Sti call dsm extension and it is the manual that collects all possible psychiatric disorders, or at least those selected on statistical criteria and on the basis of contributions provided by commissions and groups indicated by theTOPA, the American Psychiatric Association (with 38,000 members, it is the largest psychiatry organization in the world).
What is DSM
“Due to its rational approach and completeness, it has had a great diffusion all over the world,” he says Enrico Pompili, psychiatrist, professor at the La Sapienza University of Rome and director of the Department of Mental Health and Pathological Addictions of the ASL Roma 5. «The DSM has had the great advantage of being able to standardize psychiatric language in the clinical and research fields, a pity that its detractors define it as too schematic and not very suitable for defining the complexity of human behavior. In reality it remains a tool and its value depends on the skills of those who use it», adds Pompili, co-curator with Giuseppe Nicolò of the latest edition of Diagnostic and Statistical Manual of Mental Disorders – Text Revision, i.e. the DSM-5-TR (Cortina) just out.
Prolonged mourning disorder among the novelties in the new DSM
Yes, because society changes and the manual needs to be updated. Nine years have passed between the penultimate revision and the current one (since DSM III, i.e. since 1980, however, there have always been intermediate revisions). «The latest edition is important because it welcomes both social and anthropological problems new important diagnostic categories. An example? Was abolished the term race and used the term racialized. The difference between sex and gender is clearly defined, the term “desired gender” disappears and is replaced by that of “experienced gender”. The culture to which one belongs is recognized as capable of modifying the diagnosis, path, prognosis and outcome of a disorder», he continues.
Prolonged Bereavement Disorder: A New Diagnostic Entity
Last but not least: among the new diagnostic entities appears the Prolonged Bereavement Disordera pervasive and persistent grief response that continues to cause clinically significant distress or impairment for more than twelve months after death of a loved one.” «It is a condition that for duration and intensity is excessive compared to the normal mourning process. Its prevalence among bereaved individuals, one year after the death of a loved one, ranges from 4% to 10%. People experiencing prolonged mourning have clinical manifestations and neurobiological correlates different from those of other psychiatric disorders, such as anxiety and depression. Furthermore, those who suffer from a disorder of this type have an rischium major to develop serious diseases such as cardiovascular disorders and cancer», underlines Pompili.
A story
Angela is a 65-year-old housewife, mother of two children and grandmother of three grandchildren who has never suffered from psychiatric disorders and who loses her husband following an accident. Angela sinks into a state of anguish and perceives the lack of her husband as incurable. He constantly lives in nostalgia of the loved one, moods follow one another that oscillate between the anger, disbelief and prostration deeper than they make it unable to resume even the simplest and most normal activities.
She describes herself like this “I feel dead too… a part of myself is gone”. This state continues for more than 12 months. There are also other problems, i.e oscillations of the pressure, heart rhythm disturbances. The children are worried and rightly recommend a psychiatric evaluation. It will be then that we will decide how to intervene, on the basis of a personalized treatment based on the integration of different approaches (from psychopharmacology to psychotherapy).
Personality Disorders in the future DSM-6
What do you see for the future? «The big topic that is presumably going to be profoundly modified in the future DSM-6 is that of Personality Disorders», Pompili points out. “A personality disorder is a constant pattern of an individual’s inner experiences and behavior that is pervasive and inflexible, deviates markedly from the norms and expectations of the individual’s culture, and eventually results in distress or impairment.” The current classification of the manual does not yet provide a flexible tool capable of covering a wide range of dysfunctional behaviors that appear to be present in the general population in a percentage ranging from 6% to 12%».
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