Table 2.

DSM-V Proposal for the Definition of Mental/Psychiatric Disorder

Features Aa behavioral or psychological syndrome or pattern that occurs in an individual Bthe consequences of which are clinically significant distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) Cmust not be merely an expectable response to common stressors and losses (for example, the loss of a loved one) or a culturally sanctioned response to a particular event (for example, trance states in religious rituals) Dthat reflects an underlying psychobiological dysfunction Ethat is not solely a result of social deviance or conflicts with society Fthat has diagnostic validity using one or more sets of diagnostic validators (e.g., prognostic significance, psychobiological disruption, response to treatment) Gthat has clinical utility (for example, contributes to better conceptualization of diagnoses, or to better assessment and treatment)

Other Considerations Hno definition perfectly specifies precise boundaries for the concept of either “medical disorder” or “mental/psychiatric disorder” Idiagnostic validators and clinical utility should help differentiate a disorder from diagnostic “nearest neighbors” Jwhen considering whether to add a psychiatric condition to the nomenclature, or delete a psychiatric condition from the nomenclature, potential benefits (for example, provide better patient care, stimulate new research) should outweigh potential harms (for example, hurt particular individuals, be subject to misuse)