DSM-5: ¿Cambio de paradigma en la clasificación de los trastornos mentales? [DSM-5: A paradigm change in the classification of mental disorders?]

Abstract

The publication of the Diagnostic and Statistical Manual of Mental Disorders , fifth edition (DSM-5), in May 2013, was an important event. However, it was preceded by a debate with an extraordinary level of controversy. In the first part of this paper, we provide a general analysis of relevant aspects related to the revision process of the manual, including the elaboration of the DSM-5, general-conceptual changes (lifespan organization of disorders, integration of a categorical-dimensional diagnostic approach, the proposed dimensional and cross-cutting assessments), changes to specific diagnostic criteria, and the addition of new categories and groups of disorders. In the second section, we examine the main controversies and criticism related to the revision process of the manual. This includes issues related to methodology flaws, the paradigm shift, problematic new diagnoses, the lowering of thresholds for existing diagnoses, and the new emphasis on the biomedical model. Suggestions for clinical psychology are outlined.