DSM-5-TR Changes Overview

DSM-5-TR Changes Compared to DSM-5

• DSM-5-TR added Prolonged Grief Disorder (PGD)
• PTSD remains as a diagnosis
• No inclusion of personality disorders
• Biological markers not required for all disorders

Neurodevelopmental Disorders in DSM-5-TR

• Included ADHD, Autism Spectrum Disorder, Intellectual Disability, and Learning Disorders
• Schizophrenia is a psychotic disorder
• Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) are anxiety and mood disorders respectively

Schizophrenia Diagnosis in DSM-5-TR

• Requires at least one positive symptom: delusions, hallucinations, or disorganized speech
• Also requires functional impairment

Major Depressive Disorder in DSM-5-TR

• Removed bereavement exclusion
• Grief and depression can coexist

Bipolar I vs Bipolar II Disorder in DSM-5-TR

• Bipolar I: Requires one or more manic episodes
• Bipolar II: Involves hypomania (less severe form of mania)
• Both disorders can have depressive episodes, but Bipolar II does not include full-blown mania

Generalized Anxiety Disorder (GAD)

• Characterized by excessive worry and anxiety about multiple domains (lasts at least 6 months)

PTSD vs. Acute Stress Disorder (ASD)

• PTSD symptoms last longer than a month after a traumatic event
• ASD symptoms last between 3 days and 1 month after trauma

Obsessive-Compulsive and Related Disorders

• Hoarding Disorder, Trichotillomania (Hair-Pulling Disorder), Body Dysmorphic Disorder are included

Borderline Personality Disorder (BPD)

• Characterized by intense fear of abandonment, extreme emotional swings, impulsivity

Substance Use Disorder in DSM-5-TR

• Diagnosed when substance use continues despite negative consequences (social, health, occupational)

DSM-5-TR Personality Disorders

• Retains categorical model, but also includes dimensional model

Schizoaffective Disorder

• Requires mood symptoms (e.g. depression, mania) co-occurring with psychotic symptoms

Persistent Depressive Disorder (Dysthymia)

• Must last at least two years in adults, one year in children / adolescents

Panic disorder

• Panic attacks are treatable with various anxiety and mood disorders

Autism Spectrum Disorder (ASD)

• Classified by severity, removing previous subtypes like Asperger's

Cultural Considerations in DSM-5-TR

• Cultural factors must be included in assessments and use tools like the Cultural Formulation Interview.

Avoidant Personality Disorder vs. Social Anxiety Disorder

• Overlap, but Avoidant is more pervasive and long-term

Dissociative Identity Disorder (DID)

• Requires at least two distinct personality states with identity disruption

Hoarding Disorder

• Part of the Obsessive-Compulsive and Related Disorders category, not Trauma- and Stressor-Related Disorders