What is a mental/psychiatric disorder? From DSM-IV to DSM-V

Abstract

The distinction between normality and psychopathology has long been subject to debate. DSM-III and DSM-IV provided a definition of mental disorder to help clinicians address this distinction. As part of the process of developing DSM-V, researchers have reviewed the concept of mental disorder and emphasized the need for additional work in this area. Here we review the DSM-IV definition of mental disorder and propose some changes. The approach taken here arguably takes a middle course through some of the relevant conceptual debates. We agree with the view that no definition perfectly specifies precise boundaries for the concept of mental/psychiatric disorder, but in line with a view that the nomenclature can improve over time, we aim here for a more scientifically valid and more clinically useful definition.

Dysregulation between emotion and theory of mind networks in borderline personality disorder

“…In an attempt to explore the potential of the abovementioned dysconnectivity as a biological marker for BPD, it is recommended that future studies should also carry out functional connectivity analyses in the most commonly documented comorbidities of BPD, which are MDD, attention deficit hyperactivity disorder (ADHD), and PTSD. PTSD is of particular interest given that both BPD and PTSD are highly related to experiences of trauma (Zetzsche et al, 2006;Pagura et al, 2010;Philipsen et al, 2010;Stein et al, 2010), and many common neurobiological abnormalities have been identified between the two (O'Neill et al, 2013). Although MDD was the only comorbidity that was allowed in our BPD sample, which increased the homogeneity of the sample, this in itself may limit the generalisability of the findings given the high occurrence of other/additional comorbidities found in the wider population of individuals with BPD.…”

Behavioural Addiction Open Definition 2.0—using the Open Science Framework for collaborative and transparent theoretical development

“…We believe Thege [4] makes a strong argument when stating rhetorically that, as coping behaviours do not prevent a substance use disorder diagnosis, there is no reason why they should do otherwise for behavioural addiction. However, we suggest keeping a modified coping exclusion criterion because, as Stein et al [8] assert, we think that an expected response to common stressors or losses should not be conceptualized as a mental disorder. Also, when an excessive behaviour is an expression of a coping strategy and can be identified as such, this offers clear advantages in terms of treatment.…”

Caffeine Withdrawal and Dependence: A Convenience Survey Among Addiction Professionals

“…21 Association with severe medical consequences is only one measurement of a substance use disorder that defines its clinical importance. 12 A number of responder comments implied that if the DSM was to include caffeine withdrawal or use disorder, the text should clearly convey that the designated criteria are counted toward the diagnosis only if they are causing significant distress or functional impairment, or alternatively standard substance use disorder criteria could be modified to ensure that only clinically important cases would meet diagnostic criteria. The requirement that the disorder cause significant distress or functional impairment has always been part of the DSM substance dependence criteria (e.g., Criterion A: .A maladaptive pattern of substance use, leading to clinically significant impairment or distress..; APA, 2000).…”

“…Among the different criteria proposed for identifying a true mental disorder, 2,12,13 verification that the proposed disorder has sufficient clinical importance or severity is one of primary importance. Although the clinical importance and severity related to the caffeine-related disorders have been addressed in several articles since publication of DSM-IV, 5,6,8,9,[14][15][16][17] one possible approach to assessing clinical significance is to assess the beliefs of professionals in the addictions field (clinicians and researchers) about these disorders.…”