Darrel A. Regier

There is a need to refine our current psychiatric nosology to produce diagnostic criteria and disorder categories that keep pace with advances in neuroscience while at the same time enhance clinical utility. Furthermore, dimensional aspects of psychiatric disorders require greater recognition so as to improve our understanding of boundaries between disorders and underscore the heterogeneous nature of psychopathology. The Conceptual Evolution of DSM-5 provides a framework for the evolution of the forthcoming diagnostic system in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which will help advance clinical practice and facilitate ongoing development of diagnostic criteria. This manual: • Highlights recent progress in our understanding of cross-cutting factors relevant to psychiatric diagnosis and symptom presentation• Includes detailed discussions on the role of factors such as age, gender, culture, and disability in the expression of mental disorders• Provides a review of genetic evidence supporting a cross-cutting approach to nosology• Offers suggestions for integrating cross-cutting factors with DSM-5. The Conceptual Evolution of DSM-5 was written to impart a theoretical context for understanding potential revisions to DSM-5. The authors reevaluate the structure of the current manual and discuss cross-cutting approaches to facilitate clinical practice and refine research approaches that will guide clinical trials, genetics, imaging, and treatment guidelines. The authors provide the following insights: • Detailed descriptions of age-, gender-, and culture-specific aspects relevant to psychiatric diagnosis and the need for sensitivity to these factors when making diagnoses• Discussions on the dimensional aspects of mental disorders, including overlapping symptoms relevant to many or most diagnoses• Consideration of alternative classifications of disorders that recognize disorders sharing validating features• Presentation of neuroscientific and epidemiologic evidence to expand understanding of disorders beyond that of the categorical organization presented in DSM-IV• A review of clinical implications, including how clinicians may shift their conceptualization of previously reified diagnostic criteria and their consequences. As presented to the 99th Annual Meeting of the American Psychopathological Association, The Conceptual Evolution of DSM-5 explores the rapidly changing research base for the understanding of neurodevelopmental, neurocognitive, addictive, and other psychiatric disorders. The contributions in this volume confirm that DSM-5 is intended to be a living document that can accommodate revisions to specific diagnostic areas based on new evidence that is replicable and subject to review. This efficient updating process will help researchers and clinicians keep abreast of the latest protocols for the research, diagnosis, and treatment of mental illness.

Deconstructing Psychosis: Refining the Research Agenda for DSM-V provides an all-important summary of the latest research about the diagnosis and pathophysiology of psychosis. This volume gives the reader an inside look at how psychotic phenomena are represented in the current diagnostic system and how DSM-V might better address the needs of patients with such disorders. The book presents a selection of papers reporting the proceedings of a conference titled "Deconstructing Psychosis" convened by the American Psychiatric Association (APA) in collaboration with the World Health Organization (WHO) and the U. S. National Institutes of Health (NIH). The conference was designed to be a key element in the multiphase research review process for the fifth revision of DSM. This book is one in a series of ten that reflects some of the most current and critical examinations of psychiatric disorders and psychotic syndromes. APA published the fourth edition of DSM in 1994 and a text revision in 2000. DSM-V is scheduled for publication in 2013. Deconstructing Psychosis: Refining the Research Agenda for DSM-V examines the current evidence regarding the diagnosis and pathophysiology of common psychotic syndromes including: • Schizophrenia• Bipolar disorder• Major depressive psychosis• Substance-induced psychosis It also addresses broad issues relating to diagnosis such as the ways in which psychosis cuts across multiple diagnostic categories. Beyond merely summarizing the current state of the science, the authors of these papers critique the current research and clinical evidence, and raise questions about gaps in our knowledge. The book provides recommendations for the most promising areas of research in psychosis, which may lead to more refined treatments based on a better understanding of what biological and environmental factors contribute to its development and symptoms. In the learned editors' selection of papers for inclusion in this volume, they have exhibited their conviction that DSM-V is a "living document" that will reflect the pace of progress in multiple areas, ranging from molecular genetics and brain imaging to social, behavioral, and anthropological science. As a book on the narrowly defined topic of linking the classification of psychotic syndromes with their underlying pathophysiology and potential etiology, there is no other writing of comparable content available today.