was considered to be “highly desirable in comprehensiveness and sophistication” (3). Taken together, these observations hold true for volume 4, which I recommend, if for no other reason than the process is about to begin all over again. Future revisions of the manual are promised by the editors of the Source­book, and psychiatrists interested in classification can get a head start toward DSM-V by reading this book.