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Abstract

The fifth edition of the Diagnostic and Statistical Manual (DSM-5) attempts to capture the latest scientific advances and to enhance the reliability of diagnostic criteria. Among the new manual's most noticeable differences is the inclusion of patient-reported measures to identify initial clinical status and monitor progress. In 2011 and 2012, clinicians and their patients from the United States, Canada, Australia, and the United Kingdom undertook to assess the clinical utility and feasibility of the new manual. The results of the field trials are reported.

Abstract

Objective

This article describes the clinical utility and feasibility of proposed DSM-5 criteria and measures as tested in the DSM-5 Field Trials in Routine Clinical Practice Settings (RCP).

Methods

RCP data were collected online for six months (October 2011 to March 2012). Participants included psychiatrists, licensed clinical psychologists, clinical social workers, advanced practice psychiatric–mental health nurses, licensed counselors, and licensed marriage and family therapists. Clinicians received staged, online training and enrolled at least one patient. Patients completed self-assessments of cross-cutting symptom domains, disability measures, and an evaluation of these measures. Clinicians conducted diagnostic interviews and completed DSM-5 and related assessments and a clinical utility questionnaire.

Results

A total of 621 clinicians provided data for 1,269 patients. Large proportions of clinicians reported that the DSM-5 approach was generally very or extremely easy for assessment of both pediatric (51%) and adult (46%) patients and very or extremely useful in routine clinical practice for pediatric (48%) and adult (46%) patients. Clinicians considered the DSM-5 approach to be better (57%) or much better (18%) than that of DSM-IV. Patients, including children age 11 to 17 (47%), parents of children age six to ten (64%), parents of adolescents age 11 to 17 (72%), and adult patients (52%), reported that the cross-cutting measures would help their clinicians better understand their symptoms. Similar patterns in evaluations of feasibility and clinical utility were observed among clinicians from various disciplines.

Conclusions

The DSM-5 approach was feasible and clinically useful in a wide range of routine practice settings and favorably received by both clinicians and patients.

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Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Walter Martin, by Dickson Reeder, 1956. Oil on canvas. Collection of the San Antonio Art League and Museum, San Antonio, Texas.

Psychiatric Services
Pages: 952 - 960
PubMed: 23852272

History

Published online: 1 October 2013
Published in print: October 2013

Authors

Details

Eve K. Mościcki, Sc.D., M.P.H.
Dr. Mościcki, Dr. Clarke, Dr. Kuramoto, Dr. Narrow, and Dr. Regier are affiliated with the Division of Research, American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209 (e-mail: [email protected]). Dr. Kraemer is with the Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. Dr. Kupfer is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Parts of this article were presented at the annual meetings of the American Psychiatric Association, Philadelphia, May 5–9, 2012, and the New Clinical Drug Evaluation Unit, Phoenix, Arizona, May 29 to June 1, 2012.
Diana E. Clarke, Ph.D., M.Sc.
Dr. Mościcki, Dr. Clarke, Dr. Kuramoto, Dr. Narrow, and Dr. Regier are affiliated with the Division of Research, American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209 (e-mail: [email protected]). Dr. Kraemer is with the Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. Dr. Kupfer is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Parts of this article were presented at the annual meetings of the American Psychiatric Association, Philadelphia, May 5–9, 2012, and the New Clinical Drug Evaluation Unit, Phoenix, Arizona, May 29 to June 1, 2012.
S. Janet Kuramoto, Ph.D., M.H.S.
Dr. Mościcki, Dr. Clarke, Dr. Kuramoto, Dr. Narrow, and Dr. Regier are affiliated with the Division of Research, American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209 (e-mail: [email protected]). Dr. Kraemer is with the Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. Dr. Kupfer is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Parts of this article were presented at the annual meetings of the American Psychiatric Association, Philadelphia, May 5–9, 2012, and the New Clinical Drug Evaluation Unit, Phoenix, Arizona, May 29 to June 1, 2012.
Helena C. Kraemer, Ph.D.
Dr. Mościcki, Dr. Clarke, Dr. Kuramoto, Dr. Narrow, and Dr. Regier are affiliated with the Division of Research, American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209 (e-mail: [email protected]). Dr. Kraemer is with the Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. Dr. Kupfer is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Parts of this article were presented at the annual meetings of the American Psychiatric Association, Philadelphia, May 5–9, 2012, and the New Clinical Drug Evaluation Unit, Phoenix, Arizona, May 29 to June 1, 2012.
William E. Narrow, M.D., M.P.H.
Dr. Mościcki, Dr. Clarke, Dr. Kuramoto, Dr. Narrow, and Dr. Regier are affiliated with the Division of Research, American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209 (e-mail: [email protected]). Dr. Kraemer is with the Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. Dr. Kupfer is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Parts of this article were presented at the annual meetings of the American Psychiatric Association, Philadelphia, May 5–9, 2012, and the New Clinical Drug Evaluation Unit, Phoenix, Arizona, May 29 to June 1, 2012.
David J. Kupfer, M.D.
Dr. Mościcki, Dr. Clarke, Dr. Kuramoto, Dr. Narrow, and Dr. Regier are affiliated with the Division of Research, American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209 (e-mail: [email protected]). Dr. Kraemer is with the Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. Dr. Kupfer is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Parts of this article were presented at the annual meetings of the American Psychiatric Association, Philadelphia, May 5–9, 2012, and the New Clinical Drug Evaluation Unit, Phoenix, Arizona, May 29 to June 1, 2012.
Darrel A. Regier, M.D., M.P.H.
Dr. Mościcki, Dr. Clarke, Dr. Kuramoto, Dr. Narrow, and Dr. Regier are affiliated with the Division of Research, American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209 (e-mail: [email protected]). Dr. Kraemer is with the Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. Dr. Kupfer is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Parts of this article were presented at the annual meetings of the American Psychiatric Association, Philadelphia, May 5–9, 2012, and the New Clinical Drug Evaluation Unit, Phoenix, Arizona, May 29 to June 1, 2012.

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