The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–V) is due to be completed in 2011 and this volume, while not part of the official DSM revision process, is intended as a source document for the DSM–V Task Force as well as to provide guidance and recommendations for the longer-term revision of psychiatric classification in general. The book comprises 26 chapters by mostly American contributors and is divided into three parts. The first focuses on gender and examines differences in susceptibility, phenomenology, prognosis and the effects of both biological and sociocultural variables on the presentation of psychiatric disorders in women and men. Arguments for and against the inclusion of separate diagnostic categories for illnesses presenting in women and men are considered. The second section, on early childhood, presents a compelling case for an extensive overhaul of the way psychiatric illnesses in children are currently defined and diagnosed. It recommends a far greater emphasis on developmental considerations, using disorders of mood, anxiety, attachment, feeding and post-traumatic stress disorder as examples. The final section on older people highlights the importance of organic brain pathology in the genesis of a variety of psychiatric conditions, most notably depression, and exposes the inadequacies of current diagnostic systems' abilities to accommodate the impact of physical illness on psychopathology in this population.
Throughout the book the various authors lay emphasis on the changing nature of psychiatric classification and its tendency to become more aetiopathologically, rather than descriptively, based, though there is a pragmatic acceptance that given the imminence of DSM–V's publication it will still be largely categorical in nature, like its predecessors. This is not to say that descriptive psychopathology has had its day. Far from it. For, as one author points out, the precise elucidation of phenotype becomes even more important as theability to determineaetiology becomes moreaccurate.
This book will be of value both to specialists in the fields of women's mental health, child psychiatry and old age psychiatry, for whom it provides a useful summary of current research, and to non-specialists who are interested in psychiatric classification and the direction in which it is heading. On the evidence of this book, this direction seems to be an encouraging one.
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