Addictive behaviours from DSM-IV to DSM-5


Background: The 5th edition of the DSM was published in May, 2013. The new edition incorporates important changes in the classification of addiction. Aim: To compare the classification of addictive behaviours presented in DSM-iv with the classification presented in DSM-5 and to comment on the changes introduced into the new version. Method: First of all, the historical developments of the concept of addiction and the classification of addictive behaviours up to DSM-IV are summarised. Then the changes that have been incorporated into DSM-5 are described. Results: The main changes are: (1) DSM-iv substance related disorders and DSM-IV pathological gambling have been combined into one new DSM-5 category, namely 'Substance Related and Addictive Disorders'; (2) DSM-iv abuse and dependence have been combined into one new DSM-5 diagnosis, namely 'Substance Use Disorder'; (2a) the DSM-IV abuse criterion 'recurrent substance-related legal problems' and the DSM-5 criterion 'craving' has been introduced; and (2b) the criteria for (partial) remission have been sharpened. Conclusion: DSM-5 is an improvement on DSM-IV, but for the diagnosis of a psychiatric disorder and the treatment of a psychiatric patient, classification needs to be complemented with staging and profiling.

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