Press Release

Embargoed Until Contact

April 24, 2013

Sue Ducat
Director of Communications
(301) 841-9962


From Health Affairs


Independent Review Needed for Future DSM Revisions


Bethesda, MD -- Next month, the American Psychiatric Association will release the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the association's guide that sets the classification, diagnosis, and treatment of mental disorders across the United States and the world. In an analysis and commentary article, released today as a Web First by Health Affairs, the authors argue that the revision process for the DSM-5 missed crucial population-level and social determinants of mental health disorders and their diagnosis.


Some of these include environmental factors triggering biological responses that manifest in behavior; differing cultural perceptions in defining normal and abnormal behaviors; and institutional pressures, such as insurance reimbursements, disability benefits, and pharmaceutical marketing. At stake, the authors believe, are billions of dollars in insurance payments and the accurate diagnoses and treatment of patients.


Independent Review Of Social And Population Variation In Mental Health Could Improve Diagnosis In DSM Revisions


By Helena B. Hansen, Zoe Donaldson, Bruce G. Link, Peter S. Bearman, Kim Hopper, Lisa M. Bates, Keely Cheslack-Postava, Kristin Harper, Seth M. Holmes, Gina Lovasi, Kristen W. Springer, and Julien O. Teitler


Hansen is affiliated with New York University; Donaldson, Link, Bearman, Hopper, Bates, Cheslack-Postava, Harper, Lovasi, and Teitler are with Columbia University; Holmes is affiliated with the University of California, Berkeley; and Springer is with Rutgers University.


The study, which was supported by the Robert Wood Johnson Health and Society Scholars Program, will also appear in the May issue of Health Affairs.

To address future DSM revisions, the authors propose the formation of an independent, multidisciplinary task force; the commentary outlines how this task force would operate.


"As the DSM evolves, we must ensure the accuracy of psychiatric diagnoses and their equitable use in health care by systematically reviewing and applying the lessons in the population health and social science literature," conclude the authors. "Our proposed independent review body has the potential to improve the DSM and its revision process, as well as contributing to better diagnosis and treatment of mental disorders."

About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.

The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.